PL-19-1717Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 08/01/2019
Location Address Parcel Number
960 NE 95TH ST, Miami Shores, FL 33138 1132050070130
Contacts
Permit NO.: PL-07-19-1717
Permit Type: Plumbing - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 01/28/2020
PAUL WEIMER Owner
960 NE 95 ST, MIAMI SHORES, 33138
EMPIRE PLUMBING COMPANY Contractor
ALBERT V ELBAZ
1853 W WEST AVE
Business: 3055317017
Description: ROUGH DRAIN, WASTE, VENT, AND FIXTURE SET Valuation: $ 44,000.00 F
ection Requests:
1ST FLOOR KITCHEN, BATHROOM AND 2 FLOOR BATHROOMS 762 4949
Total Sq Feet: 1,000.00
Fees
Amount
Application Fee -Other
$50.00
CCF
$26.40
DBPR Fee
$23.10
DCA Fee
$15.40
Education Surcharge
$8.80
Permit Fee
$1,490.00
Scanning Fee
$3.00
Technology Fee
$38.50
Total:
$1,655.20
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$1,655.20
Check # 9645
07/25/2019 $50.00
Check # 9583
08/01/2019 $1,605.20
Amount Due:
$0.00
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 con won an �in u rmore, I authorize the above named contractor to do the work stated.
/ Applicant / Contractor / Agent Date
August 01, 2019 Page 2 of 2
Miami Shores Village RECEIVED
Building Department AJ2 5 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 1��
BUILDING Master Permit No.-?1C_0,5_IQ- Izgce
PERMIT APPLICATION Sub Permit No.R-- (3_:� t ' I q- II1�1_
❑ BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑ RENEWAL
]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
� j 9 CONTRACTOR DRAWINGS
JOB ADDRESS: ?" 0 A1E
City: rMiami Shores �1 County: Miami Dade Zip: 333 1u
Folio/Parcel#: 1 - c). W 5 ^ (3o ! — (MO Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): PC'-V.'J O_Q_o' Phone#:
Address: 266 A125�
City:009m9tnI 1 ��Ww� State: �! Zip: 381&
Tenant/Lessee Name: Phone#:
Email: -kN L1 W Qi( A. 4 S�S 19C;
CONTRACTOR: Company Name:
Nae: KMiI.W e �(xn C d� Phone#: �5 '53 ( mil--'
Address: l�r'v� fy
City: -�CMA-,\
Qualifier Name
C_
1�7c_ Zip: 3 _5 l
ne#:
State Certification or Registration #: C2--+'S (Co Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: [, G City: State: Zip:
Value of Work for this Permit: $ 7 T� Square/Linear Footage of Work: ��4A
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
color of color thru tile:
Submittal Fee $
Scanning Fee $.
Technology Fee $_
Structural Reviews $
Permit Fee $ CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
CO/CC $ -
Notary $.
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
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 on 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 feinspection fee will be charged.
Signature
leOWNEforAG T
The foregoing instrument s a( owledged before me this
day of a v 201� by
ff,64nlyLI ¢-who is personally known to
me or who has produced FL or (, C 0n5 -as
identification and who did take an oath.
NOTARY
Print: 6/N
Seal:
Signature
CONTRACTOR
The foregoing instrument was acknowledged
acknowledged before me this
day off ( U 1 20 by
is personally known to,
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: al
Print:
tzonz,aQuiaoea :S3VIdX3
Seal: 9919£t 00 # NOISSIMNOO),IN `_ 11
,a+ Pue Stephen C. Guerrero 010S 3SS113Af VHIVr F,
4� State of Florida
*Rlres 08*/#06/2022
of rV commission No.
APPROVED BY l a9 /(Q Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
MANIIIIIIIiian '19- iz4�
EMPIRE PLUMBING COMPANYCFC 027516
Drop Test Certification
Florida Building Code, Fuel Gas
SECTION 406(IFGS) INSPECTION, TSTING, AND PURGING
406.1 General. Prior to acceptance and initial operation, all piping installation shall be inspected and pressure tested
to determine materials, design, fabrication, and installation practices comply with the requirements of this code.
Owners Information:
Name: Paul Weimer
Address: 960 NE 95 St
PL-07-19-1717
Permit Number
City: Miami Beach State: FL
Contractor: Empire Plumbing Company License No: CFCO27516
Type of Installation: NEW
X UPGRADE to EXISTING
Description Work: (Must include test details and include piping and appliances)
Test new gas system to water heater and stove
System Pressure from Meter
Water Column:
7"
Test Duration: 1 Hour
Date
Contractor/Qualifier Signature
Albert V Elbaz
Print Name
If Hybrid system branch pressure:
5 tZ02D
Date
Signed, sealed, and delivered this 9 day of May , 20 20 , by Albert V. Elbaz,
owner and qualifier of Empire Plumbing Company, who is personally known to me.
A
!!��Wotol
Notary Public State of Florida
My Commission Expires: 12/21/2021
-� YVAIRA IVELISSE SOTO
=a:
MY COMMISSION # GG 136485
p EXPIRES:
December 21, 2021
8Q 4ed hru IRi� Pubk ui demam
1754 BAY ROAD. • MIAMI BEACH, FLORIDA 33139 • (305) 531-7017 • FAX: (305) 531-7513
DIRECT ALL E-MAIL: YSOTO(AD-EMPIREPLUMBING.COM WEB SITE: WWW.EMPIREPLUMBING.COM