EL-19-892 (2)Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
1225 NE 93 ST, Miami Shores, FL 33138 1132050270030
Contacts
MARK & DARLENE HUTCHINSON Owner MARK & DARLENE HUTCHINSON Applicant
1225 NE 93 ST, MIAMI SHORES, FL 33138 1225 NE 93 ST, MIAMI SHORES, FL 33138
Other:9544459705 Other:9544459705
RTC ELECTRIC CORP. Contractor
ROBERTO TOLON CALDERON
3321 SW 92 AVE, MIAMI, FL 33165
Business: 7862274180
Inspection Requests:
Description: TEMP FOR CONSTRUCTION Valuation: $ 800.00 345-7fs29
Total Scl Feet: 2,700.00
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
04/29/2019 $110.30
Amount Due:
$0.00
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing inf rmation is accurate and that all work will be done in compliance with all applicable laws
regulating c ion and zoning. Futhermore, I authorize the above named contractor to do the work stated.
4
Authorized Signature: Owner
/ Applicant / Contractor / Agent
Date
April 29, 2019 Page 2 of 2
I ;
Miami Shores Village
Building Department APR 24
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 '
BUILDING
PERMIT APPLICATION
[-]BUILDING ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL [-]PUBLICWORKS
JOB ADDRESS:
NO
FBC 20 11
Master Permit No. ^ ^ I$ 13
Sub Permit No.� Ljcfl
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
3
Folio/Parcel#: i 13 20 CC'2) 00 3 0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: -- BFE:: (,, FFE: %
OWNER: Name (Fee Simple Titleholder): ✓'2'� L ��Wohe#: ` C - iZ" L�`'� ' (
Address: (2-/,113 e'( `7 W ( Q�
City: k "w
Tenant/Lessee Name:
Email
7
State: qL Zip:
Phone#:
CONTRACTOR: Company Name: �� 1p �() Phone#:l�'r�
Address:
City:
Qualifier Name:
{'L - Zip:,3j
Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: City: State
Value of Work for this Permit: a Square/Linear Footage of Work: _
Type of Work: ❑ Addition Alteration ❑New ❑ Repair/Replace
Description of Work: rA iL 54U IN 3 `E"
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
Zip:
❑ Demolition
CCF $ CO/CC $
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
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 certifiedcopy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) da er the building permit is issued. In the absence of such posted notice, the
inspection will not be app o d and a reinspe ' n fee will be charged.
Signatur Signature _
r AGENT
The foregoing instrument\was acknowledged before me this
/ (/ day of 4ti 20 by
who is personally known to
�1. _-
me or who has produced
identification and who did take an oath.
NOTARY
Prin Notary Public bialu
Seal: • • Commission # FF 231112
My Comm. Expires May17,. 2019
....0.o Bonded through National Notary Assn.
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of 1 ' -))jG / 20 >' `� by
who i personally known -to
.......... .......
as me or who has produced
as
identification and who did take an oath.
NOTARY PU
Sign -
Print:
Seal:
*****7**�*
APPROVED BY i?4TO Plans Examiner
11
••tip pie, YAMILrRODRIGUEZ COBAS
r°T—`,i
, Notar Public - State of Flo-ida40 Commission # FF 231112P My Comm. Expires May 17, 2019
Bonded thr h National Notary Assn.
IL *********
Zoning
Structural Review
(Revised02/24/2014)
Clerk