PL-19-1703Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
�r'� 111J1fi',I IIS
Issue gate: 09/05/2019
Location Address Parcel Number
1080 NE 104TH ST, Miami Shores, FL 33138 1122320290200
Contacts
Permit No.: PL-07-19-1703
Permit Type: Plumbing - Residential
Work Classification: Alteration
Permit status: Approved
Expiration: 02/03/2020
SHORES 104 LLC Owner
Business: 3057788787 REMY@QUILLIOT.COM
EDWARD ROJAS PLUMBING CORP Contractor
EDWARDO ROJAS
880 NE 111 ST, BISCAYNE PARK, FL 33161
Business: 3059446788 EDDIE.ROJAS@HOTMAIL.COM
Home: 7864439846
Description: REMODELING BATHROOMS, INSTALL KITCHEN Valuation: $ 6,500.00 Inspection Requests:
SINK r-712-494,0
TotalSq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.20
DBPR Fee
$3.41
DCA Fee
$2.28
Education Surcharge
$1.40
Permit Fee
$177.50
Scanning Fee
$3.00
Technology Fee
$5.69
Tota I :
$247.48
Payments
Date Paid Amt Paid
Total Fees
$247.48
Credit Card
08/05/2019 $247.48
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 constrgction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Owner / Applicant / Contractor / Agent
Date
August 05, 2019 Page 2 of 2
6
40
Cl\
Miami Shores Village
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
RECEIVED
4,1 2 4 2019
BY'
FBC 20
BUILDING Master Permit No.�
PERMIT APPLICATION Sub Permit No.-PL bA IC1- A 03
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑■ PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1080 N E 104 Street
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 -2232-029-0200 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): SHORES 104 LLC Phone#: 305-778-8787
Address:1080 NE 104 Street
city: Miami Shores State: FL Zip:
33138
Tenant/Lessee Name:
Email: remy@quilliot.com
CONTRACTOR: Company Name: Edward Rojas Plumbing Corp
Address: 880 NE 111th Street
786-443-9846
city: Biscayne Park State: FL Zip: 33161
Qualifier Name: Edward Rojas
Phone#:
State Certification or Registration #: CFC 049431 Certificate of Competency #:
DESIGNER: Architect/Engineer: Scott Welnkle Architect Phone#: 786-546-5046
Address:400 Kings Point Drive city. Sunny Isles state: FL Zip. 33160
Value of Work for this Permit: &04050D Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: remodeling bathrooms - install kitchen sink
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF
DBPR $
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
M
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
Zi
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 ence o ch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT NTRACT R
The foregoing instrument was acknowledged before me this
20 day of March . 20 19 by
Remy QUILLIOT who is personally known to
me or who has produced Florida ID as
identification and who did take an oath.
NOTARY PU
The foregoing instrument was acknowledged before me this
20 day of March .20 19 by
Edward Rojas who is personally known to
me or who has produced Florida ID as
identification and who did take an oath.
NOTARY
Print:-e y-.r, , ., JEREZ Print.
��S�
r,orwa
Seal: Fi=2i3108 Seal:
e.4, 2019
'=ter-••�;,,�. - � ,. , y, ,:_, �, �,
oA Y Assn.
LOUIS DAVID JEREZ
Of F"da
00Mr..'sslc;j # FF 2,3108
'JY COM EdEires MM 24, 2019
1)'oi?ryAsses.
APPROVED BY /r/�I Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)