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EL-19-850Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 10635 NE LOTH CT, Miami Shores, FL 33138 Contacts Permit No.: EL-04-19-850 D Permit Type: Electrical - Residerrtial Work Classification: Adttion/Alteration Permit status: Approved Issue Date:05/06/2019 Expiration: 11/04/2019 Parcel Number 1122320280760 FRANCISCO GAVIRIA Owner METRO ELECTRIC SERVICE, INC Contractor 10635 NE 10 CT, MIAMI SHORES, FL 33138 OMAR R HERNANDEZ Other: 3054794654 15050 NE 20th Ave, North Miami, FL 33181 Business: 3059451991 Other:3059451991 ._.__. Description: BATHROOM REPAIR Valuation: $ 2,000.00 Inspection Requests: 49 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $111.10 Payments Date Paid Amt Paid Total Fees $111.10 Credit Card 05/06/2019 $111.10 Amount Due: $0.00 the work covered hereunder in compliance with all ordinances and regulations -nents or specifications submitted to the proper authorities of Miami Shores Tither myself, my agent, servants, or employes. I understand that separate DOORS, ROOFING and SWIMMING POOL work. ,d that all work will be done in,epmpli ce with all applicable laws or to do the work stated. ' / Date a ,, '9 Dann 1 -4:'1 pd� �c Ile 00,10 °ff ppy To", o �iy 'si3 Gee � loth pe��7i y'0� aa�foAe � • Cy'9tiaii� i79s �o�ai s fife o'fi° ti4 pby `era 00, aie afe ac° a� c, 7� elf 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 BUILDING PERMIT APPLICATION ❑BUILDING tVELECTRIC ❑ ROOFING BY: �Ut FBC 20 Master Permit No. Sub Permit No.�� ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �l�S V A 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: OWNER: Name (Fee Simple Titleholder. a' k AA1</ A Phone#: nt ) `t �" Address: / %/'D 3� %I lD fit" City: 414 ",l �'QtfP State: �� Zip: ' / ± Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: _ 6 6- L� �(%/�� Phone#:. 6—F/57 91 %, Address City n C Qualifier Name: _ 1, im pRy State Certification or Registration #: 115-C ne#: g©r r?-Y- Certificate of Competency #: DESIGNER: Architec /Engineer: f-:742216ML-1 &f!6X11X Phone#: Address: O City: State: Zip: -Value of Work for this Permit: $ afyvo Square/Linear Footage of Work: Type of work: ❑ Addition 6 Alteration ❑ New Repair/Replace ❑ Demolition Description of Work:�/1 l l�j r al ti7/� Specify co/or'`of colon ' 'x ru. the . Y� f ;a3 '•3 G� i'a'.tt ' •; .•r ... Y. .a. o•i>a yr .-r'9 ). #•{i _. �'.,`•• . Submittal Fee $ i '$ermit Fee-$ CCF $ CO/CC $ .. Scanning Fee $ Radon Fee $ Technology Fee $ % Training/Education Fee $ Structural Reviews $ w (Revi sed02/24/201!1) r DBPR $ Notary $ Double Fee $ Bond $ 66 TOTAL FEE NOW DUE $ 1 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 estimateIvalue eding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction liene will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice cnt must be ed at the job site for the first inspection which occurs even (7) days after the building permit i en such posted notice, the inspection will not be approved a reinspection fee will be charged. Signature Jr Signatur Ants r AGENT CONTRACTOR The foregoing instknowledged beforeme this a foregoing instrument was acknowledged before me this5-\ Y\ day of (� 20 0 by Qa4 day of Q4A4-beA— 20 19 by Dlfty ) 08 1 vl who is personally known to /yL L'" lP�`T `"-� who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign:_ Print: 11 Ir`�r V' Print: Seal: P,kI,�,� �tGG15817411 Seal: • * EOM October 30, 2021 m'rrfOl ��(' r,n,e.etaue��s•n�oa APPROVED BY Plans Examiner Structural Review Notary PONC sate of Flori Tom Roassm' Ali' Cagml sd ft GG 193011 X*M es4Ms Zoning Clerk (Revised02/24/2014)