PL-19-1137Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: PL-05-19-1137
Permit Type: Plumbing - Residential
Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date:05/31/2019 1 Expiration: 11/27/2019
Location Address Parcel Number
89 NE 102 ST, Miami Shores, FL 33138-2322 1132060131690
Contacts
PALOMA TEPPA Owner PALOMA TEPPA Applicant
89 NE 102 ST, MIAMI SHORES, FL 331382322 89 NE 102 ST, MIAMI SHORES, FL 331382322
Business: 7862084005 Business: 7862084005
D-AIR CONDITIONING COMPANY Contractor
ENRIQUE PRECIADOS
9802 NW 80 AVE BUILDING G BAY 56, HIALEAH GARDENS, FL 33016
Business: 7863901532
Description: NEW BATHROOM AND LAUNDRY Valuation: $ 6,800.00 Inspection Requests:
305-762-4949
Total Sq Feet: 850.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.20
DBPR Fee
$3.57
DCA Fee
$2.38
Education Surcharge
$1.40
Permit Fee
$188.00
Scanning Fee
$3.00
Technology Fee
$5.95
Total:
$258.50
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$258.50
Credit Card
05/31/2019 $208.50
Credit Card
05/20/2019 $50.00
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 construend zoning. Futhermore, I authorize the above named contractor to do the work stated.
Signature: OwAer / Applicant / Contractor ! Agent Date
May 31, 2019 Page 2 of 2
IVlldl I II JI IUI CJ V IIIdgC
Building Department
4 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
MAY 4 0 209
FBC 20
Master Permit No. 2C ` 16.1 (6 - W
Sub Permit NoR— 0 si ' �'l - 137
❑ REVISION ❑ EXTENSION [--]RENEWAL
PLUMBING
❑ MECHANICAL ❑PUBLIC WORKS
❑ CHANGE OF ❑ CANCELLATION
❑ SHOP
CONTRACTOR
DRAWINGS
JOB ADDRESS:
c/F
W-2 St .
City:
Miami Shores County`
Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO
Occupancy Type:
Load: Construction Type:
Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder): PAW rkAA, TEV P A Phone#: -79G -SI18 $�! 3f,
Address: g`I Nk_- IL') Z S z.
City: "l /IUM ( 5[fL)e--t3 State: IFL Zip: 3 3 c--Q�
Tenant/Lessee Name: Phon
Email:
CONTRACTOR: Company Name: e/�ICL ms) (� fs 0111 ON li C fdru 12Ai`J j' Phone#: -78(
Address: (01)2 NUJ G-C .
City: Kk 1 A nk i State: V�(— Zip: VIP Z
Qualifier Name: V-1" Vl 12LG1 ra'13LPhone#:
State Certification or Registration #: C F L ( t-{Zcj S 8S Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address
City: State: Zip:
Value of Work for this Permit: $ ( lisn0 Square/Linear Footage of Work:
Type of Work: ❑ Addition 5� Alteration ❑ New ❑ Repair/Replace
'' "w \ ❑Demolition
Description of Work: �, P ��i"'\ r O D W
Specify color of colon thru tile:
Submittal Fee $ �- :Q 1 Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $ rr\\
TOTAL FEE NOW DUE S JV
p �� 2c • C-:0
Mc • 4g
40q; •1 I 0
Bdtiding 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,informatioCn 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
Signature
OWNER or AGENT
The foregoing instrument was acknowledged beforemethis
day of i' / `� 20 1 -1 by
CA M who is personally known to
me or who has produced F CYt��iY�vr� LI �Qhas
T1Go•(DfoG'}I•-+D-I•Q
identification and who did take an oath.
ttt1611i1id'p,Ja_
NOTARY PUBLIC: .<`` p" TS
U A -
ruurHs>;R oy•°
Sign:
Print: a 1
Seal: '�,���; 4..OU Ala
ftrrii:ltelttt�
VV"v
Signature
ONTRACTOR
The foregoing instrument was acknowledged before me this
L S day of N` 20 by
�13tZ10-J— IVI ClA00S , who i persona II o
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
os�'tia, Notary Public State of Fbnda
Seal: ? Alejandro Garcia
My Commission GG 187807
? of nd4� Expires 12/13/2021
as
************************************************************************************************************
APPROVED BY �5�/�' Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)