PL-19-2042Permit No.: PL-09-19 2"2
Miami Shores Village P
Permit Type: Plumbing - Residential
10050 NE 2 Ave D
Miami Shores FL 33138 } Work C!/assificatlar+: Alteration
305-795-2204 1 Permit Statur Approved
Issue Date: 09/06/20 91 Expiration:03/02/2020
Location Address • Parcel Number
257 NE 91ST ST, Miami Shores, FL 33138 1132060133450
Contacts
HENRY & FRANCES HARNAGE Owner ZERO NINE CONSTRUCTION Contractor
MANAGEMENT LLC
Other: 3059518915 ALEJANDRO CAPO
55 MERRICK WAY STE 402, MIAMI, FL 33134
Business: 3058097644
Inspection Requests:
Description: RENOVATE EXISTING BATHROOMS # 1 AND #2. TO Valuation: $ 15,000.00 r2,494905 76
REPLACE PERMIT#PL18-312
Total Sq Feet: 400.00
Fees Amount
Payments
Date Paid Amt Paid
100% Permit Renewal Fee $150.00
Total Fees
$150.00
Total: $150.00
Check # 1277
09/06/2019 $150.00
Amount Due:
$0.00
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, I authorize thoVoye named cqntractor to do the work stated.
Authorized Signature: Owner
/ Cor(tractor / Agent
Date
September 06, 2019 Page 2 of 2
Miami Shores Village R.ECEIvED
Building Department EP o 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY '
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 (�
BUILDING Master Permit Nolzk-0-�- I
PERMIT APPLICATION Sub Permit No. i?L 1001 - (!a
BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION [-]SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: C� I Vy� 9--�
Folio/Parcel#:_ (J Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: l q Flood Zone: 'BFE: FFE:
OWNER: Name (Fee Simple Titleholder): :(J/h 12'A" 46� Phone#:��� `'-�-
Address: �S� /)E 9
City:
Tenant/Lessee Name:
Email:
State: 1pf, Zip: 9313
ne#:
CONTRACTOR: Company Name: 1�'� / n Phone#: 3P9- 3-1L
Address: /'7S i' 6QL1
City: 171thwi
Qualifier Name:
State: -re
_Zip: 331
ne#:3OS - 5--3i'70 U
State Certification or Registration #: _ CT C �ZCertificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
Address: City:
Value of Work for this Permit: $ % ,SO'a Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration "-rr ❑ New ❑ Repair/Replace
Description of Work: � C j Sic ai—
Zip:
❑ Demolition
Al
l
,s.
Specify color of color thru We: y, "'` Ott: �.t.;'3Y�si
4e rq, 4S' �' w� a-.��T
Submittal Fee $ Permit Fee $ 1� •Vv CCF $ # '' `"'*7-'"' Kw�"VT
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
3 V"V Cvy !*14
Notary $_
Double Fee $
Bond $
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.
Signature Signature
WNER or AG CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
2- 9 day of '' f�- 20 reI by �_ day of - �yc�GT 20 by
who is personally known to who is personally known to
me or who has produced as
me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: vim- ` n� Sign.(,
Print: s_ C• ro'�*—i Print:
Seal: OiA RCLOSTMWSw Seal: MY COMMISSION # GG 136485
WCOMMOMISOG 27M ` a a EXPIRES: December 21, 2021
0wmbv Z. ZIn : F of F��p'�• Bonded Thru Notary Public Underw ftffs
1o��
******ye ********** Yak******#**** Rik*********************** k**#**************
APPROVED BY 9 Zc�4/—Plans Examiner
�
Structural Review
Zoning
Clerk
(Revised02/24/2014)