PL-19-2412Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Location Address Parcel Number
420 NE 95TH ST, Miami Shores, FL 33138 1132060140461
Contacts
Permit O.: PL-10-19-2412
Permit Type: Plumbing - Residential
Work Classification: Gas
Permit Status: Approved
Expiration: 04/07/2020
MARIA CARVALHO Owner
420 NE 95TH ST, Miami Shores, FL 33138
Business: 7542344235 MARIA@MIACHIC.COM
AURORA PLUMBNG CORP Contractor
LEONARDO RAYON
ction Requests:
Re
Description: RELOCATE GAS LINE Valuation: $ 250.00 Ins 305-eti Re
Total Sq Feet: 1,000.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
10/15/2019 $110.30
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.
OWNE AFFIDAV II ce fy that all theore ' ' formation is accurate and that all work will be done in compliance with all applicable laws
regul9ting constructs n 4grfd zo i uthermore, I authors the above named contractor to do the work stated. _
—//
Authorized Signat6re: Owner / Applicant / Contractor / Agent Date
October 15, 2019 Page 2 of 2
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
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
®PLUMBING ❑ MECHANICAL [:]PUBLICWORKS
JOB ADDRESS: 420 NE 95th Street
Master Permit No. #05-10-1079
Sub Permit No.'R_- I r3— (9 -2L4( 2
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade ZIp33138
Folio/Parcel#: 11 -3206-014-046 11 Is the Building Historically Designated: Yes NO x
Occupancy Type: Load: ^ Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Alberto and Maria Carvalho Phone#: 754-234-4235
Address:420 NE 95th Street
city: Miami Shores State: Florida _zip: 33138
Tenant/Lessee Name: Phone#:
Email: mariagmiachic.Com
CONTRACTOR: Company Name: Aurora Plumbing Corp Phone#: 305-633-9578
Address: 301 East 10 Avenue
cl , Hialeah State: FL z;p: 33010
Qualifier Name: Leonardo J. Rayon phone#: 305-21 B-3011
State Certification or Registration #: CFC1427483 Certificate of Competency #:
DESIGNER: Architect/Engineer:_ _.... ..... _Phone#:
Address: City: State: _,. Zip:
Value of Work for this Permit: $ _..._._ Square/Linear Footage of Work:
Type of Work: ❑ Additi n Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: v IIiC.�
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $Training/Education Fee $
Structural Reviews
(Revised02/24/2014)
CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _1 10-S-0
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name cif 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,
rURNACES, 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 low 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 appr ved and a reinspectlon fee will be charged.
Signature Signature
OWNER or AGENT
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
8 day of October 20 19 . , by 8 day of October Zp 19 by
ML-Arlin Carve, I hawho is personally known to Leonardo J. Rayon who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign
Print
Seal:
Notary Public - State of florTda
Commission x GG 271971
my Comm. Expires Jan 4, 2023
re throa8h National Notary Assn,
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Print: P
Commission N GG 198242
Seal: '''.?orn ' My Comm, Expires Jul 15, 2022
Bonded though National Notary Assn.
as
APPROVED BY � �e�7� Plans Examiner _ Zoning
Structural Review Clerk
(Revised02/24/2014)