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EL-09-22-2301Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number ..... . ..... ......... ... . ..... .......... _. ........ 9509 N MIAMI AVE, Miami Shores, FL 33150 1132060130670 Contacts MARIA T BERGUA SANCHEZ DEL CORRAL Owner Maria Bergua Applicant 10603 NE 10 PL, MIAMI SHORES, FL 331382103 9509 N Miami ave, Miami shores, 33150 Other: 3058126015 Mobile: 3058126015 mariabergua@hotmail.com PARDIME ELECTRIC INC Contractor OLEY JACKSON SMITH 2629 SW 31 CT, MIAMI, FL 33133 Mobile: 3054768080 Description: TEMP POWER FOR CONSTRUCTION Valuation: $ 400.00 inspection Requests 30-762 4949 Total Sq Feet: 946.00 y� Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.30 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $10.00 Tota I : $117.90 Building Department Copy Payments Date Paid Amt Paid Total Fees $117.90 Credit Card 09/14/2022 $67.90 Credit Card 09/08/2022 $50.00 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 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. Signature: Owner GI)�a-!�k Applicant / G DLLI of c Contractor / Agent Date `-e/2 September 14, 2022 Page 2 of 2 Miami Shores Village 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 BUILDING PERMIT APPLICATION ❑BUILDING 7 ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: `1 50"l tJ M I i,K I k, V SEN 0 8 na BY: 9L�_ FBC 20 Master Permit No. Sub Permit No. C-L 01 - ZZ 7-3c' I ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: 33 (7� Folio/Parcel#: ( (-3 Z-0 C7(� -06 � V Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): Gb6R6LUJ6-00 Phone#: Address: `jSpq fj Mt At4 U City: VA l A to k S kd k P <� State: �7 Zip: S S ) s� Tenant/Lessee Name: Phone#: Email: (/�NRNI CONTRACTOR: Company Name: (I D i M c T 2 C Phone#: 305 1-t9-6angU Address: 2 y W 2C S �y) , 2'7 City: S T ( t f) State: L Zip: �© � Qualifier Name: L—__ S Q C bIN S -I Vk Phone#: 7KG 1 9 S 9o96 State Certification or Registration #.: C- 2 � � Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ cl 00 Square/Linear Footage of Work: Type of Work: r& Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: -i t_OA P roVCt VC (L C-00 S-C RuC7 l 01,_j Specify color of color thru tile: Submittal Fee $ 5®' M Permit Fee $ '�5b '00 CCF $ ` GX-) CO/CC $ Scanning Fee $ 3 . at-2 Radon Fee $ : vy DBPR $ J , cX> Notary $ Technology Fee $ � b . 00 Training/Education Fee $ 4 3a Double Fee $ Structural Reviews $ 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 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 NER or AGENT The foregoing instrument was acknowledged before me this day of20 by 1•.e, l Q��:n-� who is personally known to me or who has produced i'I- �r� J� (- ' c- as identification and who did take an oath. NOTARY PUBLIC: Signature 6 ;—n� CONTRACTOR The foregoing instrument was acknowledged before me this P- day of 20 Z-"' , by who is personally known to me or who has produced i-iL as identification and who did take an oath. NOTARY PUBLIC: U�� Sign: Sign: Print: V Print: . V t �/ ` �v1 -0- \4c Seal: ��*nv�P��.,,�� Vivienne Yao Seal: :°. `'�__ Comm.:HH 222410 ,,.';�'f P a.,,, __ = `��: �.,:�� Vivienne Yao Comm.:HH 222410 _ �— Expires: Jan. 31, 2026 _ Expires: Jan. 31, 2026 .�, Nota Public • State of Florida �'', ��.�� Nota Public - State of Florida *********** a+► ***Notav, y1*** ** ***************** ************** APPROVED B�/L' z Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)