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PL-03-19-572, 9518 N Miami AveMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 9518 N MIAMI AVE, Miami Shores, FL 33150 1131010330460 Contacts MIGUEL TEMBLADERA Owner La Casa de la s Piscinas Inc Contractor 9518 N MIAMI AVE, MIAMI SHORES, FL 331501717 Maria C Rodriguez 2601 NW 18 TER, Miami, FL 33125 Business: 3056339699 Other:3052163107 Inspection Requests: Description: POOL AND SPA PIPING AND EQUIPMENT INSTALL Valuation: $ 950.00 305-762.4949 TotalSq Feet: 338.00 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 Credit Card 04/11/2019 $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. AFFIDAVIT I ceft+fy that all the foregoing information is onstr and zoning. Futhermore, I authorize the abov �- c Signature: Owner / Applicant / Contractor / ate and that all work will be done in compliance with all applicable laws contractor to do the work stated. Date April 11, 2019 Page 2 of 2 Miami Shores Village MAR 1 4 2019 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 PP 20 BUILDING Master Permit Nob 1' P - -1 S PERMIT APPLICATION Sub Permit No.f2l --) cl-s ---1 Z ❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL [PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRA OR DRAWINGS JOB ADDRESS: �� /� ,r'(/ , `�/ r '::Zq e Folio/Parcel#: . %/ .3 �' �� C Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: _Flo d Z%e: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): Phone#: Address: City: Tenant/Lessee Name: Email: CONTRACTOR: Company Na Address: k O % City: / Qualifier Name: et7- .r a (= State: c-P F hone#: Phone#: C )'c 7� State Certification or Reg stration #: Cert' icate of Competency #: _ DESIGNER: Architect/Engineer: 7 %/1 � ' fl — Phone#: Zip: `- Address: City: State: Value of Work for this Permit: $ Y r Square/Linear Footage of Work: Type of Work: ❑ Addition Alter tion ❑ New ❑ Repair/Replace Description of Work: c�. Zip: ❑ Dem Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Structural Reviews $ _ Double Fee $ Bond $ TOTAL FEE NOW DUE $ r s S (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 ER or AGENT C NTRACTOR The fore oing instrume t was ac nowledged before me this The foregoing instrument as acknow dged before me this f� day of ' ► ! i7 , 20 1 q by �� r day of i` 20 f by Qi��I A -T�em 6�ac�erC+ who is personally known to /�✓I ' I fni�personally known to me or who has produced D LT_S1`t _G41— 90 )(&? ©s e or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: L a 41 Print: wkk n 11A . E140AS Seal: Commission 40 Notary Public - State of Florida •; Commission # GG 039055 "ql 40 My Comm. Expires Feb 12, 2021 o 11 " 0V Bonded through National Notary Assn. identification and who did take an oath. NOTARY PUBLIC: Sign: Print: r Seal: r' '7 W COMMISSKA it FF SM758 . ? EXPIRES..hmu 27,20 Bonded Tuna Notary Pubft UnderwANrs 7 04 APPROVED BY / v �'7 Plans Examiner Zoning. Structural Review Clerk (Revised02/24/2014)