PL-11-19-2791, 27 NE 94th StMiami Shores Village
10050 NE 2 Ave
Miami Shores Fl- 33138
305-795-2204
Location Address
9
f'
Issue Date: 02/24/2020
Parcel Number
27 NE 94TH ST, Miami Shores, FL 33138 1132060130540
Contacts
Permit NO.: PL-1149-2791
Permit Type: Plumbing - Residential
Work Classification. Pool - Private
Permit Status: Applied
Expiration: 08/24/2020
KRISTINE A GEORGE TRS Owner AQUATIC ENVIRONMENTS Contractor
27 NE 94 ST, MIAMI SHORES, FL 33138 LUIS ESPINOSA
11767 S DIXIE 203, PINECREST, FL 33156
Business: 7863909029 aquadesign1@bellsouth.net
Description: PLUMBING FOR NEW SWIMMING POOL Valuation: $ 900.00 F
ction Requests:
62-4949
Total Sq Feet: 578.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Plumbing - Pool - Residential
$100.00
Scanning Fee
$3.00
Technology Fee
$3.75
Total:
$161.55
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$161.55
Check # 4981
02/24/2020 $161.55
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 foregoin inf 14an is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I au z thfie named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
February 24, 2020 Page 2 of 2.
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
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610Z i ti AON
GaUaXKa
CnA
FBC 2013
BUILDING Master Permit No.EfT' I t ^ Ig Z% V
PERMIT APPLICATION Sub Permit NO.PL' 11-1 9 -21 19 r
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
JOB ADDRESS: of -::� WE 94 5-r�—ET-
DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1 k-320(o -013 -013+D Is the Building Historically Designated: Yes NO
Occupancy Type: � Load: Construction Type: L Flood Zone: )< BFE: FFE:
OWNER: Name (Fee Simple Titleholder): KR\91 KE-7 G COS'&F Phone#: _196''W-1V G l
Address: Z-4- NE- 91+ StKe- T
City: wi I t M l S HoWeS State: 1'( Zip: 3138
Tenant/Lessee Name: MA Phone#:
Email
CONTRACTOR: Company Name: Aa2ktic LRAVIROu MENts Phone#:-39()_g0 q
Address: i9 1 _+(p'4 �, t��>clP 14t. U 0-103
City:' I rLtCe_e�4- , �, /► State: Fit— Zip: �J31
Qualifier Name: 1 LI J1s LDS'P/J�(i; SX Phone#:-4-Fk`-:np CID21T
State Certification or Registration
`#: C0s PC 54 `Z i2 Certificate of Competency #:
Y DESIGNER: Architect/Engineer: F L/IC' * (OZ !D3 Phone#:
Address: F%q0 %� � I Oq Coo ;Z:f City: State: R Zip:
Value of Work for this Permit: $ ��. �D Square/Linear Footage of Work:
Type of Work: EMAddition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Vju In b1011 to new al/ 1 M u I w �1 .
Specify color of color thrultile:
Submittal Fee $ V Permit Fee $
Scanning Fee $
Technology Fee
Radon Fee $
Training/Education Fee $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ C,
Bonding Company's Name (if applicable) _
Bonding Company's Address MA
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
�JN
State
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. Inlfhp absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. , 1
�6Signature Signature
OWNEWAGENT C NTRACTOR
The foregoing instrument was acknowledged before me this The fo�r7egoing instrument was acknowledged before me this
�_ day of N bVeE20 1 ? by I —1 day of IyOVE�MBLE 201q by
Kjog/M E �1f;n((TC-` , who is personally known to �,1)I� I�iC who is personally known to
Me or who has produced
as rne.or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
as
Sign: Sign:
F A— LA
Print: Print:
ELENA A SAUUM
Seal: ,o,"a UB`�s Notary Public - State of Florida Seal:
FF 924095
t
IN �; Notary Public - State of Florida
_ ; ; .° Commission # FF 924095
Commission #
Dec 13, 2019
vc Comm. Expires Dec 13, 2019
j =''. Q : Y P
! '°s,FOFF��.��
1 �� •— oP; try Comm. Expires
Bond-d through National Notary Assn.
° mot, Bond^d thrcugh National Notary Assn.
APPROVED BY y�"� i /�3 Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)