PL-20-237Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
10400 NE 4TH AVE, Miami Shores, FL 33138
Contacts
Issue Date: 02/04/2020
Parcel Number
1121360130150
Permit NO.: PL-02-20-237
Permit Type: Plumbing - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 08/03/2020
Edelman Lopez JR Owner V&V PLUMBING INC Contractor
104004 VICTOR RENE GARCIA
Business: 7862819960
Description: plumbing work to relocation of kitchen Valuation: $ 2,600.00 Inspection Requests:
4949
Total Sq Feet: 300.00
j �
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.90
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.90
Credit Card
02/04/2020 $111.90
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
February 04, 2020 Page 2 of 2
,���� Miami Shores Village �NTRED
Building Department FEB 08 2020
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
�J Tel: (305) 795-2204 Fax: (305) 756-8972 BY
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 G
BUILDING Master Permit No ^ ' /1
PERMIT APPLICATION Sub Permit No:>L-6 - 2o-Z.34
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
1%PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 10400 NE 4th avenue
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-2136-013-0150 Is the Building Historically Designated: Yes NO X
Occupancy Type: Single family Load: Construction Type: Flood Zone: No
OWNER: Name (Fee Simple Titleholder): Edeman Lopez
Address.10400 NE 4th ave
City: Miami Shores
Tenant/Lessee Name:
Email: edelmanlopez@mac.com
State: FL
BFE: FFE:
Phone#: 7864618854
Zip: 33138
Phone#:
CONTRACTOR: Company Name: YES V Ply-,h47!,5 , . 4 L Phone#:
Address: :90/ q 114U 8e S 7-
City: ov7Q 'm/ 7 State: E6 Zip: 3 3 [1 Y- /7
Qualifier Name: Ylc76r 6arcc q Phone#: 305 'JQ>D TUJ—S
State Certification or Registration #: CFC 1 V2 9152. Certificate of Competency #:
DESIGNER: Architect/Engineer: MAn.(,c A CAM/'/36L Z Phone#:�5 —23/ Y
Address: " i —7 3 N 6- ! 2 S1- City: State: /--L- Zip: 3313 Y
Value of Work for this Permit: $ 2_z 6 Square/Linear Footage of Work: 3 Od S Q 4/-
Type of Work: ❑ Addition ® Alteration ❑ New ❑ Repair/Replace ElDemolition
ti
Description of Work: 1" `' 0,M3r'sG (_j o/ k 1—o tL eLar-4 T7 O^v
s
Specify color of color thru tile:
�a... r. _. wr .. ...'T'r.�.:1VsR"•SN":rv";'..� d �.. .
Submittal Fee $ Permit Fee $ CCF $ �w CO/CC $
Scanning Fee $
Technology Fee $
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ ) ! I - 9 n
Bonding Company's Name (if applicable)
Bonding Company's Address
City : , State
Mortgage Lender's Name (if applicable) Chase Mortgage
Mortgage Lender's Address PO BOX 78420
City Phoenix
State AZ
Zip
Zip 85062-8420
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 reinspectiorhfee will be charged.
Signatu
OWNER or
The foregoing instrument was acknowledged before me this
31 day of JAA, ice/ 20 2--:' by
EdL�i�sA�v 1-91E Z' , who is personally known to
me or who has produced
as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
3 1 day of J AN 1141 l 20 Zo by
YJGkr q' /uc7' , who is per— sonally known
ram' who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: /' Sign:
Print: ., tJ 4,24 /Z,).S a 2 Print:
Seal: :1s'y,; JUANF.ROSAS
jam,; 0114 F R06A! Sea I : � Commission N GG 907938
_�"10^ i 9p1W6 Expires November 18, 2023
': ' mo w !� p.• Bonded TMu Troy Fain Ins mncs 810.3oS101!
************************************************************************************************************
APPROVED BY ����"/��Plans Examiner
Zoning
Structural Review
(Revised02/24/2014)
Clerk