PLC-19-1790Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 08/22/2019
Location Address
1505 NE 105TH ST 19, Miami Shores, FL 33138
Contacts
Permit No.: PLC-08-19-1790
Permit Type: Plumbing - Commercial
Work Classification: Alteration
Permit Status: Approved
Expiration: 02/18/2020
BRETT & SARAH CODY ADELMAN Owner
1505 NE 105 ST, MIAMI SHORES, FL 33138
Home: 3059783871
FULL SERVICE PLUMBING, LLC Contractor
JAVIER ANTONIO ANDRADE
4699 ORANGE DR, DAVIE, FL 33314
Business: 9543278582
Description: REPLACE 3/4" PIPE FROM SHUT OFF VALVE Valuation: $ 2,563.00 Inspection Requests:
762-4949
OUTSIDE TI SHUT OFF VALVE INSIDE STAIR CLOSET.
TO REPLACE EXPIRED PERMIT PLC-12-18-3672 Total Sq Feet: 0.00
Fees Amount
Payments
Date Paid Amt Paid
50% Renewal Fee $50.00
Total Fees
$50.00
Total: $50.00
Check # 1587
08/22/2019 $50.00
Amount Due:
$0.00
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(A� t
Applicant Copy
For Inspections, Call (305) 762-4949 or Log on at hops://bidg.miamishoresvillage.com/cap/.
Requests must be received by 3pm for following day inspections.
NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
additional restrictions applicable to this property that maybe found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,
public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES.
August 22, 2019 Page 1 of 2
Al —
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ELECTRIC ❑ ROOFING
IKI]
Master Permit No.
Sub Permit No. -TLC
REVISION EXTENSION EJRENEWAL
❑PLUMBING MECHANICAL 0 PUBLIC WORKS CHANGE OF ❑ CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: SOS tit %OS�—
City: Miami Shores County: Miami Dade Zip: 13136
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Nam (Fee Simple Titleholder): j(O C-i A 1-A-V\ ( „1 �WQA Phone#:
Address:
n ,� u� A�-- . t u� C,} W� �- A
City: (U \m R" State: Zip: 3 1
Tenant/Lessee Name: )` / 4 Phone#:
Email: C�I(,( NXI I (0 (A MA , c AIA,
CONTRACTOR: Company Name: ccl �k d�(� l i Iy � n� Phone#: _ �(S c� 2� js
Address: ''A�o (Gon�r i JQ,
City: State: PLI Zip:
Qualifier Name: lQ j,le-, Procjr0r)12 . Phone#:
State Certification or Registration #: 21 I Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2.5 3 Square/Linear Footage of Work:
Type of Work: ❑ Addition .:.0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: F..G, r 314 pl n t, .Fror, $k u4 OTF 0117S f ( G fG -pH-f 0 r F V/07'V-L
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ M CO/CC $�
Scanning Fee $
Technology Fee $,
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ L--O • Gp
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 willn t be approved and a reinspection fee will be charged.
Signature 2e.Q l7� "1 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
fib'' day of pp.. 20, by
4twho is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
'"•"ti LINDA M. SMITH
Seal: -: Commission FF 917472
Expires September 21, 2019
�''/'�,o �� gpbWTMuTroyFinNw�100315-M19
The foregoing instrument was acknowledged before me this
�,S/ 0.
day of 120 by
( ✓` « `t , who is personally known to
me or who has produced
identification and who did take an oath.
APPROVED BY ct� /T�g Plans Examiner
Structural Review
as
Zoning
Clerk
(Revised02/24/2014)
UP ci d.
l� Z
APPROVfED � RY DATE
ZONING DEPT
BLDG DEPT
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pLITWING PLANS Date 2/a
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