PL-19-1395Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: PL-06-19-1395
- Wo
�'Permit Type: Plumbing - Residential
��
Work Classification: Addition/Akeration
Permit Status: Approved
Issue Date:07/12/2019 I Expiration: 01/08/2020
Location Address Parcel Number
278 NE 103RD ST, Miami Shores, FL 33138 1132060134860
Contacts
HB Growth Properties LLLP Owner APA PLUMBING CORP Contractor
278 103 LUIS ALBERTO GARCIA
7075 SW 46 ST, MIAMI , FL 33155
Business: 3059924614
Inspection Description: GARAGE CONVERSION INTO LIVING AREA. Valuation: $ 15,000.00 Inspection Requests:
2-4949
KITCHEN & BATHROOMS REMODELING
TO REPLACE EXPIRED PERMIT PL-17-1474 Total Sq Feet: 600.00
Fees Amount
Payments
Date Paid Amt Paid
50% Renewal Fee $262.50
Total Fees
$262.50
Credit Card
07/12/2019 $262.50
Total: $262.50
Amount Due:
$0.00
Building De--' '- ent 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 anj in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting his 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 12, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
❑ BUILDING
LUMBING
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
❑ ELECTRIC ❑ ROOFING
JUN 18 119
FBC 201-1
Master Permit No.
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
M MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 278 ne 103 st
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 — 3 2c-A.^-Q1 3 y Y(Gl=) Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
OWNER: Name (Fee Simple Titlehold
nn
Address: '1 w� 9 UJ V
City: UAr-AkXi tibc-F
Tenant/Lessee Name:
Email:
Construction Type: Floodj Zone: BFE: FFE:
Phone#:
State: � Zip:
Phone#:
CONTRACTOR: Company Name: J 1P tJ Phone#:
Address: Teb ) .SW 'AC,�
City: _ 0 i>� '
;Q State:
Qualifier Name: � Wbti
State Certification or Registration #: r Q 1 �4d � 90-� Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit:
Square/Linear Footage of Work:
State: Zip:
LSD
Tvoe of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
`'f
Submittal Fee $ P�mit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
DBPR $
Notary $
Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ Z.C; 2' c3-b
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
insp w► not be approved and -a—re-Inspeauzn fee will be charged.
n
Signature Signature
x�
OWNER or AGENT CONTj ACTOR
The foregoing instrument was
tl F )' day of -)50 J
me or who
ide
NOTARY PU
before me this
The fore)
20 by
ly known to
iz
as
me or wl
identifici
NOTARY
Sign:
Sign:_
Print:
Print:
Seal:
Seal:
was hcknowledaed before me this
q by
ly known to
as
sssssssssssssssssssssssssssssssssssssssssssssssssssssssssss:ssssssssssssssssssssssssssssssssssssssssssssssss
APPROVED BY �� 'Z�-/ 9 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)