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DEMO-20-437Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address I?Cir�n�ln i��? Issue Date: 02/27/2020 Parcel Number 1343 NE 104TH ST, Miami Shores, FL 33138 1122320320010 Contacts Permit NO.: DEMO-02-20-437 Permit Type: Demolition Work Classification: Electric Permit Status: Approved Expiration: 08/25/2020 AWADH ABDULRAHMAN AWADH Owner COMPLEX CIRCUIT ELECTRICAL SERVICES, Contractor 1343 NE 104TH ST, Miami Shores, FL 33138 INC. Home: 3057730012 AW@AWADWATCHES.COM JULIO ESTRADA 13214 SW 40 TER, MIAMI, FL 33175 Business: 7862183387 Re Description: FLOOR TILE REMOVAL, DRYWALL CEILING AND Valuation: $ 100.00 nests: Inspection 305-Re WALLS REMOVAL, REMOVE CABINETRY, REMOVE BATHROOM CABINETS, REMOVE SHOWER DOORS, REMOVE INTERIOR Total Sq Feet: 0.00 DOORS. Fees Amount Application Fee - Other $50.00 Building Demoloition Fee $50.00 CCF $0.60 DBPR Fee $3.75 DCA Fee $2.50 Education Surcharge $0.20 Scanning Fee $3.00 Technology Fee $6.25 Total: $116.30 Payments Date Paid Amt Paid Total Fees $116.30 Credit Card 02/27/2020 $116.30 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. OWNERS AFFIDAVIT: NI certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construc�pn a d zpi g/uthermore, I authorize the above named contractor to do the work stated. Authorized Sign ttfre: wrier / Applicant / Contractor / Agent Date February 27, 2020 Page 2 of 2 Miami Shores Village R-Ec.TIVED Building Department LLI7 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY - Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20(:� BUILDING Master Permit No. a)em,, - ) I - 19 - Z is PERMIT APPLICATION Sub Permit No. vc -d -2 ` 2'�) ❑BUILDING V� ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [:]PUBLICWORKS [:]CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 13 V-? Ale f�Y / S/y- QYL Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: j7 /Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Awr z)Wkd l `Jawd Phone#: Address: k3 V--? 'iJ o City: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: UUJU Address: 3 ZrrY ,/� 0 TR City: Z 1 State: 0" ova p:.33138 Phone#: e Jot)lee Phone#: )W ?, - 3-? Qualifier Name: Jy lid ( 6j&4 Ak Phone State Certification or Registration #: CG 1.3oo 8 y (04 Certificate of Competency #: 2 / P)-,33 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: E- NA,-C) k-�(27TA <} %, Specify color of color thru tile:, Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Permit Fee $ CCF $_ Radon Fee $ DBPR $ Training/Education Fee $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (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 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 51V -OW R or GENT The foregoing instrument was acknowledged before me this 2 day of ��, 20 --2 0 by Pvv(��-3TVl.''�41 MAN who is personally known to me or who has produced - TIA LR- i tr- N SE.. as identification and who did take an oath. NOTARY PUBLIC: Sign: R Print: (N�1-�- T� 1y2 &-4 _a Signatu CONTRACTOR The foregoing instrument was acknowledged before me this Z dayof +m,P&4 Q. 20 Z Q by .S who is personally known to me or who has produced C,73 6 V ZJ 41.3 V O 0 as identification and who did take an oath. NOTARY PUBLIC: FLAMIDALI, P,r' � dio�i5ffi GG 1 a` Expires August 6, 2021 Seal: _ = SdI�rF�oP BOWed Thru Budget Notary Smims SINDIA ALVAREZ `r.. `-23 Q :.• ,- MY COMMISSION # GG t: �273 � (too— h-4Z3- 7l— 340 0 EXPIRES: September 3, 2022 Ii APPROVED BY Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. V COPY OF QUALIFIER'S STATE LICENCES B. V COPY OF LOCAL BUSINESS TAX RECEIPT C. U COPY OF LIABILITY INSURANCE* D. L/ COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ...................... ..................J ... .now ........................................ BUSINESS NAME: BUSINESS ADDRESS: 132 Iq j� e % CITY STATES, ZIP 33W- BUSINESS PHONE: (-? 0 6) Z I J3.— 33 S� FAX NUMBER(_) CELL PHONE(_) QUALIFIER'S NAME: Z h o 0, A1441WA QUALIFIER'S LIC NUMBER: 02 - i30D 0 w 6 1� RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY Florida STATE OF FLORIDA DEPARTMENT OF BUSINE- 7Af4W : OFESSIONAL REGULATION 110 ELECTRICA tNG BOARD THE ELECTRI IE.R:E1�N"i� 5 C�I tL4, UNDER THE PROVIS , + �1 OFCF': , tTER�489F RADA ST UTES C1. ' ` RICAE � VICErS;-.. C. ►�ii �15-:1 . TER CET L CENS ,'r3EzR30D8. 67 v EXPIRATION - ATACI;�UST 31, 2020 Always verify licenses online at My FloridaLicense.com Do not alter this document in any form. a This is your license. It is unlawful for anyone other than the licensee to use this document. 008000 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY '258715 BUSINESS NAMEAOCATION RECEIPT NO. COMPLEX CIRCUIT ELECTRICAL SERVICES INC RENEWAL 13214 SW 40TH TER 7545310 MIAMI FL 33175 e- a LET EXPIRES SEPTEMBER 30, 2020 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS COMPLEX CIRCUIT ELECTRICAL SERVICES INC 196 ELECTRICAL CONTRACTOR PAYMENT RECEIVED C/O JULIO C ESTRADA QUALIFIER EC13008467-___ BY TAX COLLECTOR $75.00- 09/04/2019 Worker(s) 1 CREDITCARD-19-069812 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. Tfie RECEIPT NO hbove mast be displayed on all commercial vehictes= Miami-Qade Code Sec Ba-276. For more information, visit www.miamidgdg.gov/texcollector