EL-19-2716Miami Shores Villagc
ENTERED
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
NOV 14 2019
BY:
EWA
`` FII BC 20V�-
BUILDING Master Permit No. MC— k k — j c� — 2-:_05-
PERMIT APPLICATION Sub Permit NO.E L-11-1011 _ - (-P
BUILDING ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
` Q CONTRACTOR DRAWINGS
JOB ADDRESS:
the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Ff,41f, 4o_ri Y Aed,'!!.z Phone#: 0pS-z L✓Q-?3
Address: qc2z
/: � N FE n (e� � t'S 1/`L'." ���/ *�v
City: K (vU 1 � shoe ` - State: F lC Zip: � �29.
Tenant/Lessee Name:
Email:
Phone#:
CONTRACTOR: Company Name: Af-s yesrw Phone#:
Address: I(% I -U 41 J \V LU�N 12
City: ��� j—i(l�i State: Zip: j
Qualifier Name: 1' (I^ Phone#:
p
State Certification or Registration #: t�l_, Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ I % g Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ Nev Repair/Replace
Description of Work:
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
❑ Demolition
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 $1500, 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. zi
44Signature Signatu
-WE
RR-oAGEI�
The foregoing instrument was acknowledged beforemethis The foregoing instrument was acknowledged before me this
day of 20 L l by day of 20 20 t C by
who is personally known to �p� ,/who is personally known to
me or who has produced L 0L as me or who has produced L as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC.
Sign:_
Print:
Seal:
NOTARY PURLIC!
APPROVED BY !� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.:'EL-11-19-2716
r - - ' —L� Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Issue Date:11/20/2019 Expiration: 05/18/2020
Location Address Parcel Number
9020 NE 8TH AVE 36, Miami Shores, FL 33138 1132060420420
Contacts
RITA HERNANDEZ Owner ARS/RESCUE ROOTER Contractor
9020 NE AVE 3B, MIAMI SHORES, FL 33138 JOSEPH KENAN
18720 SW 108 AVE, MIAMI, FL 33157
Business: 3052357883 khidalgo@ars.com
Description: a/c change out Valuation: $ 5,968.00 Inspection Requests:
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$3.60
DBPR Fee
$3.13
DCA Fee
$2.09
Education Surcharge
$1.20
Permit Fee
$158.88
Scanning Fee
$3.00
Technology Fee
$5.22
Total:
$227.12
Payments Date Paid
Amt Paid
Total Fees
$227.12
Check # 8253013824 11/14/2019
$50.00
Check # 118253013853 11/20/2019
$177.12
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: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construftiipn and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Sig
/ Applicant / Contractor / Agent
_,Zv _
Date
November 20, 2019 Page 2 of 2