PL-18-2037Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: PL-7-18-2037
RPermit Type: Plumbing - Residential
Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 01/18/2019 1 Expiration: 07/17/2019
Location Address Parcel Number
1158 NE 99 ST, Miami Shores, FL 33138 1132050180130
Contacts
SUSAN PINNAS Owner SUSAN PINNAS Applicant
1158 NE 99 ST, MIAMI SHORES, FL 331382641 1158 NE 99 ST, MIAMI SHORES, FL 331382641
PSG PLUMBING SERVICES, INC Contractor
PEDRO GUZMAN
3892 NW 125 ST, OPA-LOCKA, FL 33054
Business: 3057967304 camilotamayo@ymail.com
Description: DO PLUMBING AS PER PLANS Valuation: $ 11,200.00 Inspection Requests:
305-762-4949
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$7.20
DBPR Fee
$5.88
DCA Fee
$3.92
Education Surcharge
$2.40
Permit Fee
$342.00
Scanning Fee
$3.00
Technology Fee
$9.80
Total:
$424.20
Payments
Date Paid Amt Paid
Total Fees
$424.20
Check # 1019
01/18/2019 $374.20
Deposit
01/14/2019 $50.00
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.
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
January 18, 2019 Page 2 of 2
Miami Shores Village �
L 31 018
Building Department BY.
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 �k
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC-20(--�'t
BUILDING Master Permit No(-�
PERMIT APPLICATION Sub Permit NOVL (P-1 -2-0 J?L
BUILDING ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION RENEWAL
1
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
' CONTRACTOR DRAWINGS
JOB ADDRESS: 1158 NE 99TH STREET
City: Miami Shores - County: Miami Dade Zip:
Folio/Parcel#:11-3205-018-0130 Is the Building Historically Designated: Yes NO
Occupancy Type: R3 Load: Construction Type: VB Flood Zone: X BFE: FFE:
OWNER: Name (Fee Simple Titleholder): SUSAN PINNAS Phone#:305-987-2132
Address: 1158 NE 99 STREET
City: MIAMI SHORES State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: S� �(.�If'i�/I(%�j i �Z Phone#: ` n 7 7(%` /? 0 y
Address:' �1/V CA.) / Z J `j7
City: tp `Q 1 L U ClAn-6 State:G � � i Zip:
V `-w 7
Qualifier Name: ?eOA - G40,? 4Phone#:
State Certification or Registration #: �r F(2 l YO6 252 Certificate of Competency M
DESIGNER: Architect/Engineer:
Address:
City: State: Zip:
Value of Work for this Permit: $ NO c"' M5quare/Linear Footage of Work:
Type of Work: P Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: DSO PL U rV%e71l4G1 A1C. F-F- ! 9 Q L4 t4&
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF $_
DBPR $
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ aa�' 2�
(Revised02/24/2014)
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the frst inspection which occurs seven (7) days after the building permit is issued. In the absence such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
I
Signature Signature /
OWNER or AGENT CATRACTOR
The foregoing instrument was acknowledged before me this
day of V 20 18 , by
who is personally known to
me or who has produced as
identification and I
did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
The fore going4nstrumeKt was a cnowledged before me this
day of 201 by
o is personally known to
me or who has pro uced as
identification and who did take an oat .
NOTARY PUB C ��
Print:
Seal:
Yryy'yy�ryl!"1FYV"YYV ,
r�4W PP*Go Notary Public State of Florida
Sindia Alvarez
OFib
V750
*i iisiiiiiil
APPROVED BY
Plans Examiner
Structural Review
FELIX ALEJANDRO HERNANDE2
° `;_State of Florida -Notary Public
=• *: Commission # GG 71674
=''�orr�o14, My Commission Expires
111����� February 09, 2021
Zoning
Clerk
(Revised02/24/2014)
8/23/2019
Gmail - (no subject)
RE: Permit #AL—
I P -- :; l)3(t�
INSPECTION AFFIDAVIT
Miami Shore$, F'kx
Tel: (3W
Fax: (3W)
1'f e �' pia', z d--r c. licensed as a (n) Contractor / Engineer / Architect,
(P°ranameawaideLicum�") FS 468 Building Inspector
License #.�%` r
On or about ���% G,c�r-� ` c I did personally inspect the roof deck nailing
come a tine)
work at�/ S' �;) N � �1' �� ,�
(CwPlelaJob slmfth a)
Based upon that examination I have determined the irmtallation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.844 F.S)
Zw "2.
Signature
State of Florida
County of Dade,
The undersigned, being the first duly Mom, deposes and says that he/she is the contractor for the above property
mentioned.
Sworn to and subscribed before me this 21 1 day of Aq tIAT
Notary Public, Sate of Florida at Large
JOSE P PEREZ
_°,• Notary Public -State of Florida
Commission M GG 2196S0
'?oiv. My Comm. Expires May 20, 2022
'4enernl, 8uiklrp, Ret(denlal, or Raoflnp Conba*M or arri k dWual oertffied wter 496 P.S. b such 9fl W
Perm' # and adift" a decry ahown marked an me deck for each inspecddn Plane a the roof with
Revised on c71iGW14M1110W
https://mail.google.com/mail/u/O?ik=834d6c8a24&view=pt&sea rch=a I I&permth id=th read-f%3A l 64266586327638091 0&sim p1=m sg-f%3A 16426658632 ... 2/2