EL-20-370Miami Shores Village
10050 NE 2 Ave
Miami Shores Fl. 33138
305-795-2204
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wueDate j2020 02j21y
. Expiration: 08 17 2020
Location Address Parcel Number
82 NW 98TH ST, Miami Shores, FL 33150 1131010330230
Contacts
BLUE DOT HOMES LLC Owner ELECTRICAL MASTERS INC Contractor
82 NW 98 ST, MIAMI SHORES, FL 33150 OSVALDO RODRIGUEZ
Home: 9549800623 8400 SW 14 ST, MIAMI, FL 33144
Business: 7863878296 ossierodial@hotmail.com
Description: REMOVE AND RELOCATE REFRIGERATOR. NEW GFI Valuation: $ 2,714.00 Ins ection Requests:
, r
PROTECTED RECEPTACLE AS INDICATED. !"V, �
Total Sq Feet: 1,500.00 ''` "ate t '�
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.90
Payments
Date Paid Amt Paid
Total Fees
$111.90
Credit Card
02/19/2020 $50.00
Credit Card
02/21/2020 $61.90
Amount Due:
$0,00
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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: 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 above named contractor to do the work stated.
'5'5�p * A- 41&4-,,� /z7o
Signature: Owner
/ Contractor / Agent
February 21, 2020 Page 2 of 2
RECEIVED
Miami Shores Village FE 9 z o
Building Department sY•
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
BUILDING Master Permit No. -Inc - og-i R --7 60
PERMIT APPLICATION Sub Permit No._:!F_" %!J ` 3-:4-
❑BUILDING J] ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: SZ A1 W c181h 5I Aff I S06
City: Miami Shores County. Miami Dade zip: 33( Sy
Folio/Parcel#: 1 (3 f 0 i D330 Z3 0 Is the Building Historically Designated., Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): t U�e � T'- 14owe S LL-� Phone#: 41% 2Z� 4Z 8
Address: I go NF�
City: State: YL Zip: 3�7
Tenant/Lessee Name:
Email:
one#:
(����-` �-�� \ �F` V�- --�" �� Phone#: lyG 3�� 8Z -ll'�
CONTRACTOR: Company Name:
Address: — 2_2�
City: 1)j�State: �\ zziipp: /33 \7�
Qualifier Name: S�l �`^r`-Phone#: /0
State Certification or Registration #: �Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: r City: State:
Value of Work for this Permit: $ 2 Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: R 2Wtolie 6W P( a l%/� ) &k e ge4Ug e j'Ap2 . Aj&uj 6 f l- Py &d
Qg_v[e a6 1104A
Specify color of color thru tile:
Submittal Fee $ SC) , `A Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
DBPR $
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
W
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 retarded 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 &4 °4
OWNER or AGENT
Signature
CONTRACTOR /
The foregoing instrument was acknowledged before me this The fore oing ins trum g f was acknowledged before me this
Vn
R day of,m --24
,��� �� U who is personally known toy o pefC�lly kn wn to
me or who has produced as me or who has produced as
identification and who thls� identification and w c��aI�CN,�an oa . ERIS R
NOTARY BLIC:am
IS RODRIGUEZ NotaryPODRf8UE2
B.
OTARY UBLIC: Sfataof Florida
blic - State of Florida Sm Commisaloa # FF 956580
ssion FF 956580 ""-',;ems F�My Comm. Expires May 12, 2020
Expires May 12 20p0 ""'� Bonded through National Notary Assn.
Sign.ign: '
sn. ,
Print: Print: �� uA �
IQ
Seal: Seal:
APPROVED B ins Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)