PLC-19-485Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit NO.: PLC-03-19- 86
Permit Type: Plumbing - Commercial
Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 03/06/2019 L.Lxpiration: 09/03/2019
Parcel Number
421 GRAND CONC 18, Miami Shores, FL 33138 1132060520160
Contacts
PAULA VITALE Owner
421 GRAND CONC 18, MIAMI SHORES, FL 33138
Home: 7862869097
ENVIROTECH ROOFING GROUP INC Contractor
DARWIN FERNANDEZ
13400 SW 38 ST, MIAMI, FL 33175
Business: 3052074993
Description: SHOWER PAN Valuation: $ 500.00 Inspection Requests:
305-762-4949
TotalSq Feet: 780.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
03/05/2019 $50.00
Credit Card
03/06/2019 $60.30
Amount Due:
$0.00
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
permit§.arefipquired for ELERTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
Futhermore, I authorize the above named contractor to do the work stated.
Signature: Owner ! Applicant / Contractor / Agent
Date
March 06, 2019 Page 2 of 2
Miami Shores Village RECEIVED
Building Department MAR 05 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 (�
Tel: (305) 795-2204 Fax: (305) 756-8972 r /�
INSPECTION LINE PHONE NUMBER: (305) 762-4949 �C
FBC 20++��
BUILDING Master Permit No. M` Z— I
PERMIT APPLICATION Sub Permit No. P1 C k q — y
❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
Folio/Parce
Govr
M
the Building Historically Designated: Yes NO
Occupancy Type: Load: ;,on Type: Flood Zone: BFE: �FFEE:
OWNER: Name (Fee Simple Titleholder): I/(/v/ v► �J!// —V Phone#: "160 286 g0177
Address::!� 4{
/
City: �1 /��!'I�. �`7ic7%�S State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: � L 1 6
Address: - I I)Q90 W� "�T/
hone#:
City: "IDAJ State: �� Zip: '/�1 � J
Qualifier Name: ) Y) Q// rr Phone#:() �U! � � )_�� �Q
State Certification or Registration #: C ��, 1401 Q &, Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone
Address: City: St
Value of Work for this Permit: $ Square/Linear Footage of Work: _
Type of Work: ❑ Additiglnn ❑�/ pAlteration ❑ New ❑ Repair/Replace
C
Description of Work: )1 ou e—` pan
Specify color of color thru tile:
Submittal Fee $ wTi Permit Fee $ U CCF $_
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
te: Zip:
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $ TOTAL FEE NOW DUE $ Q 2
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection wNph occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be ap rov d orrp a r,&Vection fee will be charged.
Signature
NER or AGENT
T,L,G�I� he foregoing instrument was acknowledged before me this
day of 20 ► . by
who is personally known two
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: _...._._._._._.,..
Print: # '� o y Public State of Florida
' Commission # GG
Seal: 2MyosComm. Expires Jun 28, 2020
�44111�``
Signature JC
CONTRACTOR
The foregoing instrument was acknowledged before me this
Ok day of `f 20 , by
VLU t-fyYlLifl w o is personally known to
me or who has produced_ &, b C as
iderr$jficatian and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: ;.; MYCOMMISSI;N# 1 27
EXPIRES: February 14, 2022
Bonded Thru Notary Public Underwriters
************************************************************************************************************
APPROVED BY �3�5� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)