EL-11-19-2694, 739 NE 94th StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
739 NE 94TH ST, Miami Shores, FL 33138 1132060142000
MINN., 111111111
:ontacts
MARIANA SANTANA Owner INDUSTRIAL ELECTRICAL SYSTEM CORP Contractor
739 NE 94 ST, MIAMI SHORES, FL 331382914 NESTOR I CORVEA
Other: 3055103766 10257 NW 9 ST 205, MIAMI, FL 33172
Ins section Re Description: ELECTRICAL SWIMMING POOL Valuation: $ 700.00 uests:
TotalSq Feet: 450.00 -1 NZEMIM
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
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
11/14/2019 $60.30
Credit Card
11/12/2019 $50.00
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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent ( z Date
November 14, 2019 Page 2 of 2
Miami Shores Village
Building Department 1
OVL 2 �U`'`�
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 BY:
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS
JOB ADDRESS: -ne + "te
FBC 2,n01/� �f
Master Permit No. �)PP- U_` ^1 q l —714 /
Sub Permit No. EL— It-1 q _z6 q
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zi :
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Constrution Type: FFllo'od` Zone: BFE: FFE:
OWNER: N me (Fee Simple Titleholder);ar-)CIrro �� ��G Phone#:
Address: fie t.l
City: "d)�► `U� State: Zip:
Tenant/Lessee Name: Phone#:
Email
CONTRACTOR: Company Name
Address: /�/
City:
Qualifier Name: h C 19 W-2A 6Z
State Certification or Registration #:
DESIGNER: Architect/Engineer: _
r2l aan°�k
Value of Work for this Permit: $ J,) L:L2
Type of Work: ❑ Additioonn—j ,❑ Alteration
Description of Work:
Specify color of color thru tile:
ne#:
Zip:
Phone#:
_Certificate of Competency #:
Phone#:
City: State: Zip:
Square/Linear Footage of Work:
❑ New ❑ Repair/Replace ❑ Demolition
�Ie�.
Submittal Fee $Sty -t&AI G Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ �04
(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 no be approved and a reinspection fee will be charged.
Signature` Signature 1" w
OWNER or AGENT CONTRACTOR
Ther foregoing instrument was qcknowledged before me this The foregoing instrument was acknowledged before me this
day of / vl 20 by day of I1�1� 20 l� by
o is personally known to viOn who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
d
Print:
as me or who has produced
identification and who did take an
NOTARY PUBLIC:
-;;
0004
Sign:
Print:
Seal: Seal:
as
***s*****.**ss•***.***..***.*.*s***********s*****r*************r*****r************ss*s:sr*.•*ss•***.******
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)