PL-19-2549Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
I-Uf Uri 11.1;)
Issue Date:11/15/2019
Location Address Parcel Number
10634 NE 11TH CT, Miami Shores, FL 33138 1122320280440
Contacts
Permit NO.: PL-10-19-2549
Permit Type: Plumbing - Residential
Work Clossrfrcotion: Alteration
Permit Stotus: Approved
Expiration: 05/13/2020
JENNA RASSIF Owner
10634 NE 11 CT, MIAMI, FL 33138
Other: 3053084774
APA PLUMBING CORP Contractor
LUIS ALBERTO GARCIA
7075 SW 46 ST, MIAMI , FL 33155
Business:3059924614 apaplumbingcorp@bellsouth.net
I62-4949
Description: PLUMBING REMODELING, 2 BATH, 1 KITCHEN Valuation: $2,000.00
ction Requests:
SINK, DISHWASHER, DISPOSAL, ICE MAKER, WATER HEATER
AND FIXTURES INSTALLATION Total 5q Feet: 2,000.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
11/15/2019 $61.10
Credit Card
10/25/2019 $50.00
Amount Due:
$0.00
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Owner L--" / [,Applicant / Contractor / Agent Date
November 15, 2019 Page 2 of 2
r col
BUILDING
PERMIT APPLICATION
Miami Shores Village 01'j, 5 pig
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BC 20 b
Master Permit No. FiC Q —1 1 " 1 U-�o
Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
, CONTRACTOR DRAWINGS
JOB ADDRESS: 106-3 r `f // 0-y ///
City: Miami Shores County: Miami Dade Zio:3-3/30
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type• V n Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): J V_ata Jc— Phone#: a0s —5P?�3 9 J �?
Address: /y & 3 v 'V 6 // 0'qr�
City: State: �/ Zip:4 O
Tenant/Lessee Name: Phone#:
Email: �
CONTRACTOR: Company Name:/ f� � � ��✓�� Phone#:-gos'" %rf.2
Address: W75 x4_1 el(_
City: xl? State: T/ Zip: �?�•�.S
Qualifier Name: 42,f6-1 Phone#:
State Certification or Registration #: f 1q- �793 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2:�,`,_. f�Square/Linear Footage of Work:
T�
Type of Work: ❑ Addition ❑ Alteration ❑ New 'C tRepair//'R�eplace / ❑ Demolition
Description of Work: / /(%y%/,�i{ Ino �L j , !2 67c- o, i�
Spec.,. ,)lor of color t ru tile:
Submittal Fee $ 2 0 ► Permit Fee $ 100 CCF $ CO/CC $
Scanning Fee $ 3. 6d Radon Fee $ a2.00 DBPR $ V . Notary
Technology Fee $ ;z- SCE Training/Education Fee $ 0. ` D Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $
4onding •Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a rein ection fee will be charge
Signature
Al
OWNER or AGENT
The foregoing instrument was acknowledged before Cme this
1 day of V 20 1 by
D (�l ; S who is pe sonally known o
me or who has produced as �or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
identification and who did take an oath.
NOTARY PUBLIC:
d.
Signature g�pn
ONTRACTOR
The foregoing instrument was acknowledged before me this
Lday of � � . 20 � � , by
rY wh personally known t�
as
�: - Commission # GG 112949 J
Seal: S I=;1F oPa:' My Comm. Expires Jun 8, 2.021
Bonded through National Not
Assn.
Illlll\\
g ;a;
ty Public State of FiondB
Maria Perez
,.on GG 191084
a�estId9fdl2"********************************************************************
APPROVED BY a /Mans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)