PL-10-27 �
Miami Shores Village
10050 N.E. 2nd Avenue A r!
Miami Shores, FL 33138 -0000 r o
Phone: (305)795 -2204 Q ' ._ t ?;;
3 Expiration. 0711 2010
Project Address Parcel Number Applicant
117 101 Street 1131010220150
Miami Shores, FL 33150- Block: Lot: KATHRYN HAMILTON
Owner Information Address Phone Cell
KATHRYN HAMILTON 117 101 Street
MIAMI SHORES FL 33150 -
Contractor(s) Phone Cell Phone Valuation: $ 750.00
KINGS PLUMBING SERVICE
Total Sq Feet: 127
Type of Work: KITCHEN AND BATH PLUMBING For Inspections please call:
Type of Piping: (305)762 -4949
Additional Info: Available Inspections:
Bond Return: Inspection Type:
Classification: Residential Top Out
Re Pipe
Main Drain
Heater
Water Service
Final
Water Main
Lavatory
Underground
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $0.60 PL -1 -10 -36757 $ 365.88 $ 365.88 $ 0.00
DBPR Surcharge $0,64
Education Surcharge $0.20 Check #: 1035
Permit Fee - Additions/Alterations $180.00
Radon Surcharge $0,64
Scanning Fee $3.00
Technology Fee $0.80
Work without Permit Fee $1 80.00
Total: $365.88
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated
February 05, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 05, 2010 1
I'
Miami Shores Village
Building Department JA
10050 N.E.2nd ,Avenue, Miami Shores, Florida 33138 N 0 5 RECD
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBEIr: (�05) 762.4949
BUILDING Permit No. 1 %0
PERMIT', APPLICATION Master Permit No.
FBC 20
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) KA-114 . ' 1 L Phone # 30:5 b - 1 [ — !) 7 79 _
Owner's ISO � vg
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city, MIAMI Sta F1.• Zip I! 33131
Tenant/Lessee Name Phone #
Email I Lq
Job Address (where the work is being done) _ ( 111W (Ot �7'
City Miami Shores Village County Miami
FOLIO / PARCEL # t i
Is Building Historically Designated YES NO _ _ Flood Zone
Contractor's Company Name a�j iPI(r�0; gE;��J((,E ",Phone# 'tDS
Contractor's Address I L10 N W V C
cih' bW MIAMI State
Qualifier Name {Z(, c Z T Phone # 30.T (o$S
State Certificate o$ Registration No. r4AC t = 49 2• Certificate o f Competency No.
Contact Phone *- 7& Z E -mail - -- ✓��11 Cpl _
Architect/Engineer's Name (if applicable) Phone #
Al,�f- �'1�Ft►r thislerxni�t $, Square / Linear Footage Of Work:
Type -of -W-er c : ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
9�nk
Describe Work: 1048rn Pik - Ltn a' ,
a
Submittal Fee $ Permit Fee $� CCF $ ' CO /CC $
Notary $ Training/Education Fee $ o • Technology Fee $
Scann' ' Radon $ � DPBR $ Bond $
Double Fee $ J Violation'date:
Structural eview. $ Total!Fee Now Due $ 3to4 • Vd�
See Reverse side -�
Bonding Company's Name (if applicable)
Bonding Comp sny's Address
Ci ty State Zip
Mortgage Lende'r's Name (if applicable)
Mortgage Lender's Address
II
City State Zip
i
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, FURNAC% BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.....
' I
IOWNF,R'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 conslrruction and zoning.
� �'�WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
OMMENCEMENTI MAY RESULT IN YOUR PAYING TWICE FOR
�ROVVIENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REeORDING YOUR NOTICE OF COMMENCEMENT."
'j
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a cd�y of the notice of commencement and construction lien law brochure will be delivered to the person
whose property , is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs s en (7) da s after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a inspection fee 11 be charged.
IV
Sx a Signature
The foregoing instrument was a knowledged before me this `T The foregoing instrument was acknowledged before me this 9
day of '� , 20 1a, by O hFV/ 1 l$il/ /t✓ day of r , 20 , by
who is personally known to me r who has produce who is personally known to me or who has produced
A. Ue - As identocation and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOT Y PUBLIC:
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. Eneida Lopez
My Commission Expires. My Commission Expires:
=•: .•- Commission #rin5477f32 ° •
';`• Expires July 28 r. ()10 y #DD 919634 Q
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lAPPRO, D B /PianKi&L Zoning
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Engineer Clerk checked
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(Revised 07/1 0 /07)(Revised 06/10/20091) ��
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 132746 Permit Number: PL- 1 -10 -27
Scheduled Inspection Date: March 10, 2010 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael
Inspection Type: Final
Owner: HAMILTON, KATHRYN Work Classification: Addition /Alteration
Job Address: 117 NW 101 Street
Miami Shores, FL 33150- Phone Number
Parcel Number 113101022015
Project: <NONE>
Contractor: KINGS PLUMBING SERVICE
Building Department Comments
Inspector Comments
Passed W1
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 09, 2010 For Inspections please call: (305)762 -4949 Page 5 of 24