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PL-19-679 (2)
Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 04/03/2019 Location Address Parcel Number 175 NW 100 ST, Miami Shores, FL 33138 1131010230320 Contacts Permit NO.: PL-03-19-679 Permit Type: Plumbing - Residential Work Classification: Gas Permit Status: Approved Expiration: 09/30/2019 CHRISTIAN LANSER Owner CHRISTIAN LANSER Applicant 175 NW 100 ST, MIAMI SHORES, FL 33150 175 NW 100 ST, MIAMI SHORES, FL 33150 Other:3057724313 Other:3057724313 SMART PLUMBING LLC Contractor CANDIDO ABEL Business: 9547723446 Description: PROPANE GAS Valuation: $ 1,500.00 Inspection Requests: 305-762-4949 Total 5q Feet: 609.00 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 Credit Card 04/03/2019 $61.10 Credit Card 03/29/2019 $50.00 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. OWNERSr9EEID_AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws re ating construction a oning. Futhermore, I authorize the above named contractor to do the work stated. re: Owner / Ap-tisant / Contractor / Agent Date April 03, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC Miami Shores Village RECEIVED Building Department MAR 291019 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 (\� Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 Qh FBC 20 r' Master Permit No. 12C . j__�_ Z`•) Sub Permit No. P d J - P (0-9_9 ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL LUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: -� I J �N J Lcn i City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancv Tvpe: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): ._ ' " `� —� """-' _ " ' ' ' Phone#: G i Address: City: hA Am State: Zip: Tenant/Lessee Name: Phone#:_ __ Email CONTRACTOR: Company Name: Address: 3 City: Qualifier Name: Ci/7/V6/`rc"-'t State Certification or Registration #: DESIGNER: Architect/Engineer: 1 (C . Phone#: 3oeJzz ,Xo07% State: ' Zip: 33 02>0 W C-l"�- Phone#: / _ / q0 Certificate of Competency M Phone#: Address: f City: State: Zip: Value of Work for this Permit: $ J D© `©D Square/Linear Footage of Work: Type of Work: ❑ Addition r,P -`Al�teration�...Q ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 'S, y �-,n r- .._�n....�.,. .� ,. .. _ ... +e...,«.......,� ram.*,....Kti...c4..ti.,E�...e�.:ll..:�...te?±...r..�.•.aa...r Specify color of color thru tile: ` A Submittal Fee $ r Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $_ DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ f� h TOTAL FEE NOW DUE $ (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 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. Signat re Signature or AGENT C NTRACTOR The foregoing instrument was acknowledged before me this 2e�` clay of 1 • IQ.e20 19 by tt L�,h — , who is<personally known to //` me jpr who has produced as identification and who did take an oath. NOTARY PUBLIC: The foregoing instru nt was acknowledged before me this dda(y�of� - 20 19 by hJ( a{La.S who is personally known to me or who has producedOSG—O as identification and who did take an oath. NOTARY PUBLIC: 7 ! Print: re 2e Print: tWAY A". ALICIA K MUSA Seal: ��.���N�,,,, BETSY D. PERE2 Seal: ?F ®•'- Notary Public - State of Florida Notary Public - State of Florida " Commission 9GG 283703 d�'' a • e a n : My Comm. Expires Apr 9, 2023 Commission # FF 182380 My Comm. Bonded through National Notary Assn. Expires Apr 3, 2019 APPROVED BY l�//� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)