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PL-19-1954Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 �I➢Ilj � �IJ_ l� � 1 ftsueDate: 09/19/2019 Location Address Parcel Number 101 NW 100TH TER, Miami Shores, FL 33150 1131010220220 Contacts Permit .: PL-08-19-1954 Permit Type: Plumbing - Residential Work Classification. Alteration Permit status. Approved Expiration: 03/17/2020 GB&T INVESTMENTS LLC Owner JORGE ALFONSO Contractor JENNIFER TAMAYO 16016 149 101 NW 100 TER, MIAMI SHORES, FL 33150 Home: 3059702905 Description: REPAIR AND REPLACE FIXTURE. CONNECT LINE TO Valuation: $ 2,400.00 Inspection Requests: EXISTING 30a 762-4949 Total Sq Feet: 190.00 Fees Amount Application Fee - Other $50.00 CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $50.00 Scanning Fee $15.00 Technology Fee $2.50 Total: $123.90 Building Department Copy Payments Date Paid Amt Paid Total Fees $123.90 Credit Card 08/23/2019 $50.00 Credit Card 09/19/2019 $73.90 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. 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 the above named contractor to do the work stated. Signature: Owner / Applicant / Contractor / Agent Date September 19, 2019 Page 2 of 2 Miami Shores Village R E C E Building Department AUG 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 I-+ `°�" BUILDING Master Permit No. PC 04- I g 3-�-)T PERMIT APPLICATION Sub Permit No. &- oL3 -Iq - lg5l ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10 i( N . W t 00 TW City: Miami Shores County: Miami Dade Zip: 3 3 (j0 Folio/Parcel#: I I - � m - o 2.2 - 0 2 2. 0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C-1 T (N V e5 TMSN -r5 LAC Phone#_:_(305) 9 j n - 2-9 05 Address: ( 1 4+0 0 S ' L"j 0 A\J City: State: L Zip: 3 143 Tenant/Lessee Name: Phone#: Email CONTRACTOR: Company Name: %y ' `�� V Phone#: 30-f-oq- /3011 Address: we*� 5") 1q:q City: State: �L Zip: Qualifier Name: �' ©A) ° Phone#: TZTV'i3qf State Certification or Registration #: G FC: d74 DESIGNER: Architect/Engineer: Certificate of Competency #: Phone#: Address: City: Value of Work for this Permit: $ o �. Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace State: Zip: ❑ Demolition Description of Work: R2 nit iY �^^� �� d ,�^ - �� � �` �L-1 �'U2 A-o Specify color of color thru tile: Submittal Fee $ 1,50 VaJ\ Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $. DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $� 3 �� a (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 ME WE 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 Qay o OWNER or AGENT Signature ONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this i�-day of20 by fZZ day of Ae-2,4-1 20 A7 by `�jACc�uI�C./n rf1 ho is personally known to r%h�R- (�• i�/�?Pub� who is personally known to e A me or who has produced (� l � T l �as me or who has produced oCA(r,6rAt -5L as identification and who did take an oath. NOT identification and who did take an oath. NOTARY PUBLIC: �';�p1RES �•' :o60�i., L-0 5 Sign: — _ _ = Sign: //nn((.. �/ /(� tl S •G\�Iv r, \ • '� �1-rl�,J Print: a Z �,y ;;moo �••�� Print: 1� %. U Seal: '', •° • °° �a• ��,m� Seal: Notary Public State e�B7yy���� li6140 9�� °� Y aYra A Morales of Florida you My Commission GG 148587 OF Expires 10/04/2021 *************************************************************** * * * ****** ************* APPROVED BY ��--�Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk