PL-10-21711
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Applicant
1009 NE 94 Street
Miami Shores, FL 33138-
1132050150010
Block: Lot:
YNGWIE & APRIL MALMSTEEN
Owner Information
Address
Phone
CeII
YNGWIE & APRIL MALMSTEEN
1009 NE 94 Spur
MIAMI SHORES FL 33138 -2942
Contractor(s)
BIONIC PLUMBING CORP.
Phone
305 -498 -9100
CeII Phone
Valuation: $ 125.00
Total Sq Feet: 0
1
Type of Work: GAS VENT
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.25
$2.25
$0.20
$100.00
$3.00
$0.80
$109.10
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL -12 -10 -39622
12/09/2010 Check #: 2720 $ 50.00 $ 59.10
12/13/2010 Check #: 2732 $ 59.10 $ 0.00
Available Inspections:
Inspection Type:
Final
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 1 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.
December 13, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
December 13, 2010 1
Miami Shores Village
Building Department o 6113
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 i
Tel: (305) 795.2204 Fax: (305) 756.8972 `i':
INSPECTION'S PHONE NUMBER: (305) 762.4949
U.. �
BUILDING Permit No. ` l � �' f l I
PERMIT APPLICATION Master Permit No. 1 -10 ^ 10 - i `i 6
FBC 20
PCd ,J
Permit Type: MECHANICAL I j/� 1 �,, ,� ^ ,
OWNER: Name (Fee Simple Titlehold r): (� I i ' I V� 57Y 1 Phone #:
Address: IOCR 1,4 cV-kirIN
City: 1 ` State: P 1 P.
Tenant/Lessee Name: Phone#k6) (eI3- 7743
Email:
JOB ADDRESS:
t 0 09 Gt4s r
City: Miami Shores County: Miami Dade Zip: 3 N 518
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: 1 ) Phone #:3 ,5_ yp' g »'o
C} (
Address: 1 C
City: YV\ t A• State: Zip: 3 /2
Qualifier Name: ' ( (y -. oat,' ,' c-y e- Phone #:
State Certification or Registration #: Certificate of Competency #: ` t 7 l 2 i C7('
Contact Phone# Q5 7 l g ,0.0' Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ /0/ ° " Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: (2.1k.-% ...t/ff.-,4.) 7'. / N ste, t�.01..
* *** *********** ********* ****** ******** Fees************* **:x:x****** * * * * * * * * * * * **** *** **
Submittal Fee $ L_ . ermit Fee $ ((%(' CCF $ CO /CC $
P'c
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
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 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 y l not be approved and a reinspection fee will be charged.
Signature.
Owner or Agent
The foregoing instrument was acknowledged before me this-04e,
, 20 /O , by %/4/" /4. /171e4re57-z-7�/j' ,
11/ Ponally known tt me or who has producedAs identification and who did take an oath.
PUBLIC:
d
r�rit F4'7/l 4 . 'am
,pNNN.. f e"G
mission Expires: S X2D'f
Signature A
Contractor
The fore in instrument w acknowledged before me this
day of 201, by
who is personally known thine ar who has produced
as identification and who did take an oath.
NOTA' PUBLIC:
Sign:
Print:
My Commission Expires:
Claudia ,: •�a
;1'1,j
er';1
,2
noxvra;!...s,
* ***** * ***:x************:xx ******** *+ x*+ x** *******:x********** ** ************* ******+x****** **** *** *** ***
APPROVED BY
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Plans Examiner Zoning
Structural Review Clerk