EL-08-22-2172Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
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9509 N MIAMI AVE, Miami Shores, FL 33150
Contacts -.._.
Permit NO.: EL-08-22-2172
Permit Type: Electrical= Residential
Work Classification: Addition
Permit Status: Approved
issue Date: 08/29/2022 Expiration: 03/01/2023
Parcel Number
1132060130670
MARIA T BERGUA SANCHEZ DEL CORRAL Owner Maria Bergua Applicant
10603 NE 10 PL, MIAMI SHORES, FL 331382103 9509 N Miami ave, Miami shores, 33150
Other: 3058126015 Mobile: 3058126015 mariabergua@hotmail.com
PARDIME ELECTRIC INC Contractor
OLEY JACKSON SMITH
2629 SW 31 CT, MIAMI, FL 33133
Mobile: 3054768080
Description: NEW ELECTRICAL OUTLETS, SWITCHES IN NEW ! Valuation: $ 9,175.35 Inspection Requests.
ADDITION AND INTERIOR REMODELING 305-762-4949
Total Sq Feet: 946.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$6.00
DSPR Fee
$4.82
DCA Fee
$3.21
Education Surcharge
$3.00
Permit Fee
$271.14
Scanning Fee
$3.00
Technology Fee
532.11
Total:
$373.28
Building Department Copy
Payments
Date Paid
Amt Paid
Total Fees
$373.28
Credit Card
08/29/2022
$323.28
Credit Card
08/29/2022
$50.00
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 POOLwork.
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.
/ 2F/2
Owner ! Applicant ! Contractor I Agent Date
August 29, 2022 Page 2 of 2
Miami Shores Village RE'CMVEI)
Building Department AIIG 29 12.2
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 7S6-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20RO'7"'
BUILDING Master Permit No. RC-VZ ZI-'>346
PERMITAPP CATION Sub PermitNo.u:� 2Z gilz-
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP__
CONTRACTOR DRAWINGS
JOB ADDRESS: q5Oq
City: Miami Shores County: Miami Dade Zip: 371S'O
Folio/Parcel#: kV3?-0 0% W 6%0 Is the Building Historically Designated: Yes NO
Occupancy Type: Z • Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ft0" T,,t3(.0 GtAll� e1 Phone#:
Address: OMOR 0oaaw fti/v44Iw&wc
City: Ko1 3WX0 V(4ACb0 State: r011Al0 Zip: 33�
Tenant/Lessee Name: Phone#:
Email:
n�.f� ti
CONTRACTOR: Comcianv Nam�V�'� ) mt�'•
Addre9g:;"Ii • w,
Email: "Srn a
Qualifier Name:
State Certifications#:
DESIGNER: Architect/Engineer: _
Im
of Competency #:
Address: _ City: State: _Zip:
Value of Work for thi Permit: $ / q [ 17 Square/Linear Footage of Work:
Type of Work: Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: N3W �I��CY1tGf� Csutlx�CS, .9,01cl-wi lei NSW
IKND (bJId1Ud1 ( f�pC liuC�
Specify colon -of color thru tile:
Submittal Fee $ ? O ' Permit Fee $ . CCF $ CO/Cc $
Scanning Fee $ DCA Fee $ DBPR $ Notary!
Technology Fee $_
Structural Reviews $
Training/Education Fee $
Double Fee $
P&Z Review $ Bond $
TOTAL FEE NOW DUE $
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(Revised04/05/2022)
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 io 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 reinspectionfee will be charged.
a C
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
a-3 day of AU°IU aI 20OU by
t�L,rt4j cv , who is personally known to
me or who has produced JL N6.11. '55$81l as
identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
.Z3 day of A-)5Jbk 20AX_ by
who is personally known to
me or who has produced 17L b 620 67043 0�0 D as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: n�C Sign: n V6�"'' ✓v`
Print: ELOA612G .C�' atg-7�- Print:-106hC4 r-kir4ildo-,
Seal: "J"• XIAgA N kIHAAD> Seal: j... ,QFa.rAM MIR,:0,F
A
i7!r"a's eatay Domic State as Florida (Fg�.'a'r:; Nct+ry oueu< Sutele.le+>?Comnissicn •fl•06tf6B�166MY (CT.III, EL(;Vaa DC: i. $Di4 M1 M Ci. [VplrlS D, iDiA rctary Assn. :eras :-.r .gn sax=al rtry Assn.
APPROVED BY
Plans Examiner
Zoning
(Revised04/05/2022)
Structural Review
Clerk