PL-17-1228Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
■
Permit NO. PL-55-17-1228
Permit Type: Plumbing - Residential
Work Classification: Addition!Alteration
Permit Status: APPROVED
issue Date: 5/5/2017
Expiration: 11/01/2017
Parcel Number
Applicant
9300 BISCAYNE Boulevard
Miami Shores, FL 33138-
1132060141640
Block: Lot:
GABRIEL COSENTINO
Owner Information
Address
Phone
Cell
GABRIEL COSENTINO
9300 BISCAYNE Boulevard
MAIMI SHORES FL 33138-
(305)962-1893
9300 BISCAYNE Boulevard
MAIMI SHORES FL 33138-
Contractor(s)
ACA CONSTRUCTION INC
Phone
(305)788-8914
Cell Phone
Valuation:
Total Sq Feet:
$ 2,500.00
0
Type of Work: PLUMBING WORK FOR NEW ADDITION & NE
Type of Piping:
Additional Info: PLUMBING WORK FOR NEW ADDITION & NE
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.80
$3.38
$3.38
$0.60
$5.00
$225.00
$3.00
$2.40
$244.56
Pay Date Pay Type
Invoice # PL-5-17-63906
05/04/2017 Check #: 3495 $ 50.00 $ 194.56
05/05/2017 Credit Card $ 194.56 $ 0.00
Amt Paid Amt Due
I
Available Inspections:
Inspection Type:
Top Out '
Final
Review Plumbing
Underground
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.
May 05, 2017
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
Building Department Copy
May 05, 2017
1
obot
6\50
BUILDING
PERMIT APPLICATION
.BUILDING ❑ 71/PLUMBING ❑ MECHANICAL
Miami Shores Village
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
❑ ROOFING
❑ PUBLIC WORKS
RECEPJFD
MAY--Q 4 2017
BY:
sth
FBC 201
Master Permit No. Rc16-26br
Sub Permit No. PL 1� i 228
❑ REVISION ❑ EXTENSION
❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
t.
JOB ADDRESS: I3OO 1?, IscAN )J e ? LV D
County: Miami Dade - Zip: 3313 A.
Folio/Parcel#: I —.320Q,--,0I`{— I(p'-0 _-, Is the Building Historically D
esignated: Yes NO
Occupancy Type: Load:.. . ,.Construction Type: Flood ,Zone: 1 'r. BFE: i t., .: :.FFE:•
City: Miami Shores
OWNER: Name (Fee Simple Titleholder):
Address: 9300 . (3t5C-A-y&(F
City: MIAM c SHoaes "FL
CAR-br(I Cose►'+► o
t3L Jp
State:
Phone#:
Tenant/Lessee Name: Phone#:
Email:
zip: 37Di Sc
CONTRACTOR: Company Name:
/4Ckt COnI sT/CTtON( INC.
Address: (01 2 S 5w 53
Phone#: 05 - 7 2-J8' 9f I if
City: (P M 1
Qualifier Name: AN'DRES LMM1u
State:
State Certification or Registration #:. C t C_ y 2,1(p S ?,
Phone#:
zip: 33 I !oS
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
•
•
Address: • .. _ City: State: Zip:
�
Value of Work for this Permit: $ LpO Square/Linear Footage of Work:
Type of Work:
Description of Work:
Addition ❑ Alteration ❑ New
N . 1�M1 .
. t
❑ Repair/Replace ❑ Demolition
o CVo1 pi U or
f
M t% th'71 lEt AM e; R r^ e
Specify color of color thru tile:,
Submittal Fee $S0 fQ t d - Permit Fee $ 2
Scanning Fee $ L Radon Fee $
Technology Fee $ - 2 - l 0 Training/Education Fee $
Structural Reviews $
i ac,Atorl Vt. :.i Oar.F..1,14,1C1;J Yt fi'i' . ,. e
H ')fi i i 1t,41 ,'3^''-I'igxJ `,.r .7,s i
CCF $ A
DBPR $ Notary $
•ice
S
Double Fee $
Bond $
TOTAL FEE NOW DUE $ liC ' ' 5`'2
(Revised02/24/2014)
•
.,
1y
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or GENT
Signature
CONTRA TOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of OVAt
G , 20 / , by 'day of 3-e , 20 (C , by
/�4rf O�pivi'jII..., , who is�ersonally kno o -knd1v-es LVYILlJS' , who is personally known to
as me or who has produced-) L52° '000,(D2308 a?
identification and who did take an oath. 8 _ 20 20
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: _ e Sign:
im.^O
U
Print: / r Print:
YANAUY PRI
��""•"• `Y °- ET0
Seal: Seal: ,:,;: MYCOMMISSION4FF214031
,,� - EXPIRES: March 25, 2019
.'4,8 10. Bonded Thru Notary Publ o Underwriters
BEs
MAR EL EL ELMEDEROS
rn
u . ''':• MY COMMISSION #FI=101525
d!:. EXPIRES March 13. 2018
(407) 398-0i53 FlorldallotaryService.com
APPROVED BY /e1.{l 5 ��(7 Plans Examiner
r•
Zoning
(Revised02/24/2014)
' ' Structural Review Clerk
RICK SCOTT. GOVERNOR,
he ;PLUMBING tON .., ,,...
mede'btiiiiiS''GF �^ .
NaA.N
UtYdef:the PrOVisiins`get3
-• tation'date AUG.3t;:. s't$•-,••
ISSUED: 07/2412016
• .. .'$ • . 0' SEGRE1 RY
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1111 Vilarni Shores; '�/i+illage
�Bu.lding Depart i ent
1,0050'NEE-2nd Avennue
Miami:Shores;. Florida 33,1,38
T,ei:(•3.05j 795'.220� }
#Fax: (305) 7589,7,.2!
Notice to Owrier- Workers' Con ensat onyinslurance Eiteni
!Flonda.Law'requires rWorkers' 4Compeneation:insurapce,coverage under Cliapter 440xofrthe Florida Statutes. Elt'Statr § 440:05���
gallows corporate officers:im,the construction industiylo' exempt thernselves•froimthis- requirement�.for any,LiTonstructio"n,p'rojecttpnos
jmom: �, ._ � _ � -
obtammg a building permit. P,ursuant;toahe.Flonda_Division ofWorkers'�CompensationcEmployer=Fac"ts'rBrochurre?
A l employer sih the 1constrruction industry who employs' one ;o% more full=tune;
employee's, including the.owne:f; must obtain` workef ' compensation coverage. Corporate dffieTs,
orrmembers.of a, limited'1iability, company_ :(LLC)ain th .construction, industry may elect to :lie
exempt, if:
1'.Tlie'officer. owris;at.least 1 OTOcent4the�stocic,of the co 'oratiop; or in"`Rhetcaserof
ELC, awstatement-attesting to the miiuumumrl0lpeicent':ownership;
2 The' officer, s)listed L& officer1of.the�corporafio'n++inNtleiirecoids of the Florida-
Departrtinentrof State;.DivisionKof C' orpo ons; and
3 The ,corporationis4registeredand listed as! active ;with. tilt"Florida,, Dep_artmentrof"
State; Division'of.Gorporations
. iNoniore;than•tliree;corporatvofficgrs.p`a%corporation;orilunitedMhability c.,,ompany t chliers•are
allowed to +be ,exeept;. Const"ructionkexemptions are vali'dc edf, penod'aot+ztw5 . !ears,:or u ittl a
voluiitary revocation :filedronthe exemptionii's4ievoktd1hy theelhvision.
Yoe contractor is q estmgaa permit, underdlus4workefs' co pe nsahbntexemptioii anc ilias{acknowledge, that he on sh"e4will:no' ise
day 1 bor, part=time,employees of. sulicon"tFactorscfor yourrproject. +Tl eecontractor.°has �prev cied,an� a davit stating that lie tors she-
. $
be'tlie only¢person�allowed•to we rk.off .yourcproject:tIn,th{ese eireumstancess,:Mtami:Shozes; V<ilrago. does no`,tgre4u e verification of
, workers'compensation•insu, ranceeco g from•the'con tf°aetor'sldom an �fqr dayria�bor`tpartt e'emj yees or: fu•co tractors._.
BY SIGNING . BELOW, YOU, ACKNOWLEDGE +iR 'T YOU 'UE + ' THIS NOTICE A'4,� + - ERSTAND ITS,
CONTENTS. = ,
iiiviggyii
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Ines,
State ofaFlo'rida
County of h iiam .;Dade
The.foregoing,was_aekriowledge:before fae:this
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