EL-19-2388Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Expiration: 04/13/2020
Location Address
Parcel Number
1225 NE 93 ST, Miami Shores, FL 33138 1132050270030
Contacts
RTC ELECTRIC CORP. Contractor
ROBERTO TOLON CALDERON
3321 SW 92 AVE, MIAMI, FL 33165
Business: 7862274180
Inspection Requests:
Description: TEMP FOR TEST 30 DAY Valuation: $ 100.00
€(2 s €'S' 6 .
Total Sq Feet: 3,200.00 zn Ruh"
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Notary Fee
$5.00
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$115.30
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$115.30
Credit Card
10/09/2019 $50.00
Credit Card
10/15/2019 $65.30
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 A FID IT- l ce if'that II the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulatTi-g so str i a n ore, I authorize the above named contractor to do the work stated.
1
Authorized Signature: Owner / Applicant / Contractor / Agent Date
October 15, 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
FBC 20 l�
BUILDING Master Permit No. r-11 C ^ S
PERMIT APPLICATION Sub Permit No.E: L (V -t9
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I ZZS A E cl3 S /
City: Miami Shores n County: Miami Dade Zip: 33C3 06
Folio/Parcel#: �� _3 Z U C ' Oc� / Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):O �Glf ��- (�,1 t�J �n,S CPhone#:
`i � j I2�Z3C 1
Address: q �,� � - 1J S r o C D rk'ye_
City: �A' P%Y6 S)'kyL)S State: Zi�p::G/��� �
Tenant/Lessee Name: / �J/�� I - Phone#:
,t�
Email: V tEne �v•�%1, Y\.SC`i'1� r k�"1�� L'1` � CCM
CONTRACTOR: Company Name: `<-- t �_ �� � C-1`1l �G� I (� Phone#: 31't& `272.1- 1
Address: 'VLo0 c,�, jar �7j
City:
Qualifier Name: , -'�-(*
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Add
p:
hone#:
Certificate of Competency #: 11 0 tF u00 ) Z
Phone#:
City: State: Zip:
(3-3
Value of Work for this Permit: $ (� lT� ' �� Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: 3C) CU 1 1 '0YY1 I)
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
❑ Demolition
CO/CC $
Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ `Z's • 3�i
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 low 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 s ch posted notice, the
inspection will not be approved and a reinspection fee will by charged.
Signature
Si �—�
Signature g
OWNER or AGENT CONTRACTOR'
The foregoing instrument was acknowledged before me this
day of () O:R).� CZ— 20 f ! by
who is personally known to
me or who has produced��� as
identification and who did take an oath.
NOTARY,P U BLI C:
Sign:
Print:
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
FAQ SINDIA ALk/AREZ
<;
Seal: Seal:
1= '` my CCI�dPAIS5IGN # GG 238273
EXPIRES: Se c mbar 3, 2022
pw
Bonded Thru Notary Public Underwriters
as
c**�****************************************************************
APPROVED BY,/) f�G! � Plans Examiner Zoning
Structural Review 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
AFFIDAVIT FOR 30 DAY TEMPORARY -ELECTRIC SERVICE
NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY
TERMINATION UNLESS APPLICATION IS RENEWED.
It is understood that the temporary -electrical approval by the Miami Shores Village, Building Department given
connection with the building being constructed under:
Building Permit N: Electrical Permit N:
At Address: 5 s-� Miami Shores, FL
For Owners: 1 /)t ,mot,-G VVo -AcL)t ter it and is being given only for
construction purpose or for testing the following equipment in said
structure:
The owner does herby agree to assume the responsibility of maintaining the installation in such manner t
there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said
structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further
inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of
Occupancy or Completion is obtained.
The undersigned also understands that the temporary electric approval is subject to rescission and
cancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of
ie building concerned is occupied before final inspections are approved and/or obtained a Certificate of
Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will result in your
beiun ble to obtain future Temporary for Test permits.
I, 1,L''( ,nX �C:h.yiSg\ , being first duly sworn, depose and say that I am the owner of the
above described property, and that I agree that the structure covered in this agreement shall not be occupied
until the building contractor has obtained approval of final inspections and/or obtained a Certificate of
0.9 pancy of Com te: Failure to comply with the provisions of his affidavit will result in your
belinc� uor Aable t i Tem ---, _
p rRLVAREZ
MY COMMISSI^N # GG 2382?3—
of Owner EXPIRE: cembcr 3, 2022Si
P `' n
j 'f S,F,!;;°• Bonded Thru Notary Public Underwriters
of Notary
I, -2 —A CA-J-\. , being duly sworn, depose and say that I am the ectr cal Contractor for
the above -de cribed property and that the electrical installations as now existing_Will n t cre to a safety hazard
if t rary is connected. aV'P� ,,, Maricel Alvarez Abreu
Commission # GG147349
Signature of Electrical Contractor =' Expires: October 1.
. aatture o ar
Bonded thru Aaron Nbt2�y' �
I, rsrJ /� f , being first duly sworn, depose and say tW-1--ai i the Buildin ant actor
of he above described property nd that I will not permit occupancy of this building until final inspections have
been called for by the contractors and sub -contractors concerned and final approval by the inspection division
obtained and that I have the authority ins
a ea=1ncerned to
r aibt ccupancy
a yo mule issjuQd.N
until suchfinal inspections are obtained a oe1
/ 1
Commission # GG 366127
My Comm. Expires Aug 14, 2023
Bonded through Nationat Notary Assn
gnalure of MildYng Contractor
of Notary
Signature of Inspector Signature of Notary