PL-09-71110050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. I t 0 q.:11,1
PERMIT APPLIcATION aster Permit No. IVID 01" 5$
FBC 20
• Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) 4 el e c, gerfr
Owner's Address 6 Ai ei 3
• City Hlow)!-0. s).., apt. 5 State zr
Tenant/Lessee Name Phone # 66 1 (2-50
Email
Contact Phone)96 61
• Architect/Engineer'sName (if applicable)
0/
. • .
Miami Shores Village Wive/NA-0
Building Department
Job Address (where the work is being done) t2. 6 Ai t 9.3 3
City Miami Shores Village County Miami-Dade Zip • 33 L 3 ifej
FOLIO / PARCEL # tt S206, -0IS 31
Is Building Historically Designated YES • • NO V •
Contractor's Company Name tryvig 1'/oo4;49 IftAt. Phone # P9 P/-5Yr3
Contragor's Address,. i IN &fob/
City 141) tea( State ' Zip 3V
Qualifier Name ,41704 .
State Certificate or Registration No. g /V76 66 Certificate of Competency No.
..■.•■•••
4t,
Zip
Phone # 1164649
E-mail a L .aiko C..C
Type of Work: DAddition nAlteratinn EINew Repair/Replace Demolition
)
Describe Work: 4_ cor.1 u res ' •
*el s cl-t ye-) el C.- 'fu b civA
Phone # •
Value of Work For this Permit $ Square / Li ear Foo •ge Of Work:
4 C.7 3-s.,
.0-
Flood Zone
Alket -n-LP
Suhnu 1 Fee $ Permit Fee $ CCF $ 61 0 CO/CC
- , Notary $ Training/Education Fee $ n AO Technology Fee $ t 13
Scanning $ t•! Radon $ • •
Bond $
Code Enforcement $ DPBR Zoning $
Double Fee
Structural Review. $ Total Fee Now Ihie $ ' P525
See ReverSe side
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
...°
•
Mortgage Lender's Addre
City � `' 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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that ali work will be done. in compliance with all l '
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 $2500, the applicant must
promise in good faith that a copy of notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,•a certified'copy of the recorded notice-of commencement must be posted at the job site
for the first inspection which occurs seven (7) days diter the building permit is issued. In the ab ence of such posted notice, the'
inspectio t L� proved and-a�'nspection fee will be charged. . • 0
Signature -( Ad/ �
O� A
The foregoing instrument w. ac ■ wledged before me this 2 5 •
day of x a-6i in , 20 04 1. by r- ctscJk -tekS
of 1 4a r G h . , 2019q, by 8b -) (
who is personally known to me or who has produced
As identification and who did take an . `OI GO I icntification and' who did take an oath.
r lrnna
who is pe t;, me or who has produced
NOTARY PU I LlC
Sign:
(Revised 07 /10/07)
Print: Le/'(tp-i/,c)/ a 'e2i
My Commission Expires: V ,Q C NOTARY PUBLI ST TE'OFFLORIDA-
f aparani
Commissi . n # DD685086
Expires: JUNE 13, 2011
BONDED TIIRU ATLA. C BONDING CO., INC.
APPLICATION APPRO
Signatur
* * * * * * * * * * * * * * * * * * * * * ** : ** l 3v; * * * * * * * * * * * * * * * * **
Contractor
The foregoing instrument was acknowledged before me this Z 5
NOTARY PUBLIC:
Sign:
Print: - NO'PARY STA "', ; `•
,., ena Pa
Comm'.
G mmtss i on # 00685086
••` Expires: JUNE 13, 2011
• BONDED TI RU ATLANTIC BONDING CO., INC.
•
/f * * * ** * * * ** *** ** * * * **** *** *, ***** *$ *r*** ***
4 Or •
t
xatrfiner Zoning
Engineer • • • Clerk checked
Inspection Number INSP- 112866
Permit Number: PL -4 -09 -711 I
Scheduled Inspection Date: June 03, 2009
Inspector: Levrock, James
Owner: HERNANDEZ, FRANCISCO
Job Address: 126 NE 93 Street
Project: <NONE>
Contractor: LEYVA PLUMBING SERVICES INC.
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
a ? r•• i
Miami Shores, FL 33138-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shor
Phone: (305)795 -2204 Fax: (305)756-
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (786)282 -9014
Parcel Number 1132060133130
Phone: 786 -316 -0631