EL-06-21-1587, 304 NE 93rd Stor LAC_ 4-INS
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 0 ELECTRIC ❑ ROOFING
Master Permit No.
j2I2, I-1.oL2
FBC 2U?.z
RC-12-20-2945
Sub Permit No. EL-06-21-1587
❑ REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS MANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 304 NE 93RD ST,
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 1132060136350 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Bradley Johnson Phone#:
Address: 304 NE 93 ST.
City: Miami Shores State: Fl Zip: 33108
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: ONLY ELECTRIC COMPANY INC Phone#:
Address: 348 NW 102ND TERRACE
City: PLANTATION State: Fl Zip: 33324
Qualifier Name: ADIKA, YOAV Phone#:
State Certification or Registration #: EC 13002313 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 10,000.00 Square/Linear Footage of Work: 2300
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: interior remodel, bathrooms and other areas, replace electrical panel
outlets.
Specify color of color thru the:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF 5
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $ �J C y� 1,
TOTAL FEE NOW DUE $ 1 J•y C+
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 aDproved and a reinspection fee will be charged.
Signature Signature ��---
OWN or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 , by
Bradley Johnson , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
19 day of December , 20 22 by
Adika, Yoav , who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
_.x
Sign: ILCHEZ PYp , IiTH A VILCHEZ
Sign: .=,P a` Public -State of Florida
e �" 9
'. Notary a �r tata o �,,m�ssicn #
Print: =_ i 4 # GG 328519 Print: Yudith Vilchez ;� „„-omrnission Expires
s, nA ssion o Apri
Seal: Aprii 29. �023 Seal:
as
APPROVED BY ►" Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/20141
Permit Number: EL-06-21-1587
Owner's Name (Fee Simple Title Holder): Bradley Johnson Phone:
Owner's Address: 304 NE 93RD ST.
City: Miami Shores State Florida Zip Code:
Job Address (where work is being done):
City: Miami Shores State:
304 NE 93RD ST.
Florida
Contractor's Company Name: Ampe Arrived Electric LLC
Address: 12550 Biscayne blvd Suite 800
City: Miami
Qualifier's Name : ALFREDO EARRUFAT
Architect/ Engineer of Record Name:
Address:
City: State:
Describe Work:
State: FI
33138
Zip Code: 33138
Phone :
Zip Code: 33181
Lic. Number: EC13007721
Zip Code:
I hereby certify that the work has been abandoned and/or the contractor/architect is unab e
or unwilling to complete the contract. I hold the Building Official and the ami S
harmless of all legal involvement.
Signature
Ow er / gent
The foregoing inst ume was aknowledged
before me this 12 day of Dec ,20 21 , by
Bradley Johnson Who is personally
known to me or who has produced
indentification.
Notary Public: YuditX/,��hez
Sign and Seal:
11062020 -/Cha
Signature `
'Cont ctor / rchit t / Engineer
T g i strumen was aknowledged
before a this 19 da of Dec '20 22, by
ALFREDO EARRUFAT Who is person
known to me or who has produced
�tv�wc as indenUfication.
Q_ � O
_ Notary Public 5 a ILCHEZ
f FlondA
YUDITH A `'ILCHEZ
�Notary Public `.. of Florida Sign and Seal:
Commis c _+ <,G 328519
My Cc^ }on Expires
.tate o
k GG 328519
Sion Expires
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