PL-16-744 Miami Shores Village F'BrnT? T pjtt(ri)}( i i ldetiti
10050 N.E.2nd Avenue NE
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Miami Shores,FL 33138-0000
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Phone: (305)795-2204
P trAPJFt
COR[Op' r3
x , 812 Expiration: 09/24/2016
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Project Address Parcel Number Applicant
1234 NE 94 Street 1132050100210
Miami Shores, FL Block: Lot: STANLEY WHITMAN
Owner Information Address Phone Cell
STANLEY WHITMAN 1234 NE 94 ST (305)335-9039
MIAMI SHORES FL 33138-2947
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
THE NEW MIAMI SHORES PLUMBING (305)751-2446 (786)553 5424
...- _.._ , ._ __.. ... __ .__ _ __._ - .__�,__ ._. -.._.._ .. _..___...._.. Total Sq Feet: 0
Type of Work:REPLACE SEWER LINE UNDER HOUSE Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
Bond Return: Top Out Final
Classification:Residential Scanning:3 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee Invoice# PL-3-16-59097
$2'25 03/22/2016 Check#:2524 $50.00 $116.70
DCA Fee $2,25
Education Surcharge $0.40 03/28/2016 Check#:2534 $ 116.70 $0.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $166.70
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 rk will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-nam�d contr or to do woWstat d.
f March 28, 2016
Authorized Signature:Owner / Applicant / Contractor/ / Agent Date
Building Department Copy
March 28,2016 1
---
\\ `� Miami Shores Village =r> _, 'q 77,
Building Department
MAR 2 z 2016
10050 N.E.2nd Avenue,Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 64111
FBC 2014
BUILDING Master Permit No. PLI (6— 701ti
4
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City:" • Ahffi WShl; County: Miami Dade Zip: 53
Folio/Parcel#: �9 I5 " IN d - CL--t 0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: I _ Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Gl ` e V`I MGl Ll Phone#:
Address:
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City: F- 6r't A( ���l S State: �l Zip: 33
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: zu pk-w Miami ShoY-eS P1umbipoone#: t565) ISI Z4¢(p
Addressor `t: 00 NW 1-+-+4-h S+r-�
M
City: I am l State:_ �L zip: 331 Loa
Qualifier Name: -D-P iniS H914--M hlf'h Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Jt Square/Linear Footage of Work:
Type of Work: ❑ Additi ❑ Iteration 14 ❑ New ❑ Repair/Replace �❑ Demolitiq�
Description of Work: !r Z�
Specify color of color thru tile: ,*
Submittal Fee$ 151 rJ " C Permit Fee$ !� CCF$ 7 c� CO/CC$ 0
Scanning Fee$T �® Radon Fee$ o� DBPR$$ Notary$ )�
Technology Fee$ 1p
_ -� y Training/Education Fee$ 14C) Double Fee$
Structural Reviews$ Bond$ 0 -�
TOTAL FEE NOW DUE$ I (CO ^9 0
(Revised02/24/2014)
♦4' - .
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 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the a ence of such posted notice, the
inspection will not be approved a reinspection fee will be charged.
��Signature)( Signature
OWNER or AGENT COTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Z2- day of M arch .20 1 La ,by k day of H A K-(�h ,20 t�- ,by
.S±ctI'I F-e�j hiJMQA,who is personally known to J:)ttv1hjs MaLA14601 ir4iho is personally known to
me or who has produced 1-L--DL as me or who has produced L— DL as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
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Sign: D _` J• `� i •� Sign: 111JW►1�;U'�"� ® — : �� .o
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Print: Van-ala OS1�1 nt$ �� o�;->Ar _ Print: Va1�2S'S'Q US `17a
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Seal: aRFf939020 Seal: '�2�9q••°��vsninn;':•'� (S
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APPROVED BY 3® Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)