ELC-02-19-324, 9050 NE 8th AveMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
9050 NE 8TH AVE, Miami Shores, FL 33138 1132060110020
Contacts
GHG SDB001 LLC Owner METRO ELECTRIC SERVICE INC Contractor
GHG SD13001 LLC GHG SDB001 LLC SAMUEL AZUZ
12301 NE 6 AVE, NORTH MIAMI, FL 33161 15050 NE 20 AVE, Miami, FL 33181
Business: 3059451991 henrygarzon@hotmail.com
E
Inspection Requests:
Description: RE -INSTALL GFCI AS SHOWN ON PLANS s Valuation: $ 16,000.00
"
TotalSq Feet: 50.00
.j
Fees
Amount
Application Fee - Other
$50.00
CCF
$9.60
DBPR Fee
$7.20
DCA Fee
$4.80
Education Surcharge
$3.20
Permit Fee
$430.00
Scanning Fee
$3.00
Technology Fee
$12.00
Total:
$519.80
Payments
Date Paid Amt Paid
Total Fees
$519.80
Credit Card
02/12/2019 $50.00
Credit Card
02/26/2019 $469.80
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 Owner / Appit6nt / Contractor / Agent Date
February 26, 2019 Page 2 of 2
If
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 /ECTRIC ❑ ROOFING
REC I ELF
EB 2 20 9
BY: ti,
FBC 20 22
Master Permit No. U-IH� -3.. S9
Sub Permit No. G L - 02 cl `3 '47-4
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
_ CONTRACTOR DRAWINGS
JOB ADDRESS: ?0 � 7L,.e
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: IQ> 0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Typed (Flood
Zone: BFE: ,c � FFE:
OWNER: Name (Fee Simple Titleholder): ��i ti1 -7 �' �� d wl Phone#: , g -2 V
Address:
City: —Alt t Ly1 1 State: �` Zip:
Tenant/Lessee Name:
Email
hone#:
CONTRACTOR: Company Name: M r -N c ' �L Phone#:
Address: tN�
City: 41 (, G VI-q 1 State: 1�L _ Zip:
Qualifier Name: 04"p- 2`cZ- Phone#:11.
State Certification or Registration #: i 3 0 b �� 3Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work: Xe(✓t'
Specify color of color t ru tile:
Submittal Fee $ 1 Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
'L Z
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
469.9�
L . q (09 , �
bw-fins its
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
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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
:,T-- c�
\/day of 20 1 1 by
1Ct ( r (f zi1r, it, i who is Re to
to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
r.1y
111*44
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of G� 20 by
h personally known o
me or who has produced as
identification and who did take an oath.
NOTARY PU
JOUdEisi PaEr�'iE
Sign:
—
Sign:
`.��,
+ ro:ida
Pri
Print:
4, 2020
�..w� P �.,,
Sea .,. �e•
LYNN MAY VELIT
Seal:
0
6
=.<
�,io ��,
Notary Public - State of Florida
`
'
Commission #r GG 050483
;;,
My Comm. Expires Nov 28, 2020
****
Bonded throw h National ar Assn **********************************************************************
APPROVED BY
I J Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)