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PL-10-21-2772
� � z ������� � � �� � 11 ������ � ������ � ��� ,�� iarrgi Shor+es Villag� ��,��� �� � ��� � ..� ; � � � r��� � �� � � �; , t � �, , �� � ��� �ot�so rv��a,�� �. � � � � t s�� , � ���, ���` �� Miami Shores FL 33I38 ; ` � �... ��`��'��������"�i��`�'�������z � z � � � ���i. z ��� 3Q5-795-2204 1 � ��`�?�������a����� �� �°�}a4��� , ,. :..; �...�... . < . s... ...�. �d3Ett� �� �c�,. ������ ���������` Expir�tt�n: (��4/2f/2�2� Loc�fii�r�Address Parcel lVumber � : __. � .� . .�..__ .. _ �, _,, me,.�.�_. . .. .. �_w�. �a.v. n..._�.. _. �.......... ...... „� � ,�e , 10�43�iE 6TF�A1fE,�dliarns Sh�res,Ft 3313� 12223i0S2Q230 Cantacts :_.e_v,..,...._..____�.,_...�._.._,...�................._._w.._.._..................._.._......,...._..._�..�_....�.n.......................�......_... _.._ . _..................,. .. .._...N.. , _,._.._..�.�...,........__.,.,. _..........._...�_.........,.....__...r..._.._......_...__.......__.......__.....�.�...................�., �run��ibonatfi �wner AIFC}NSO SEPT(C C(�NTRACTQR I(VC �e�ntractor � ? 1C}343 NE 6TH AVE,�lliami Shores,F� 3313� 1QS��OLANOS � blibonaOC}63@gmail.cam 1391 W 36 ST,NIAE.EAH,FC�3052 i �usines5:7862514099 r � ��� ��� �� � �__�...�.�.��._.�.._.,._....__.a_......_.m._ �......�_....��_.�.....�_.__.__...._.__�_._.,. , ..�_�_���.._�._._...._.._.__. _...�,__..�....,...��_...._,..._.,,.....___..._�m��..�_.._._..._,r....�.,�.,....,_...._..,..,..; E Rescriptic�r�; INSTA�E.AND SUPPtY�NEW 900 GALLC}NS SEPTIC �� Valuation; $4,�40.00 Ins �cttan Re aests: ������������; � 1 TANK AiVD 3QQ SQFT DRAIN�IEL[�.�C3 REFtJkC� � T�ta!Sq Feet: E}.t3� � PERMIT#PL-06-20-134(} � �� d, �� . y.. �,��� �ees eimount F�ym�nts Da�e Paid Amt Faid Id0%Permit Renewa!Fee $168.00 1'otal Fees $168.00 Credit Card 1Q(26f 2021 ��gg.Qp l'otal: $16$AQ Am�unt CDt�e: �0.00 1� 1 � In oonsid�ration af tMe issuane� Eo m� of thi� permit, I agree to perform the work covered hereunder in ee�mpliane�with aIl ordinanc�� and regulations pertaining Fh�reto and in striet conformity witht the plans, drawings, statements or �p�cification� submitfied to the pr�per authorities e�€ Miami Shores Viilage. I� accepting this permit I assume respon�ibility for all w�rk done by eithee myself, my agent, sen+�nts, or emplpyes. I understand that separate permits�re required For E�E�TREGAG,P�UMBING,MECHANICRL,W(NDCJITV�, DOORS, R t?FIN�and SWIi�MENG ROOL work. QW�VEf�S P�FFIL?AVIT: I certify that aIl the foregoing information is accurate and th II wark wiil b� done in eampliance with ali applicable laws r�guiatir�g constructioc��nd zaning. Futh�rmore, (authorize the above n�med contra ar o o the work staf�d. Authorized Signature:Own�r ! Applicant/ Cc�ntractor t Agent Date � �ctober 26,2Q21 Pa�e 2 af 2 �� � ��.�`� I 1 �1 � S i�� � �; �_� ��;,�o-� �i °,�i �� �;� ��� � ��� ;��,^ �� � � •� � i� ���m� uildir� �part ent � ���} , � � ���� �f ,,: �;�_� �_� �.A� 1C105Q N.E.2nd Auenue, [Vliami Shoees, Flc�rida 3313� Te6:(3Q5}795-2204 Fax:(3t}5}756-89T2 ��. INSPECTtQN I.INE RHONE NUM�ER:(3Q5}762-4949 ��-�� F � �� �� ��. � Mas�Cer Rermit N�.����� ��� ���°�� PERIVIIT APPLICATIC�N Sub Permit Na. ❑�������� � ��Ec-r-��c � ���a�ir�� � R���saQ� � �x�-E�s�c�� ❑�E�v�w�� �PLUM�ING � MECHANICA� �PU�LIC WORKS [� CHANGE C}F ❑ GANCELLATIUN � SHOP CONTRACTQR DRAW I NC;S �os a��R�ss: �G`��- �`�. � �. � � � Citv: Miami Shores Countv: Miami Dade Zip: !`� �� FaliejParcel#: ��-�;,�;� " ��—� `� �_��� Is the Building NistoricaEly��si�nated:Yes NO �ccupancy Type: E�ad: ConstructiQn Type: Fic�ad Zone: BFE: FFE: owNER: Name(Fee sEmp�e Titlenold�r}.� �¢ €������.�� �j� j��.�'/. Pnone#: Address ff)���'�.. ��. l� �t1 �' Gty: � t� ��e �;,��� --a� State: �:� ' �rP��:' ` � ��_..,_.._ TenantJl.essee Name: Phane#: Email: CONTR�4C"F't?R:Company Name: � �.�` ` �?��� �c�.�t�C���° ��.��t � Pho�e#: �r���.� � �--�(�� � Address: � s�°° City: ��'�����.�= Stat�: ��� Zip: � � t.:�l"� Quali�ier Name: � � Phar�e#:� "��eh;�°�� L��, � � State Certifieation or Registr�tion#:��_ 7'"���,��-_-- Certificate of Campeteney#: ���`,�������- �� � DES161VER:ArchitectJEn�ineer: --_���=°�1 Phc�ne#: Addr�ss: City: Sta�e: Zip� Valu�af 1Nork for this Permit:$ ����� Square/Linear Footage of Work:-;���",�_ Type of Work: ❑ AdditiQn t�€ Alteration New � RepairJReplac� � t_,_t�E�einplEti�nv�; Description of Work: � �2�� �� r�,,.G�,�' ,��� � -� � � �J Spec%f�r�ofor o�"�c���rr�hru fil�: � suam�t�a��ee� � ��c��t,Fee� �� ccF� co/cc� Scanning Fee$ Radon�ee$ DBPR$ Notary$ Technolo�y Fee$ T'rair�ingjEducatian Fee$ Double Fee$ Structueal Reviews$ �and$ TOTAL FEE NC3W DUE$� �� - '" (Revi sedQ2/24 j2014) �onc3ir�g Company's�lame(if applicabl�) Bondirtg Campany's�ddress _ City State Zip f�ort�age L�nder's Name(if applicable� R�ortgage Lender's Addr�ss City � State Zip Application is hereby made to obtain a permit ta do the work and installatians as indicated. I certify that no work or installatian has commenced prior tc� th� issuance caf a permit ar�d that all wark will be performed to meet the standards of a!I laws regulating construetic�n in this jurisdiction. I understand Chat a separate permit must b� secured f�r �LECTRIC, PI�UMBING, SIGNS, POOLS, FURNACES, BOILERS, HEAT�RS,TANKS,AIR COND1TI�htERS, ETC..... QWNER'S AFFIDAVIT: 1 certify th�t all the foregoing infarmatian is accurate and that ail wark will be dane in compli�nee with all �pplicable laws regulating constructiQr�and zoning, "WARN�NG T'Q +C�WNER: YQUR FAILURE TO RECQRD A NQTICE QF CQMMENCEMENT MAY RESU�.T IN YQUR PAYING TWICE FQR IMPROVEMENTS TQ YQUR RRORE�TY. IF YQU INTEND TQ C}�TAIN FI�IANCI�tG, �t�NSU�.T WtTH YGUR LEI�QER QR A►IV A� ORNEY BEFt}RE RECQEtQING YQUR Nt�TICE C1F COMMENCEII�ENT." Not/ee to Applieane� As�s eondition ta the issuance of a buitding perrrrit with an estimated va(ue exeeeding$ZS00, the appficant must promise in good faith that a capy of the notice vf commencernenf and construction tien faw brvcf�ure wil!be delivered to rhe persan whose prap�rty is subject to attachmene. ,4lsea,a certified cop}�of the recorded nc�crce of eommencement rnust be posted crt the fob site for the�rrst inspeetion whieh occurs seven (7) days after the buiiding permii is issued. in the absenee a�'such posted notice, the inspectian will not be ap�roved and a reinspection fee witl be charged. �� e , . �. .� _,.. � -� � . � Si�natur� � ��'��. , �.'� �.��� *���������„��"ti,� �„v _ �` Signature �WNER or AGENT �'' C(JNTRACTC}R TMe foregoing instrum�nt v,+as acknowledged before me tl�is Th�fore�oirtg instrument w�s acknowledged befe�re me this �� day of � � 20 �� , by ' ��a day af ��` �° _� �Q � , �Y � �1�� � ,w o is persanall�n ' o +�,� ��- ca�S ,wh ' � nall�know me�ar wha has produced as me or who has produced as identifieatian and who did take an oa�h. identificatiQn and wha did take an oath. ����,� ~ ,�� � ��i .z NOTARY PUBLIC: � � , , '� NOTARY PU�LtC: � � ��8� Pd�4��Y�Ut�t�S�$�6df F�k}flCf� �' B 51ni�A�����F2t�-�FdIA,S SI�R; A �° '.� �a N4y C�tntrn��#�MP^i Q49�89� �7�,.J�a'�''r�✓f� C_.�C�f�^�"�fe�a - j�-�'t°6�'"� Slgll: ���• Print: f -� Print: ��'�"°� �d���� �' �l�$ Seal: Seal: �p ��� ����p���,r�c�a � ;� e 5Ll5�AFi�!�t���tP,-�6�i;�� � � �„ , ��� F9ht£}t 96 �� ���� Expar�s07 2tY2� ���*a������*����x�x��x:�*�w*������:�������*���a��a�������*��:�����x��x�*�s�� ' ���*�**�z�m APPRC3VED BY Plans Examiner Zanin� Structural Review Clerk (�ev�seda2/z412osa� ���I�`�� �� ���1'i� �'��FC���l�' �"T�� J�����LA�#t�� ���� 1391 V����`3fi�`f���1° �i�.�L F�, Fk� 33Q12- �3�` �`` ���t��l�{� ��R�"4� �C?t��"�2.���'C)R (�� , �� �u�i����Aa�Y�c��i��t�c�n; ��Q171��7 �F�49�'�276 �w���i`�,`�''�°��Ya�'�r���+,`��z"2 �;:.M�.7{t'�t�i�. ti;3�� `"s�.``��':i.�,�.w.�*�""S „4,� ����.�� . � ii� �� I fp ° �` �' I��'III�iI ` � � '6 I i �� ',� , ,� �� �., � . ,�. ��. �� �� , �. � . .: ���� � �.���� � :� �'���� . �' �. 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