PL-18-3344Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
issue Date:11/13/2018
Location Address Parcel Number
279 NW 111TH TER, Miami Shores, FL 33168 1121360010370
Contacts
Permit NO.: PL-11-18-3344
Permit Type: Plumbing - Residential
Work Ctossi/iration: Alteration
Permit status: Approved
Expiration: 04/30/2019
HECTOR VALDES Owner GREENTECH GROUP SOLUTIONS LLC Contractor
9120 NE 8TH AVE 3G, MIAMI SHORES, FL 33138 JUAN PEREZ
92300 S HIGHWAY 204, TAVERNIER, FL 33070
Business: 3052890949
Description: PLUMBING WIRKS RELATED TO RENEWAL OF Valuation: $ 900.00 Inspection Requests:
KITCHEN 305-762-4949
Total Sq Feet: 13.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Notary Fee
$5.00
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Work Without Permit 1st Offense
$100.00
Work Without Permit 1st Offense
$100.00
Total:
$315.30
Payments Date Paid
Amt Paid
Total Fees
$315.30
Credit Card 11/01/2018
$50.00
Credit Card 11/13/2018
$165.30
Amount Due:
$100.00
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, jjI aut__horize the above
/'named contractor to do the work stated.
4"qo'-, ,
Authorized Signature: Owner / Applicant / Contractor / Agent
November 13, 2018 Page 2 of 2
BUILDING
PERMIT APPLICATION
❑ BUILDING
PLUMBING
❑ ELECTRIC
Miami Shores Village v o1 2018
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 TO
INSPECTION LINE PHONE NUMBER: (305) 762-4949 l
FBC 2C6, (�- l
Master Permit No. �( Ci ��cq
OT Sub Permit N(a — -3 3'
❑ ROOFING REVISION ❑ EXTENSION RENEWAL
❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 279 AvV /�/ 74- c'zace—
City: Miami Shores County: Miami Dade zip: 33168 .
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): ^ 7/�G "l- - v �. Phone#: 56 ' '40e ��A
Address:_ ��9 /yw ��� l-l��.L. cc
City: + S40<" State:
Tenant/Lessee Name:. /y•A'
Email: kc- a --Vet. e S17rtlYG
CONTRACTOR: Company Name:
Address: 00 o `
City: �R✓2vu�i?i✓
Qualifier Name:
State Certification or Registration #C - G
i
DESIGNER: Architect/Engineer: O�
Address:
Value of Work for this Permit: $
Type of Work: ❑ _ Addikon ❑ Alteration
Description of Work: j-'
ft.
p: 33/Gc�
30r- 2$7 09,�9.
te: Zip: 33�70
"C7> Phone#: %�
Certificate of Competency #:
.�/ Phone#:
State: F- • Zip
Square/Linear Footage of Work:
❑ New ❑Repair/Replace ❑Demolition
/t&--fed /-0 AP'uw-j off' 6
336 3
Specify color:of co/or,,thru tile•
�+ `, "" 1_
r , �:• .
Submittal Fee $ _ << Permit Fee $ Imo'
CCF $
Scanning Fee $ y Radon Fee $ '
DBPR $ Notary $ ` �V
Technology Fee $ Training/Education Fee $
Double Fee $
Structural Reviews $
Bon
n /�
TOTAL FEE NOW DUE $ 4CJ�
(Revised02/24/2014)
*�t • 11 ,,i
Bonding Company's Name (if applicable)
Bd ding 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.
Signature
:�4" /4--
OWNER or AGENT
Si gnat
CONTR CTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day ofNV\)Zn'r 6�;C� 20 1 �' by �e�i day of N 0. 20 (143 , by
VA �- " o is personally known to `r1��AN JC who is personally known to
me or who has produced 1` �2 (�17�2- �.i �l �s me or who has produced �iCC - LC
identification and who did take an oath. identification and who did take an oath.
NOTARY UBLIC: NOTARY PUBLIC: 1
Sign: Sign:
Print: (f� ! Print: �-
S ..........SINDIA ALVAREZ Seal: m...•�
MY COMMISSION # C,0 238273 SINDIA p,LVAREZ
, . EXPIRES: September 3, 2022 MY COMMISSION # GG 238273
,0
iF SOP. Bonded Thtu NOtery Public UIIfIOtMglhfs EXPIRES: September 3, 2022
is ur4enrtilors
*aBoe4r�iAN *******
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)