PL-07-22-1841Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
9509 N MIAMI AVE, Miami Shores, FL 33150
Contacts
MARIA T BERGUA SANCHEZ DEL CORRAL Owner
10603 NE 10 PL, MIAMI SHORES, FL 331382103
Other: 3058126015
Permit NO.: PL-07-22-1841
Permit Type: Plumbing - Residential
Work Classification: Addition/Alteration
Permit Status: Applied
Issue Date:I Expiration: 01/16/2023
Parcel Number
1132060130670
Miguel Perez
7213 NW 46th Street, Miami, FL 33166
Business: 305-640-8229
Mobile: 954-854-0492
�1
Contractor
servilacon@gmail.corn
Ins ection Requests:
Description: new bathroom kitchen and laundry Valuation: $ 8,901.77
305-762-4949
TotalSq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$5.40
DBPR Fee
$4.67
DCA Fee
$3.12
Education Surcharge
$1.80
Permit Fee
$261.56
Scanning Fee
$3.00
Technology Fee
$7.79
Total:
$337.34
Payments Date Paid Amt Paid
Total Fees $337.34
Check# 842 07/21/2022 $337.34
Amount Due: $0.00
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
rggylatigg Forf$trVetiRn and zoning. Futhernore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner ! Applicant / Contractor / Agent Date
July 21, 2022 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
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
❑■ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 9509 North Miami Avenue
FBC 20"'
Master Permit No.z -Z I" 334e
Sub Permit No.
41
❑ REVISION ❑ EXTENSIONS ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Folio/Parcel#:11-3206-013-0670 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: _
OWNER: Name (Fee Simple Titleholder): Gabriel & Marla Phone#:305-812-6015
,,,,,.,,«.9509 North Miami Avenue
City: Miami Shores state: Florida Zip: 33150
Tenant/Lessee Name: N/A Phone#:
Email: mariabergua@hotmail.com
CONTRACTOR: Company Name: SERVILACON CORP Phone#: 305-640-8229
Address: 7213 NW 46th Street
City: Miami State: Florida zip: 33166
Qualifier Name: Miguel A Perez Phone#: 954-804-0492
State Certification or Registration #: CFC 1429610 Certificate of competency #:
DESIGNER: Architect/Engineer: Mark A. Campbell Phone#: 305-754-2318
Address:372 NE 95th Street City: Miami Shores state: FL zip: 33138
Value of Work for this Permit: $ — - Square/Linear Footage of Work:
TypeofWork: ❑ Addition ❑■ Alterettio I '@��E New ❑ Repair/Replace ❑ Demolition
Description of Work: New Bathrooms, Kitchen and Laundry
Specify color of color thru tile:
Submittal Fee $ - 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 $ �, [7 • _
(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
LTE
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law broc ure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencwnent must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the Bence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signaturej . k 2 11 k,&
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 20 ZZ by
0.t'i ct XY u . ,$gnCl�#z �rrG.
who is personally known to
me or who has produced rt 1>rVer5 as
identification and who did take an oath.
NOTARY PUBLIC:
Print: V t Vt -e'r e\-P- \/q,,
Seal:
The foregoing insf
1114 day of
me or who has produced
was acknowledged before me this
20 2.% by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: V L-Lk(An6 rfCAKdC.t
as
VNlenne Yao Seal: :oNulixxaewo.
Comm.:HH222410 *> xmaryweec•smlorn! de
Expires: Jan. 31, 2026 My Comm. �Commis * E/ HN , Ircs Otta 7, 20 tON
irdublic- Slate of Florida xrn4 tWoW eMor#' "oUry Ann.
Plans Examiner C J Zoning
(Reviwd02/24/2014)
Structural Review Clerk