PL-17-1474 (2)Rt"pA
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. PL-6-17-1474
■ t
Permit Type: Plumbing - Residential
erl� work Classification Addition/Alteration
Permit Status: APPROVED
Parcel Number
Issue Date: 12120/2017 I Expiration: 06/18/2018
Applicant
278 NE 103 Street 1132060134860
HB GROWTH PROPERTIES LLLI
Miami Shores, FL 33138-2431 Block: Lot:
Owner Information Address Phone Cell
HB GROWTH PROPERTIES LLLP 17071 W DIXIE Highway
NORHT MIAMI BEACH FL 33160-
17071 W DIXIE Highway
NORHT MIAMI BEACH FL 33160-
Contractor(s) Phone Cell Phone
G&L PLUMBING SERVICE 305-551-5090 (786)225-3648
of Work: WORK BASED ON PROVIDED PLANS
of Piping:
onal Info:
Return :
ification: Residential Scanning: 1
Fees Due
Amount
CCF
$9.00
DBPR Fee
$7.88
DCA Fee
$5.25
Education Surcharge
$3.00
Penalty Fee
$100.00
Permit Fee
$525.00
Scanning Fee
$3.00
Technology Fee
$12.00
Work without Permit Fee
$525.00
Total:
$1,190.13
Valuation: $ 15,000.00
Total Sq Feet: p
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-6-17-64184
12/20/2017 Check#: 5141 $ 1,190.13 $ 0.00
Avarlame Inspections:
Inspection Type:
Top Out
Final
Review
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 'pl4ponsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PL BING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I Artify that a accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin . orize the above -named contractor to do the work stated.
December 20. 2017
'---X-uthori Signature:Owner / Applicant / Contractor / Agent
Buildin Department Copy
December 20, 2017
Miami Shores Village
Building Department RECEIVED
10050 N.E.2nd Avenue, Miami Shares, Florida 33138 JUN 0 2017
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: 1305) 762-4449
FBC 20W
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
QPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [:]SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 278 NE 103rd Street,
City: Miami Shores County: Miami Dade zip:
Folio/Parcel#:11-3206-013-4860 is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee simple Titleholder): HB GROWTH PROPERTIES LLLP Phone#:954-774-4616
Address:17071 W DIXIE HWY
City: MIAMI State: FLORIDA Zip: 33160
Tenant/Lessee Name: Vacant Phone#: -
Email:
CONTRACTOR: Company Name: G & L Plumbing Service Inc. Phone#: 305-316-5694
Address: 13957 SW 140th Street
City: Miami state; Florida Zip; 33186
Qualifier Name: Eloy Arriera Phone#: 786-354-6816
State Certification or Registration #: CFC 056755 Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address; __11�AA��--AA City: State:
Value of Work for this Permit,�--'�.,.,...6" (�, 1� Square/Linear Footage of Work:
Type of Work: ❑ Addition FEI Alteration ❑ New ❑ Repair/Replace
Descdation of Work: Work based on provided plans. _
Zip:
❑ Demolition
Specify color of color thru tile:
Submittal Fee Permit Fee $ S� Z �' %� CCF $? - Q CO/CC $ �0�_
Scanning Fee $ 3 _ C� Radon Fee $ S 6 PR $ Notary S
Technology Fee $ 2 Qo Training/Education Fee $ 3" C%_ ub€e F 5S
Structural Reviews $T� Bond
(dQ . TOTAL FEE NOW DUE $ — l ;� 3
(Rev1sed02/24/2014)
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 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 inspection fee will be charged.
Signature Signature
T CONTRACTOR
The for going instrum t was nowledged before me this The fare 'ng ins/umeoas acipowledged before me this
day of 20 by _ _ daY 20 by
wh ersonall n tom who ' rsonaily known t
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: t EXPIRES: MAR 06, 2021
a^d Bonded through 1st State Insurance
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seal: ikeCIOV EXPIRES: MAY 12, 2020
Bonded through 1st State Insurance
APPROVED BY R T11 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)