EL-03-19-573, 9518 N Miami AveMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
9518 N MIAMI AVE, Miami Shores, FL 331SO 1131010330460
Contacts
MIGUELTEMBLADERA Owner SUNSHINE ELECTRICAL CONTRACTORS Contractor
9518 N MIAMI AVE, MIAMI SHORES, FL 331501717 CORP
MARIANO SANTIESTEBAN
1300 SW 85 CT, MIAMI, FL 33144
Business: 3052654958
Other:7862736194
Description: POOL ELECTRICAL
Valuation:
Total Sq Feet:
Inspection Requests:
$ 850.00 305-)11
r
338.00.
,
i
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
04/11/2019 $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.
ERS AFFIDAVITI I certify that all the foregoing infor tion is accurate and that all work will be done in compliance with all applicable laws
sting construction and zoning. Futhermore, I authorizedhe b e named contractor to do the work stated.
ti
Authorized Signature: Owner
! Applicant / Contractor / I Agent
Date
11, 2019 Page 2 of 2
Miami Shores Village MAR 14 Z019
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �p
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
FBC 201--1
'O
Master Permit No. 19 -S J
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
'7
JOB ADDRESS: c� / ��J✓�l
fv 0
>r� fo iG'3G
Folio/Parcel#: �A Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zo e: BFE: FFE:
t %
OWNER: Name (Fee Simple Titleholder):��� `�"", 1c:?C:7e-' �'� Phone#:
Address:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email: r �•
CONTRACTOR: Company Name: -XI
Address: 1--3 2
City: State: f'` zip:�l
Qualifier Name: �' ^� �� '� � `�' `� �` G� Phone#:
State Certification or Registration #: C'/. ^-�CertificateTr�_
ompetency #:
DESIGNER: Architect/Engineer: 7 !�d%V EPhone#:
Address: City: State: Zip:
Value of Work for this Permit: $ r Square/Linear Footage of Work:
Type of Work: ❑ Addition- Alteration ❑ ew ❑ Repair/Replace ❑ Demolition
p ,
Oaccrintinn of Wnrkc
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
_ Bond $
TOTAL FEE NOW DUE $ S
(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 SignatureL��
R or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
The foregoing instrument was acknowledged before me this
day of �a,i�� 1 20 I q by
e day of "` �� 20 ' -1 , by
t P' personally
�QY�1 U�4 YG who is ersonall known to
_
s ersonall known to
"/ FT' Jv�i1 f> - t'� C�i� � t. o Y
me or who has produced bM� 4-,5`t"1— 96- V6 `a
me or who has produced as
identific ion s yv o i I I M5 RattKAS
'
RY Poll
identification and who did take an oath.
NOTAR �tl ", = Notary Public - S to of Florida
/
NOTARY PUBLIC:
mmissia # G 0 9055
My C m xp s 12, 2021
Bo ed (h i al Nolar Assn.
Sign:
Sign:
Print: 0i t'I 4-air-
I� �
RIGU
Print:
Seal:
Seal:' EVIRES: Apd 26, 2021
�o11do9 ft Nobly P&k UedeiwiMa
APPROVED BY Plans Examiner. Zoning
Structural Review Clerk
(Revised02/24/2014)