ELC-08-19-2004, 9990 NE 2nd AvEMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
9990 NE 2ND AVE, Miami Shores, FL 33138 1132060132080
Contacts
MIAMI SHORES VILLAGE Owner AUM CONSTRUCTION INC. Contractor
MIAMI SHORES VILLAGE HUMBERTO ORTIZ
10050 NE 2 AVE, MIAMI SHORES, FL 331382304 278 ATLANTIC AVE, SUNNY ISLES, FL 33160
Other:3057511271 Business:3054564848
Description: INSTALLATION OF LICENSE PLATES RECOGNITION Valuation: $ 0.00 Inspection Requests:
CAMERAS WITHIN THE PUBLIC RIGHT OF WAY.
10698 NE 6 AVE Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
DBPR Fee
$2.00
DCA Fee
$2.00
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$109.50
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$109.50
Deposit
09/17/2019 $109.50
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 construcUoR wrgzoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner
/ Applicant / Contractor / Agent
Date
September 17, 2019 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 vkv%
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 201 -4
BUILDING Master Permit No. r, L c- 09 - 10 - I V1 I
PERMIT APPLICATION Sub Permit No, F- L C - 0 -.X0 A
OBUILDtNG �ELECTRIC Q ROOFING REVISION n EXTENSION nRENEWAL
nPLUMBING DMECHANICAL PUBLIC WORKS CHANGE OF f-I CANCELLATION n SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS. 1619
FoRo/Parcel#: x0l-f " js the Building Historically Designated: Yes NO —X
Occupancy Type: _ Load: Construction Type: _Flood Zone. BFE: FFE: —
OWNER: Name (Fee Simple Titleholder): -Vi-l* .,I(F Ae'll N1LfWone#: 3t9!5,- ;31-
Clty: z/-(-zjW z whet- State: Zip: 17;1 ;;/ -3 5
Tenant/Lessee Name: Z/ pawal —Phone#-. 5e!5; - 2!�;Zeq <
Email:
CONTRACTOR: Company Name: Phone#:
State: 11,:9t"147ok zip: 01 0
Qualifier Name: Phone#:.3�
State Certification or Registration #: _Certificate of Competency#: z-
DESIGNER: Architect/Engineer: &Z' Ize", Phone#: 33�-4(1-70-
Address: g��L _r/f/ 5 ?,- '4v&'5LAe ;O�G City: X'6*1 wt state: zip;
Value of Work for this Permit: $ Square/Linear Footage of Work.
Type of Work: 0 Addition C3 Alteration New Repair/Replace Demolition
Description of Work: .71416141421atu
Specify color of color thru tile;
Submittal Fee $ Permit Fee CCF $— CO/CC $
Scanning Fee $ Radon Fee DBPR $ Notary $
j
Technology Fee Training/Education Fee $ Double Fee $
Structural Reviews Bond $
TOTAL FEE NOW DUE $
llke�sec)02/24/2014)
Bonding Company's Name (if applicable),
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address _
City state 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 low 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_ 1J
OWNER or AGENT
Signature_
CONTRACTOR
The foregoing instrument was acknowledged before me this The fare oin instrument was acknowledged before me this
-r? u U day of 20 9 101 %o by day of I�A U 20-J � by
11.Lll� 0
leej,whoi --------to _
.4n,� Re- e; 1��sonallyj�n to
�!�Ily �1110
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC.
identification and who did take an oath.
NOTARY PUBLIC:
Sign: gg,��
Sign: sWA
Print: 141>
Prin M,
Seal: Notary PUW StSW (091 FWWddift
Sydney Herrera
my coftwstwn 00
expku 1010412023 343073
Seal:
Notary PtAft State of Flwida
Sydney F*ffera
<. My Cor"MAW GG 3430-13
Mn Expires 100412023
APPROVED BY S,5 Plans Examiner Zoning
Structural Review Clerk
[Revised02/2412014)