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EL-17-578 Permit No. EL-3-17-578 �sHO1s y� Miami Shores Village Permit Type: Electrical-Residential 10050 N.E.2nd Avenue N ' work Classification:Repair "' Miami Shores,FL 33138 0000 Permit Status:APPROVED(305)795 2204 FCowi'D` Issue Date:3/7/2017 Expiration: 09/03/2017 Project Address Parcel Number Applicant 10001 N MIAMI Avenue 1132060131400 Miami Shores, FL 33150- Block: Lot: RICARDO RODRIGUEZ-ROA Owner Information Address Phone Cell RICARDO RODRIGUEZ-ROA 10001 N MIAMI Avenue (415)370-6964 MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 600.00 LONGMAN ELECTRIC INC (305)758-1211 _... _.� �.� d... Total Sq Feet: 0 Type of Work:REPAIR RISER TO F.P.L Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:3 Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoke# EL-3-17-63187 $2.00 03/07/2017 Credit Card $64.60 $50.00 DCA Fee $2.00 Education Surcharge $0.20 03/06/2017 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 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. March 07, 2017 Authorized Sig ature:AOwner / Applic ,/ Contractor / Agent Date Building Department Copy March 07, 2017 1 Miami Shores Village � '�'�,ya '� Building Department MAR s 2017 BY. 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION PfRENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP M ^ -,, CONTRACTOR DRAWINGS JOB ADDRESS: QQO I IJ. \ �1QM� �G City: Miami Shores County- Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: nConstruction Type: 1 Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): t��C l 17111 1LnlXC�AV�G� A Phone#:CG 15�3 70'6q(n"I Address: x05 �k 1 , LAD (,:; . City: N fA4 Yin State: N 7v Zip: W.n.3(i Tenant/Lessee Name: Phone#: Email: l 'Mxo`t'S o s� 09A %\.C.(Dm CONTRACTOR:Company Name: Lam, _9n/ e -e-ak C, Phone#: Lz> Z/ Address: �S l City: /Yl�v Gl�/��^� A State: � Zip: 4Q Qualifier Name: q Q,l �ey S M'9 Phone#: State Certification or Registration#: ��/►(_ !' 3 p O 37)3Certificate of Competency#: DESIGNER:Architect/Engineer: � 1�I Phone#: Address: City: State: Zip: Value of Work for this Permit:$ .(0,(! Square/Linear Footage of Work: Type of Work: ❑ AKey n ❑ Alteration ❑ New 11SI New ❑ Demolition Description of Work: 1 ;p7cl 10 rPaP C� 1 I -27U 3 Specify color of color thru tile: Submittal Fee$ Permit Fee$ lll'di dbO CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ L ' (Revised02/24/2014) • A , f Bonding Company's Name(if applicable) /V Bonding Company's Address _ City State Zip 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 f J Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _04_day of 1' CL r k ,20 17 by day of 201 - .by cqi?40 &L"(`,urz 2-- Z A- ,who is personally known to m,Ltiwho is ersonally known me or who has produced 7 1c f i d't u;ver '6 ss-_as me or who has produced as identification and who di take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: i Sign: ( Sign: "Print: �1 f}/ll' #Iyq Lt— Print: G' e ke-2— Seal:, Seal:, V TUAN ANN LE Seal: NOTARY PUBLIC-STATE OF NEW YORK �d� rr` Notary Public State of Florida No.01 LE63a5600 Michelle Perez My Commission FF 000321 ...��.*.s........#,...,atrr�ll�a��m�ae�i1�,►.�....�....*..�.... :. It�re�►trrr�*.�.*..«. ...�..... My Commisaion Expires 07-25-2020 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)