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PL-10-21-2667 � � : �..�\ �c;{ ��a ����'� '���"� < s a� � t � . � � � ,�� � ��,,�"� iarr�i Shc�r�s Viila�e ��� � :, � � �� ����k�' � ��� � <. � � ,,,�.c � '����� 1005Q EVE 2 la�� �� � ��"� ��'� � r � ��� ���� �� ��� �� Miami Shores F�3313� �. � ���� ? f ,� �;�� 305-795-22Q4 `��`t'����t��`���������� F.�,�E c 3 \ � . ::v. ,.`$�� ... ,i,... � - � .:,a tN s;,. .. � ����{��� . ., , .. �: .�:; ` �+��������'������; Exp�r�f�on: �5/04j2022 � Loc�ti�n Address Parc�l Nu�ber w.a K� �� .,.�,,. ..r .. m__ ,���..e.. �.w�._,�_,..e.�... e�m .. ......� ��em.r. �� m..w _v,.....n . ...� ��v �t,�.�w���.���._� 1291 R4E 9��`6i S1`,iVliami Shc�r�s,Fl 3313$ 11320501�t�202 ��� a � ������������� Cont�cts .M.w_...A��s�.�.��_�...e.��.__��._ � ��..�.�.�_A� . __u .,��.�.....,. ' 1C?M13ATHAN 1EROIVE Own�r WESTEA�fD RLUMBIiVG C�ftR �ontraetor � 1291 NE 9G ST C�REOS CO�OS t 2C}1 W 24 51�,HIAIE,AN,F!�33Q1Q � Business:3(�58636223 lcobos@we$tiandplumbingearp.com �ther:7�62360298 � y� t,._.__,__,�_._._._,...�,._._,.__,�.���.__.����_._.....�._._...___n_.,....�,..,_....___...................�r.,.,_.,._.._�........_......�,._..._.r.._.,�..._�_ �......_..,..._�n_...�...�.......,._m_..,.........._..._�__.._.,._.�.._.........�_... �_....., ir�s eet�on Re u�sts: i D�scri tian:REPLACE TU&FQR SHOWER FOR BATH AND � Valuatiors: $ 554.44 � ����`������ i REPIACE�OTH FLUM�fNG EIXTURES FQR��TH 2 f�2 i � Total Sq Feet: O.OQ � . .. .. ' � Fe�s l�mount �aymants Date Paid Amt t�aid Application Fee-Other $50.Q0 TOt�I Fees $21�.3Q CCF $0.60 CM�ck#15757 111�4/202] ��,p,3p D�aR Fee 52_40 Ceedit Card 10/14J2021 �50.40 DCA Fee $2.QQ Education Surcharge SQ.2p Am�unt�ue: $O.Ofl Permit Fee $SO.OQ Scar�ning Fee $�Q� TechnQlogyFee $�.SQ Total: �110.30 t�1� 1 t°1 � }i In consideratian af th� issuanc� ta me af this permit, I agree to perform the work cavered hereur�der in complianee with ail ordinances and regulations pertaining thereta �nd in striet conformsty with th� plans, drawings, staf�ment� or specificatians submifted to the �roper �uthoriti�s af N11ami Shor�� Village, fn ace�pting this p�rmit I assum� r�span�ibili�y for al!�vark done by either myseif, my�g�nt, seevants, or employ�s. 1 underst�nd that separate permits are requir�d for�L�GI�REC��, PLUM�ING, MECFIA€JICA�,WIhIDOWS, C?QC?RS, ROt�FfE�G and SWI��(NG POC1L work. QWNERS AFF(QAVIT: I certif}r that a!I th�: foregoing information is accurate and work done in compliance with ail applicable laws regulating canstruetie�n and zaning. Futherm�r�, !authorize th�above named etae to do t or ,-� �°I � �.�1 Autharized Signature:t}wner ! Appiicar�t 1 C�ntraetor ! Agent D�te Nouemb�r 04,2Q21 Page 2 of 2 � � �� ��a;� p� 4� ���� �� � � a i �� %��.; t f'� 4,.��^ � �.. i.. �S i i r s ill �� �E � � � �c��.� s�� ,, �..k. ; ��� `'.. U I� I�1 �� t .w;� ,..���w ��-�``�-'�-�__�� 1005�N�E.2nd Avenue, Miami Shares, Florida 3313� � � re�:(305�795-22E74 Fax:(���}7s�-s��2 .� � E�vs��c�r�c���.t€�c��tc����unn���t:(�o�}�sz-���� "���� ��i� ��� � ��. � Master Rerrr�it Rlo.��°��- � � � � `���.~�,� PEI�MIT' �1PPLI�ATIC�1\I su�t��rmit Nc�.���-� �C�- ��.� � ����,� �����.���� ���c-r��c ❑ �o����� � ��vEs�c�N � Ex-rE�vs��� �}���EWa� , ��.�n��f�� � r��c�-+a��c,�� ��ua�ic woR�s ❑ eHarv�E oF � ca�vc�L�A-raoN � s�oP cc�N���c�ra� ���v����s �a��o��ess: � �� � �"� �itY: Miami Shores CountY: Miami Dade �i� � �,' Falio/Parcel#:��°�° � � ��� �° � 1 C� � ts�he Buildin�Historie�lly C�esi�nated:Yes NO C}ccupancy Type: La�d: Canstructic�n Type: Flood Za e: BFE: FFE: ��� w� ..Y`" � �� � t�WNER:Nam�{Fee Simple Titleholder}. � � `1 ��' � � �� Phc�n�#: � ����'°�- � � �� Address: ���� � �� City. < � A� �`� State: � Zip: � � TenantJ�ess�e Name: Phone#: � Email. � � � . CONTRA�'TOR:Company Name: ���"� �� ���{���� Phone#;,„� C �q�� Address:� � City: � State: Zip: �� ._�..._._...� C}ualifiier Nam�: � ��C�� � Fhone#: � °� ��� State Certificati�an�r Registratic�n#: �� Certificate af Competency#: CtESfGNER:Architect/Engir�eer: Phone#: Address: City: State: Zip: Value of Work far thEs FerrrsEte$ �� SquareJ�inear F�cat��e of W�ek: 1"ype of Work: ❑ �ddition ❑ Alfieration [� New RepairjReplace � C�emolitican Descripteon of W�rk. t"'� ��c� � � � � Specify cvlor of cotor thru ti/e: su��,��at���� '� �� � ��rm�fi��e S cc�� c�/ec� Seannin�Fee$ Radan Fee$ DBPR$ N�tary$ Technol�gy F�e$ Trainin�jEducation Fee$ Rouble Fee$ Structural Reviews$ �ond$ TOT��FEE NOW Dt1E$ (Revis�doa/z�/aoa.4) � s Banding Company's Name(if applicable) �onding Campany's Address — Ctty $tatC' Z�P Mart�a�e Lee�der's Narr�e(if applicabEe} f��rtga�e l�end�r's A,ddress City State ��P Applic�tion is h�reby made tca obtain a permi�to do the wark and instailations as indicated. 1 certify that na wark or installation has commenced priar ta the issuance of a permit and that all wc�rk will be perform�d to meet the standards af a(1 faws regu{�ting construetian in this jurisdiction. I understand that a separate permit must be secured for E�ECTRiC, PI.UM�ING, SIG�1S, P�C3�S, FURRIACES,B�ILERS,NEATERS,T�NKS,APR�C}NDiTIC}NERS, ETC...., C�WNER'S �FFI�AVIT: ( certifyr that alf the foregoing ir�farmation is aecurate and that al! wark wiil b� done in compliance with all applicable laws re�ulatin�construction and zc�ning. " �RN1N� `T4 QWNER: Y�UR FAILURE TQ RECO�tD A NQTI�E QF C EN�E ENT AY RESULT IN Y�UR PAYING T"WI�E FOR iMPRQVEMENTS T� Y�l1R RR�PER . tF 1fQ�t1 IRiTEND TQ Q�TAII� FltVA►NCING, C�tUSU�T WITM YQUR LEN�E� QR AN A �RNEY BEFQRE REC�RQINt� YQ►UR RIC?T[CE �F �Q�MMENCEMENT.►, Natice to Applicant. As a cc�ndition to the issuance of a bultding permit with crn estimated value exceeding$25Q0, the appdicant must prar�ise in good faith that a ca�py of the nc�tiee of camrrrencement and construction lien !aw brochure wiit be detfvered ta the persor� whase property is subject t�attachment. A�so,a eertified cc�py of the recc�rd�d natice vf commencerraeni rraust be posfed at the jerb slte ft�r the first inspect€�n whtch oceurs seven (7) days after the buflding �ermit ts issued. tn the absen�e c�f s�eh posted natice, th� insp�ction will nag be crpprpved and o reinspection fee wi/1 be eharged. � �� Si�natur� Si�natu 0 NER or A�ENT CONTR.A� � The fore�oin�instrument was aeknowledged befQre rr�e this The foregoing instrument was acknowledged befc�re me this �day af ��c" ���� �°'� �.2Q ' by �� day of � 2Q�.» _, by �� � ' �i,�� '� ,wha is ersonall kna fl to �� ,� ,whc�is ersanall�known ta me ar who has�roduced as me ar whc�has produced as identi�ication and who did take an oath. identification anc!wh�did take an aath. NOTA.RY Pt1�LIC: N�TARY PU�LIC; Sign: '�� � � Sign: � : �� � �� � , p Print: ��$� � S �e•` �1� N�ta�y Publ�c�Stat�o(Fl�rida S�al: ,���i�"��"�r�'`=. h8YR1AM Rt�J�S `��° 'n�`� Commissfon X GG 2�7642 '?�.' �`; Natar�+Pub(ic-5tat�of Fior'tda ���'��!"�i��r}`�'� hty Car�m.Expir����p 2,2922 <: �: Cam�fs�ion�GG 2�7642 �_6on6e�d through NaEi�nal P#atary Assr�. ���o����`� �y C�r�m.E��leea Sep E,2@2� �:��*��z��»:#�e***��e�a�*�**���;��az���**��:����������:�*���*�x:��:x:*��*�� ,,....,�� de kr � ��������'��* ������:���*�*�* APPRQVEt��Y � � Plans Examiner Zoning Structural Review Clerk {Revisedo2I�412oz�}