DEMO-18-2108L'`
Miami Shores Village
`yµmEy
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
�ORIOp'
Permit No. DEMO-8-18-2108
Permit Type: Demolition
Per im
Work Classification: Electric
Permit Status: APPROVED
Issue Date: 9/12/2018 1 Expiration: 03/11/2019
Project Address Parcel Number Applicant
9801-9845 NE 2 Avenue 1132060134380
Miami Shores, FL 33138- Block: Lot: PARK LLC
uwner mtormauon Address Phone Cell
PARK LLC 4141 NE 2 Avenue _
MIAMI FL 33137- ()-
4141 NE 2 Avenue
MIAMI FL 33137-
Contractor(s) Phone Cell Phone
SAME & Q ELECTRIC INC (305)219-0427
of Demo: Electric
ional Info: ELECTRICAL FOR DEMO
,ification: Commercial
ning: 1
Fees Due
Amount
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$1.60
Total:
$110.20
Valuation: $ 2,000.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO-8-18-68478
09/12/2018 Credit Card $ 110.20 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Electrical
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, WttgffO-1 , DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing informations accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the abpve-namo contractor to do the work stated.
Authorized Signature: Owner / Ap Ii
Building Department Co
/ Agent
September 12, 2018
September 12, 2018
1
Miami Shores Village �.11..1.
Building Department G °, 2018'r
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY
Tel: (305) 795-2204 Fax: (305) 756-8972 T
INSPECTION LINE PHONE NUMBER: (305) 762-4949 f l�
FBC 20 �D
BUILDING Master Permit No.0�734() R V
PERMIT APPLICATION Sub Permit No. � (9 —W 00
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
Q �` CONTRACTOR DRAWINGS
JOB ADDRESS: I ' e � "
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: Q
OWNER: Name (Fee Simple Titleholder): � L—C--C Phone#: S— otC
Address:
City: Stater Zip: I
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: c\ AJILE 1� Phone#: �aK 2 tel C4
Address_` 1 10 C �.. -4
lJDS�
city: 2A \, %vim zS State: zip:
Qualifier Name: �—k r\ �,jy EL a U eg "!N A- Phone#: Z f 1 l Oq T
State Certification or Registration #: je7e Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
Phone#:
City: State: Zip:
Value of Work for this Permit: $Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
❑ Demolition
Permit Fee $ CCF $ CO/CC $
Radon Fee $ DBPR $ Notary $
_ Training/Education Fee $ Double Fee $ _
Bond $
TOTAL FEE NOW DUE $ 11 o . 20
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State 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 &,-eA4
OWN R or AGENT
The foregoing instrument was ackno fledged before me this
day o Gli 20 (';:F) , by
cj , who is personally known to
me or who has produced
identification a w o id a an
NOTA PUBLI
Sign:
Print:
Seal:
MY GUMrvuw ... �019
EXPIRES: October 15, tes
Eonded Thru Notary P��!�� e4011
Signature 01
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of V 20 I'W, by
ma",-ek aiueg who is personally known to
as me or who has produced
identification ant,who did take an oath.
NOTARY PUB
Sign:
Print:
CAROLINAR.HERNANDEZ
Seal: * MY COMMISSION # FF 928131
h;= EXPIRES: October 15, 2019
Bondad Thru Notary Public Underwriters
*************************************************************************************************
APPROVED BY Plans Examiner
Structural Review
as
Zoning
Clerk
(Revised02/24/2014)