PL-19-2260Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:11/07/2019
Location Address Parcel Number
9342 NE 9TH AVE, Miami Shores, FL 33138 1132060020050
Contacts
Permit NO.: PL-09-19-2260
Permit Type: Plumbing - Residential
Work Classification: Akeration
Permit status: Approved
Expiration: 05/05/2020
FRANCES PEA Owner
9342 NE 9 AVE, MIAMI SHORES, FL 331382904
KARL'S PLUMBING, INC. Contractor
WILLIAM TRUMMERT
2140 NW 82 TER, PEMBROKE PINES, FL 33024
Business: 9548683331
Description: PLUMBING AS NECESSARY FOR REPLACING Valuation: $ 2,000.00 Inspection Requests:
BATHROOM SINK TOILET AND TUB. 305-762-4949
Total Sq Feet: 0.00
�j
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.10
Check # 980
11/07/2019 $111.10
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. 7/1
orized 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
RECEI JEG
SEP 2 6 2019
FBC 2n (-)
Master Permit No. (-"-0l — �� ^u 310
Sub Permit NoTL_n —(Cl 2(Lc�
❑ REVISION ❑ EXTENSION ❑RENEWAL
Fff PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
JOB ADDRESS: 9342 NE 9th Ave
DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-320"02-0050 Is the Building Historically Designated: Yes NO X
Occupancy Type: single Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Frances Peake Phone#: 305-318-8994
Address: same as job address
City:
State: Zip:
Tenant/Lessee Name: n/a Phone#:
Email: frances@proctorandpeake.com pp
CONTRACTOR: Company Name: Kayl"" P I Q oAm Phone#: qs1
Address: D LAgi 1'�u 0 Z T:Cj�
City:
Qual
2tState: & Zip:�3�Zy
ifierName: `166,rn k VLWICV'L4-A ' Phone#:
State Certification or Registration M � �l L MLS Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ 2,000 Square/Linear Footage of Work: 25 sq ft
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New M Repair/Replace ❑ Demolition
Description of Work: Plumbing as necessary for replacing bathroom sink, toilet and tub.
Specify color of c9lor thru tile:
Submittal Fee $ Permit Fee $ CCE S. CC/CC $
Scanning Fee $ Radon Fee $ - bePN $ _ _ __ _ . Nogty $_ _ _ _ _.I _ _ . ..._._.
TechnolM Fee S _ - - - TrsihMSIEftestion Fee $ _. Do" Fe!-
strucbIral Aevlews $ j_ - _ - _ - -_ Uw $
tMAL F$E Now pttE $
(*eV1ft 02/24/=4)
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: 1 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 on 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.
-� Signature Signatur&�
OWNER or AGENT
The foregoing instrument was acknowledged before me this
3j day of U "—'A . 20 � � by
f"r2.A.Nczs I vim' �EA. who is personally known to
me or who has produced`' D� U W u"o�� ash
identification and who did take an oath.
NOTARY LIC:
Sign:
Print:
Seal: SINDIA ALVAREZ
MY COIv1MISSION # GG 238273
EXPIRES: September 3. 2022
Bonded Thru Notary Public Undenrriters
ssssssssssssss
CONTRACTOR
The for oing instru ent was acknowledged before me this
day of _ , 20J by
1 V.� who is personally known to
me or who has produced
identification and who di
NOTARY PUBLI
Sign:
Print:
Seal:
APPROVED BY �� /;� _ Pima Elrbmihrt
IY COMMISSION # GG 041376
EXPI2020
�nM"TRhruNotay unE: D609mb8f defwrit"
sst
1. YOnins
v n `a Z er Pew _ CWrk
(I Wbod02/24/2014)