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EL-18-3141Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date': Location Address Parcel Number 299 NE 99 ST, Miami Shores , FL 33138-2434 1132060134580 Contacts Permit No.: EL-10-18-3141 Permit Type: Electrical - Residential Work Uassftation: Addition/Afteration Permit Status. -Approved Expiration: 11/20/2019 TREVOR & KRYSTLE HAGUE Owner TREVOR & KRYSTLE HAGUE Applicant 299 NE 99 ST, MIAMI SHORES, FL 33138 299 NE 99 ST, MIAMI SHORES, FL 33138 Other:3053934461 Other:3053934461 BALLAD ELECTRIC INC Contractor HENRY NIGEL Business: 7544008588 BALLADELECTRIC@YAHOO.COM Mobile: 8133626161 Description: NEW ADDITION FOR HOUSE MASTER BEDROOM Valuation: $ 15,000.00 Inspection Requests: SUMMER KITCHEN Total Sq Feet: 1,393.00 Fees Amount Application Fee - Other $50.00 CCF $9.00 Change of Contractor $110.00 DBPR Fee $7.88 DCA Fee $5.25 Education Surcharge $3.00 Permit Fee $475.00 Scanning Fee $3.00 Technology Fee $13.13 Total: $676.26 Payments Date Paid Amt Paid Total Fees $676.26 Credit Card 06/18/2019 $110.00 Credit Card 10/22/2018 $566.26 Amount Due: $0.00 Building Department Copy 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. OWNE S AF (DAVIT: I krtify hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulati g con truction and konin .�Futhermore, I authorize the above named contractor to do the work stated. / Contractor / Agent Date June 18, 2019 Page 2 of 2 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 BUILDING PERMIT APPLICATION ❑ BUILDING Q ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL [—]PUBLICWORKS JOB ADDRESS: 299 NE 99th street 1 1 1 8 19 -T. FBC 20 Master Permit No. R�C-04-18-984 Sub Permit No. I U-io (B -3111 ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Krystle and Trevor Hague Phone#: (305)613-5978 Address: 299 NE 99th Street City: Miami Shores State: Florida Zip: 33138 Tenant/Lessee Name: NA Phone#: NA Email. NA CONTRACTOR: Company Name: I I a Ca [ '-C f del C I n L Phone#: ��- �Z Ub/ Address: L4% 25 01 S t' City: !-f� Irt/C13'� State: Zip: O `L Qualifier Name: 6 , I': f q Phone#: State Certification or Registration #: OR I ; 01 !� 19 2 Certificate of Competency M / 6 b 0 e00 zo DESIGNER: Architect/Engineer: Ralph Tait Phone#: (954) 592-2841 Address:11820 Miramar Parkway, S 121 City. Miramar State: FL Zip: 33025 Value of Work for this Permit: $ SOOa Square/Linear Footage of Work: 6, Type of Work: F Addition ❑ Alteration ❑ New ❑Repair/Replace ❑ Derr litio Description of work: ELECTRICAL FOR NEW HOME ADDITION S {W�- ,M��i jvcovv^ Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ (Rev1sed02/24/2014) TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) NA Bonding Company's Address City State _ Mortgage Lender's Name (if applicable) NA 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 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. t Signature 0Signature OWNER or AGENT 0 CONTRACTOR The foregoing instrument as acknowledged before me this The foregoing instrument was acknowledged before me this I S fir day of U nv` 20 0 by 1 h day of VA k4 20 l by �j�ft,►S}�`e °�01 °`I who is personally known to I Rol who is personally known to m or who has producedriJ IrCtp F h `P as me or who has produced ;CU h S as identifi ti o did take an oath. ��N�t�nlllq/�j iden ifica 'o who did take an oath. �V►YlP NOTA Y PUB \��\` `I PR1ETo /////��� NO RY P LIC: ��```` k ........ .. T�'//�i Hk7'. i i re �+ .�cs Ind �*; •�• •* Sign: ` • Sign: s 2a *c'a �" P e Print: AWo a ti '!.' ¢ Print: hnU ►1'.d i • y °nd d.�° �`�•�O�` Seal: ���y' cu�a° �� Seal: ��ii�/'°lr'•'•.....•&V Th APPROVED BY Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk ORES - Miami Miami Shores Village Building Department O�01rop 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204� Fax:(305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. - L- it -• 1 - 31`1 i Owner's Name (Fee Simple Tide Owner's Address: City:. tU-A IX -Phone # (3 n) 1< 13 `- c5rl4 0 State: Gin:'t(XC� Zip Job Address (Of where work is being done): a 1 t K%C 91 T(a City: Miami Shores State:_Florida Zip Code: 5 3 1 B k Contractor's Company Name: Ki. Iy b,11 X C: El � '*n '1'Phone #. 05 cI \1 +l 3LI - 6 iCO Address: la11 WC-161 it 5-t a\t2. City: State: F'! - Zip Code: Qualifier's Name: �E_WS-on Lic. Number: FJ C bOQ 13 �5 Architectl Engineer of Record Name: �47�1 Tf1U Phone Address: 11R,3Ct+ 7 n1U City: Ht + Y tt\C ; rate: Zip Code: :5 fi l5 i k F Cvf , Describe Work: ►,Xi.% A(i.SkIT C:4- i hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. i holfment ing Official and the Miami Shores harmless of all Ic It. Signature �T ----ri re QvM AjMi The foregoingins ument wu aknowledgedb f re me The foregoingknowledged before me tots day of 2o�9.by�C�u� this I!) day of �U h t , zd� by i<tl t r1 S O n Who is personally own to me or who h produced who is personally known to me or who has produced NrfEr Sign: Seal: 1125 #W 2$726$ p°11ded %e as Indentl0cadon. J[ W ID W h as bwe tiicauon. Notary Public: --- Sign: C( Seal: EM ARIACOLUCCIpublic - State of Fioncaission r GG 26556m. Expires Oct 7. 2022h Natia+al Notary Assr. 1- , Ij �'Y 8 A 19 c Permit ►vo.: EL-10-18-314 Miami Shores Village Permit Type: Electrical - Residential 10050 NE 2 Ave Miami Shores FL 33138 Work Classification: Addition/Alteration 305-795-2204 Permit Status: Approved issue Date:10/22/2018 Expiration: 04/09/2019 Location Address Parcel Number Project 299 NE 99 ST, Miami Shores, FL 33138-2434 1132060134580 <NONE> Contacts TREVOR & KRYSTLE HAGUE Owner TREVOR & KRYSTLE HAGUE Applicant 299 NE 99 ST, MIAMI SHORES, FL 33138 299 NE 99 ST, MIAMI SHORES, FL 33138 Other:3053934461 Other:3053934461 KELLY BENSON ELECTRIC INC Contractor KELLY PATRICK BENSON PO BOX 223425, HOLLYWOOD, FL 33022 Business: 9549215400 Description: NEW ADDITION FOR HOUSE MASTER BEDROOM Valuation: $ 15,000.00 Inspection Requests: _ SUMMER KITCHEN [305-762-4949 TotalSq Feet: 1,393.00 Fees Amount Application Fee - Other $50.00 CCF $9.00 DBPR Fee $7.88 DCA Fee $5.25 Education Surcharge $3.00 Permit Fee $475.00 Scanning Fee $3.00 Technology Fee $13.13 Total: $566.26 Building Department Copy Payments Date Paid Amt Paid Total Fees $566.26 Credit Card 10/22/2018 $566.26 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 permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certifythat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co nd�iir zog. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner f / Applicant / Contractor / Agent Date October 22, 2018 Page 2 of 2 Miami Shores Village RECEIVED Building Department OCT 112018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Cjj Tel: (305) 795-2204 Fax: (305) 756-8972 +1 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 BUILDING PERMI PPLICATION ❑BUILDING ELECTRIC ❑ ROOFING FBC 201q Master Permit No. RC / 8 99 y Sub Permit No. E� V9 ❑ REVISION ❑ EXTENSION ❑RENEWAL F-IPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP •� CONTRACTOR DRAWINGS JOB ADDRESS: ol-/Q1Q A d q0 S i City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):�CIA � Phone#: ��5�� 3 — I 8 City: Alin 1 State: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: d /3V.' 2�-3 S City: kw/J State: Qualifier Name: State Certification or Registration Certificate of Competency #: DESIGNER: Architect/Engineer: hone#: Address: �^ City: State: Value of Wor or this Permit: $ �S v Square/Linear Footage of Work: Type of Work Addition ❑ Alteration ❑ New f ❑ Repair/Replace Description of Work: 1 Specify color of color thru the: Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ "a% )� Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $, DBPR $ CO/Cc $ Notary $. Double Fee $ Bond $ TOTAL FEE NOW DUE $ p: 9s-11-YLIy W YI Zip: 151j2'/T /Z�/���Qq Phone#: T r3/- S/lY'Ir`�'''/ / Zip: Demolition (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 Zi 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 t ce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature V` Signature OWNER or AGENT ONTRACTOR The foregoing instrume�ntt was acknowledged before me this The foregoing instrument was acknowledged before me this k C) day of DC47) 'V CD 20 _, by day of c�@(�> 1 0, 20 by (�i Ir i S �� C A L�y 6who is personally known to VF(JJ ?�JOj� r 1� �, who is personally known to me or who has produced as me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PU IC: Sign: _ Sign: Print: Gi'Y Print:O_Q�'M(—\ _ t7 Seal: Seal: DUFFIN CATHE�Fw` NotaryPubRCNEStatt of Florida �''"SINDIAALVAREZ ' MY COMMISSION # GG 238273 Commission # GG 104296 5 f: '`AMy Comm, Expires May 14, 2021e°` EXPIRES: September 3, 2022 '•aE'C1F K1S OF qQ� ************�k�r*****�1Ge4egktpr�+ehryk>em�+syrw** ************************ ********** APPROVED BY Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014)