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PL-19-2583Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date11/07/2019 Location Address Parcel Number 155 NW 91ST ST, Miami Shores, FL 33150 1131010000220 Contacts Permit NO.: PL-10-19-2583 Permit Type: Plumbing - Residential Work Classification. Pool - Private Permit Status: Approved Expiration: 05/05/2020 JESSICA SIRMANS Owner 155 NW 91 ST CALYPSO POOL CO Contractor CARLOS GONZALEZ 7400 NW 7 ST SUITE 111, MIAMI, FL 33126 Business: 3052621424 info@calypsopools.net Other:3055929392 Description: NEW POOL Valuation: $ 1,200.00 Inspection Requests: 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Plumbing - Pool - Residential $100.00 Scanning Fee $12.00 Technology Fee $3.75 Total: $171.35 Building Department Copy Payments Date Paid Amt Paid Total Fees $171.35 Check # 5995 11/07/2019 $171.35 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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated./ Authorized Signature: Owner / Applicant / Contractor / Agent Date November 07, 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 . Nu ice" OC i 2 � zo, gY: b� F BC 2M-1 Master Permit No. k7PP—LC�—'A25 Sub Permit No. ?---:-AD-1 Ot —Z 5'�5 3 ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [—],CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 33I1Sb Folio/Parcel#: I ' '�I� d00 dFL?.O Is the Building Historically Designated: Yes NO .t Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder)::3n m :S) YY an's Phone#: Address: L City: V%Y%l S Y e5 State: FL Zip: 2�z l SO Tenant/Lessee Name: Phon Email: CONTRACTOR: Company Name: lily, Y�� % . Phone#: s20.20,- u.l-W Address: 'IuCA NW '"1kYl fit. ## Ill City: 1110d) State: IGL . Zip: '22A (P Qualifier Name: LbyIOS E Y1?nkm Phone#: State Certification or Registration #: mffisnln34 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $ 112W Square/Linear Footage of Work: Type of Work: [A Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Pl ombilro► Ay NW pno ..._ .. •-..-t J,. - ,,_. Specify color of 'color thru tile: Submittal Fee $ 4 Permit Fee $_ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ - CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ Zip: ., (Revised02/24/2014) TOTAL FEE NOW DUE $ 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 reinspection fee will be charged. IV 7f<Signatur41W9 Signature OWNER or AGENT CONTRA OR The foregoing instrument / was acknowledged beforemethis ©C� day of 6'V 20 ( by Si rr•e who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: The foregoing instrument, nwas acknowledged before me this l 3} day of Ocl-be/- , 20 15 by Cfv443 (76nT7--A /t Z who is personally known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: V l Print: Se; GDYSBORGES Seal. my (COMMISSION 0 GO 271799 Ate; p�gtES: Dempber 17, 2022 '• o►n°`�= BondedralloWyPd*� APPROVED BY C-ff� i( 15 1q Plans Examiner GIADYS BORGES t1Y COM MMION 0 GG 271799 EXPIRES: December 17, 2022 Bonded Tlxu Notary Pt tc "fwdla as Zoning Structural Review (Revised02/24/2014) Clerk