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EL-19-2895Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 01/17/2020 Location Address Parcel Number 1085 NE 97TH ST, Miami Shores, FL 33138 1132050170080 Contacts Permit No.: EL-12-19-2895 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Expiration: 07/15/2020 CHAD MASON Owner HI -TECH ELECTRIC & FIRE CORP Contractor 1085 NE 97 ST, MIAMI SHORES, FL 33138 EDMUNDO I JARQUIN Home: 9542431064 1500 SW 101 AVE, MIAMI, FL 33174 Business: 7863260931 Inspection Requests: Description: INSTALL 2 RECESSED LIGHTS, 1 WALL FIXTURE Valuation: $ 950.00 Inspec ion Re REPLACE CFCI OUTLET. 49 Total Sq Feet: 0.00 11 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 01/07/2020 $110.30 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 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 ,,aboveramed contractor to do the work stated. Authorized Signature: Owner / Applicant / 6ontractor ! Agent Date January 17, 2020 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 ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS �;�EIVED DEC 0 5 2019 BY: FBC 20 Master Permit No q L -1z -\q - 2 9 Z Sub Permit No. ❑ REVISION ❑ EXTENSION [-]RENEWAL ❑ CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 101b S N e ci -7 S-rr e Lt City: Miami Shores County: Miami Dade Zip:. 3l 8 Folio/Parcel#: Is the Building Historically Designated: Yes NO +� Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Q f h raj A/) aSa r, Phone#: 3 GS 3 gr/ / % 7 Address: /n 6 S Ne G77 Sfi�t �f City: �A:i / QM t' S�_d' State: TL Zip: Tenant/Lessee Name: Phone#: Email Me?sonKlZi -4, CONTRACTOR: Company Name: Address: 15-,e)a Sw 1.0/ City: Qualifier Name: ,40-6?A Phone#: %AK .37-6.0'73 Zip: 33 / / 4 Phone#: <" 3u.093 / State Certification or Registration #: gG I3 04 26 0 dr Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: n e Value of Work for this Permit: $ !/ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: /N 5T/tLL 2 �P�'c�ss�� 1-16#7'S' r Z UJAIZ Zc-P / cC- CFC I o o-rLE7_ Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ 02 TOTAL FEE NOW DUE $ 110. 7( "Z (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 p r1 Signature OWNS or AGE C6WRACTOR The foregoing instrument was acknowledged before me this day of 0. 1) r 20 19, by ri14 / ,09 5,6Gy who is personally known to me or who has produced OVAL Q,\ Ci4QDeA"-) as identification and who did take an oath. NOTARY PUBLIC: f ADRIANACECILIAVALENCIASM: MY COMMISSION E t3f3 3183<" Sign: v .' Print: 2zq� ..t�'«`��,' iad�dllruNchryP�lelkM�. • Y .�Y Seal: The foregoing instrument was acknowledged before me this < 10 day of N© ,20 f ! by 1FAVON )b Ii9,2 lylly , who is personally known to me or who has produced eAC2� C,+ZCD-�• as identification and who did take an oath. NOTARY PUBLIC: / :-% RIWCECILIAVALENCI IMA Sign: !�WCOMMM Print: ADU4✓A 'A RES:Apri1,2023 Seal: :*.s****s*****s*****sss***s********r•**s*sr*r**ss+ess**s**ss*s***r***********s****s*r*:*****#�*******ss:s**:: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)