EL-16-2490 Permit I��PZ- I ..- -16-249 }
Miami Shores Village permit.7Yi6 � tfeRt[I .:,
10050 N.E.2nd Avenue NE
Work cation:Ac#ditlp#>tlAlt J"Z
•" Miami Shores,FL 33138-0000
Phone: (305)795-2204 £}VEC
a -: 1t1/ $! 1 n: Expiration: 04/26/2017
Project Address Parcel Number Applicant
1050 NE 105 Street 1122320280060
Miami Shores, FL 33138-2106 Block: Lot: PHILIPPE ALLUARD
Owner Information Address Phone Cell
PHILIPPE ALLUARD 1050 NE 105 Street
MIAMI SHORES FL 33138-
1050 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 1,200.00
PARDIME ELECTRIC INC
__....._ Total Sq Feet: 0
Type of Work:ELECTRICAL WIRING FOR DOCK.CONNECT Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning: 1 Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
Underground
W.W.
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1,20
DBPR Fee Invoice# EL-9-16-61269
$3.38 10/28/2016 Credit Card $ 187.96 $50.00
DCA Fee $3.38
Education Surcharge $0.40 09/08/2016 Credit Card $50.00 $0.00
Permit Fee-Additions/Alterations $225.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $237.96
In consideration of the issuance to me of this permit, I agree o perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,draw' gs, tatements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work d e by ither myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WI DOWS, DORS.ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: 5h�'
hat all the foregoing inf rmatio s accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. e,I authorize the ab a na d contractor to do the work stated.
October 28,2016
Authorized Signature:O ner / Con ractor / Agent Date
Building Department Cop
October 28,2016 1
Miami Shares Village SEP 08 2016
Building Department BY.
10050 N E.2nd Avenue,Miami Shores,Florida 33138
Tod:(305)795-2204 Fast:(305)756.8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 ► `��—
BUILDING master Permit woo= ` lC_-_
PEriMIT APPLICATION Sub Permit Na L.1(— Zq_"O
❑BUILDING e"t CTRIC ROOFING L-_7 REVISION E EXTENSION ❑RENEWAL
[]PLUMBING MECHANICAL a PUBLIC WORKS F_' CHANGE OF CANCELLATION ❑SHOP
�^— CONTRACTOR DRAWINGS
JOB ADDRESS: `p ' ,"f'
City: Ml mi Shores Count Miami Dade
Folio/ParcelB;, ..' n 0 Is the Bugding Hlstorkally Designated:Yes ` NO.rl
Occupancy Type: Load: Construction Type! Flood Zone:• BOE: FFE:
•p ;
OWNER:Name(Fee Simple Titleholder) WAM
Phone4l:_
Address: S
City: /J Slaw. �!. ;-----
Tenant/Less Name: Phone#:
Email: L '
L
CONTRACTOR:Company Name:
AddresQ4�o
Cltvv� _State: — Zip3�_
Qualifier Name. . V# x('111, p, r Phonex: _
� � Kms`$
State Certification or Registration#: � l 1 S Certificate of Competency#:
DESIGNER:Arch)tect/Engineer: 4CAA&. 0 - �aK`IWO Phone#
- ;� : "�: .j.
Address: 1as _ City:[ lOWN, R `itate:, Zip: ^
Value of Work for this Permit:$ 19. ®Q •0 0 Square/linear Footage of Work:
Type of Work: ® Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: / �1�'C101101V 4 ��� �C � eT 710 M&AI
- N� u 6 �-�! Qce�� ISS is. �SF� 0274 L. Lt?o1Ny>RE L fF'7- lit QZ04f
Specify color of color thru tile:
Submittal Fee S Y Jul Permit Fee S '` CCF S 1 CO/CC$
Scanning Fee$_ _ `� Radon Fee S� DBPR$ Notary$
Technaloilly Fee S 0 - TrainindEducation Fee S 0 y Double Fee$
Structural Reviews ---.__123--_— Bond$
TOTAL FEE NOW 011f$
i Revised02/a4,'20141
Bonding Company's Name(if applicable)
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 o condition to the Issuance of a building permit with an estimated value exceeding$25W,the applicant must
promise In good faith that a copy of the notice of commencement and construction lien low brochure will be delivered to the person
-- -- -whose-property►fssnbJe�-Eo�ttochmer�—�4/so,-mcert�red�apYaf�h aft�ltrn�rrcelller�i^mv37'1�p�i'ed'�'tife�ob"sPle
for the first inspection which occurs seven (7J days r the building permit Is issued. In the absence'af such posted notice, the
inspection will not b o m and a reinspectionwe wig be charged.
Signature Signatur
OWNER or AGENT CONTRACTOR
The foregoing Instrument was acknowledged before me this +fogoilngnstrument waseacknowledged before me this
ay of .20 byof ./ 24 ,by
who is personally known to C who is personally known to
me or who has produced as me or who has produced as
)dentiflcation and who did take an oath. Identification and who did take an oath.
NOTARY PUB NOTARY PUBLIC:
Sign: 1 Sign: �+
Prim. S C Z Print: K / L
Seat: Seal:
JOSE 4ItGM DE LA CRl1Z
•: : W COWASSIQN i FF 016157
p�., J0 _ EXPIRES:May 12,2017
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APPR Plans Examiner Zoning
Structural Review Clerk
(RMISed0424n014)