PL-19-1621Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 07/26/2019
Location Address Parcel Number
1167 NE 99TH ST, Miami Shores, FL 33138 1132050180080
Contacts
Permit NO.: PL-07-19-1621
Permit Type: Plumbing - Residential
Work Classification: Pool - Private
Permit Status: Approved
Expiration: 01/22/2020
YOHIR AKERMAN Owner
1167 NE 99 ST, MIAMI SHORES, FL 33138
BIG PLUMBING CORP Contractor
ARMANDO GONZALEZ
Business: 3058212880
Description: BACK FLOW CONNECTION Valuation: $ 1,500.00 Inspection Requests:
Total Sq Feet: 1,384.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Plumbing - Pool - Residential
$100.00
Scanning Fee
$3.00
Technology Fee
$3.75
Total:
$162.35
Payments
Date Paid Amt Paid
Total Fees
$162.35
Credit Card
07/26/2019 $112.35
Credit Card
07/15/2019 $50.00
Amount Due:
$0.00
Bui4ii g'bepartment 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.
Authorized''Signature: Owner / Applicant / Contractor / Agent Date
July 26, 2019 Page 2 of 2
Miami Shores Village RECEIVEDJUL 15 2019
Building Department BY
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 �^�r tt
INSPECTION LINE PHONE NUMBER: (305) 762-4949 W �
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
QPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 1167 N E 99 ST
FBC 20^\` _
Master Permit No. �e - V✓1� 51�
Sub Permit No-B:. o�— l -I ,[(Dzi
❑ REVISION ❑ EXTENSION [:]RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 -3205-018-0080 Is the Building Historically Designated: Yes NO X
Occupancy Type: RESD Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): YOHIR AKERMAN Phone#:
„A.4,-,,.1167 NE 99 STREET
City: MIAMI SHORES
Tenant/Lessee Name:
Email
State: FL.
Phone#:
33138
CONTRACTOR: Company Name: BIG PLUMBING CORP. Phone#: 305-821-2880
Address: 9190 NW 119 ST BAY NO. 10
City: HIALEAH GARDENS State: FL. Zip: 33018
Qualifier Name: ARMANDO GONZALEZ Phone#: 305-821-2880
State Certification or Registration #: RF0066479
DESIGNER: Architect/Engineer:
Address
Certificate of Competency #: 97P000310
Phone#:
City: State: Zip:
Value of Work for this Permit: $1'15v0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: BACK FLOW CONNECTION
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $ CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
a i
Bonding 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 reinspection fee will be charged.
J"<-7 1 "
Signature Signatur
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged beforemethis
I day of Ut 20 ' 1 by
ow r F1 r`Nrh,CI,%o who is p rsonally known to
'�
m r who has produced ��J�Q Irk ,,Sy as
iddntificatibR aibd wft did take an oath
N TARY P
Si
Print: k
Seal:
V 3
v�����
'
� • N 23,
•.
_
The foregoing instrument was acknowledged before me this
10 day of JULY 20 19 by
ARMANDO GONZALEZ who is personally known to
me or who has produced N/A
identification and who did take an oath.
NOT
Prinj: '�4Dq ANE C. BONANNO
************************************************************
APPROVED BY � %/� Plans Examiner
Notary Public State of Florida
Arriane C Bonanno
My Commission GG 109475
or r.° E AIP"s 06/3012021
as
****************
Zoning
Structural Review
(Revised02/24/2014)
Clerk
MIAMI•C)AIg 4
MIAMI-DADE WATER & SEWER DEPARTMENT
METER OPERTATIONS & MAINTENANCE
CROSS -CONNECTION CONTROL UNIT
1001 N.W. 11r" STREET. MIAMI, FL 33136.2209
Phone (305) 547-3046 Fax (786)2G8.5485
I3ACKFLOW PREVENTION ASSEMBLY TEST REPORT,,
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Revised: 5/27/2010 0-mall: CCC cOmiarnidadca.c ov C 1 weab: http:llwww.miamidacicr.gov(water/cross-con nection-backflow asp