EL-04-216 Miami Shores Village
D
Building Department
� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
BUIL I_NG Permit No. ecaw a
PERIV�T APPLICATION w L
Master Permit No. 3 Pa`o0Y— /0g.5-
FBC 2001 �� E E 0
Permit Type (circle): Building lectric Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) CC TOYI Phone 6 65 ) -7J_9
`,:�?3
Owner's Address
City (OLM V State // /Q Zip �3
Tenant/Lessee Name Ct /C' s — )lu ek Phone#
Job Address(where the work is being done) 5 N(� S /
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO �!
Contractor's Company Name LA/[-P.erL7 e L2 Phone# 30 =OCA f j_
Contractor's Address 993 Al(,S, /t/3 S i-
City A41-AM( State Zip 32/6
Qualifier l)0 M A l A A1, 1,-C ( /
UDS
State Certificate or Registration No. j -0 0/5 2 92-- Certificate of Competency No. U D 33 3
Architect/Engineer's Name(if applicable) Phone#
$Value of Work For this Permit 415-t)4) Square Footage Of Work: D
Type of Work: ❑Addition [EIAlteration ❑New ❑ Repair/Replace ❑Demolition
Describe Work: /LIS/A-/ L �5/ Y L/(iT�f! ��/ t�/ / d L 1</T('/-1(
Uv
Submittal Fee$Z• Ci! 11"l3S Permit Fee$ i op o'O CCF S !� CO/CC
Notary $ Training/Education Fee Sr o� l7 Technology Fee$
Scanning$ Radon $ Zoning Bond
Code Enforcement$ Structural Plan Review. $
Total Fee Now Due-�. �
(Continued on opposite side)
Bonding Company's Name(if applicable)
Bonding Company's Address
r
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State 11 �` , f a'- 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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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.
i
Signature
ture ��
Signa L•��'
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this%'7
day of 20_,by day of J U �4 20 o y,by D1 o Ai N )AJ)ct l+9tA
who is personally known to me or who has produced who is personally known to me or who has produce j...
OFFICIAL�T pc
As identification and who did take an oath. as identificatiop`'�n 'olcho did L'0oath.
0 COMMISSION NUMBER
NOTARY PUBLIC: NOTARY PUBLIC: ODI 13279
N
MY COMMISSION EXPIRE
Sign: Sign: m_ �PR.30,2006
Print: Print: )—
My Commission Expires: Commis on Expires: 111d012=0CD
APPLICATION APPROVED BY �� ✓l/L a lans Examiner
Engineer
Zoning
Chc 05/13/03
Miami Shores Village Electrical Permit a„
10050 NE 2nd Avenue '
Phone: 305-795-2204 Permit Number: EL2004-216 OR
Printed:8/4/2004 Page 1 of 1
Applicant: NATHANIEL STRONG
Owner: STRONG NATHANIEL
JOB ADDRESS: 85 NE 97 ST
Contractor ENERGETIC ELECTRICAL, INC Contractor's Address: 991 NW 143 ST
Local Phone: 305-685-7139
Parcel # 1132060131020 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 22 &23 BILK 7 LOT SIZE
Fees: Description Amount
FEE2004-7872 Building Fee $100.00 Total Fees: $1_03.3Q
FEE2004-7873 CCF $0.60 0. "
FEE2004-7874 Training and Education Fee $0.20 Total Receipts: " $0. 0
FEE2004-7875 Technology Fee $2.50
Total Fees: $103.30
Permit Status: APPROVED Permit Expiration: 1/24/2005 Construction Value: $500.00
Work: INSTALL SIX LIGHT FIXTURE IN KITCHEN
Signed: (INSPECTOR)
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 1 assume responisibility for all work
done by either myself,my agent,servants or employes.
Signed: (Contractor or Builder) BY:
Miami Shores Village Electrical Permit ;.
10050 NE 2nd Avenue
Phone: 305-795-2204
Permit Number: EL2004-216
�'�oRtvp
Printed:8/4/2004 Page 1 of 1
Applicant: NATHANIEL STRONG
Owner: STRONG NATHANIEL
JOB ADDRESS: 85 NE 97 ST
Contractor ENERGETIC ELECTRICAL, INC Contractor's Address: 991 NW 143 ST
Local Phone: 305-685-7139
Parcel # 1132060131020 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 22 &23 BLK 7 LOT SIZE
Fees: Description Amount
FEE2004-7872 Building Fee $100.00 Total Fees:$103.3p.)
FEE2004-7873 CCF $0.60 Total Receipts: 0.0
FEE2004-7874 Training and Education Fee $0.20 S 3, 0
FEE2004-7875 Technology Fee $2.50 3
Total Fees: $103.30
Permit Status: APPROVED Permit Expiration: 1/24/2005 Construction Value: $500.00
Work: INSTALL SIX LIGHT FIXTURE IN KITCHEN
Signed: (INSPECTOR)
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 responisibility for all work
done by either myself,my agent,servants or employes.
Signed: (Contractor or Builder) BY:
gOREs
Miami Shores Village Electrical Permit lost
10050 NE 2nd Avenue
Permit Number: EL2004-216 `� Mot
Phone: 305-795-2204
Page 1 of 1
Printed:8/4/2004
Applicant: NATHANIEL STRONG
Owner: STRONG NATHANIEL
JOB ADDRESS: 85 NE 97 ST
Contractor ENERGETIC ELECTRICAL, INC Contractor's Address: 991 NW 143 ST
Local Phone: 305-685-7139
Parcel # 1132060131020 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 22&23 BLK 7 LOT SIZE
Fees: Description Amount
FEE2004-7872 Building Fee $100.00 Total Fees $103.30
FEE2004-7873 CCF $0.60 Total Receipts: 0.00
FEE2004-7874 Training and Education Fee $0.20 -S 3,3
FEE2004-7875 Technology Fee $2.50
Total Fees: $103.30
Permit Status: APPROVED Permit Expiration: 1/24/2005 Construction Value: $500.00
Work: INSTALL SIX LIGHT FIXTURE IN KITCHEN
Signed: (INSPECTOR)
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 responisibility for all work
done by either myself,my agent,servants or employes.
Signed:
(Contractor or Builder) BY:
OR
Miami Shores Village Electrical Permit 2824, u " ,,,„
10050 NE 2nd Avenue
Permit Number: EL2004-216
Phone: 305-795-2204 a��~�
Page 1 of 1
Printed:8/4/2004
Applicant: NATHANIEL STRONG
Owner: STRONG NATHANIEL
JOB ADDRESS: 85 NE 97 ST
Contractor ENERGETIC ELECTRICAL, INC Contractor's Address: 991 NW 143 ST
Local Phone: 305-685-7139
Parcel # 1132060131020 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 22 &23 BLK 7 LOT SIZE
Fees: Description Amount
FEE2004-7872 Building Fee $100.00 Total Fees:$10,3.30a
FEE2004-7873 CCF $0.60 Total Receipts:- -10.00
FEE2004-7874 Training and Education Fee $0.20
FEE2004-7875 Technology Fee $2.50
Total Fees: $103.30
Permit Status: APPROVED Permit Expiration: 1/24/2005 Construction Value: $500.00
Work: INSTALL SIX LIGHT FIXTURE IN KITCHEN
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, 1 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 responisibility for all work
done by either myself,my agent,servants or employes.
Signed:
(Contractor or Builder) BY: