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EL-16-1177 Permit No. EL-5-16-1177 Miami Shores Village Permit Type:Electrical -Residential 10050 N.E.2nd Avenue N ' Work Classification:Addition/Alteration Miami Shores,FL 33138-0000 Pen Permit Status:APPROVED hF' Phone: (305)795-2204 LORIDA Issue Date:5/6/2016 Fxpiration: 11/0212016 Project Address Parcel Number Applicant 9301 N BAYSHORE Drive 1132050270560 GUY&SELIN KURLANDSKI Miami Shores, FL Block: Lot: Owner Information Address Phone Cell GUY&SELIN KURLANDSKI 9301 N BAYSHORE Drive MIAMI SHORES FL 33138- 15811 COLLINS Avenue SUNNY ISLES FL 33160- Contractor(s) Phone Cell Phone Valuation: $ 33,480.00 FUSE ELECTRICAL INC (305)970-4379 .� n...,. _..... ....w. a... ... ..,,. Total Scl Feet: 1000 Type of Work:REPLACE AND ADD OUTLETS AS PER PLAN Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning: 1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $20.40 Invoice# EL-5-16-59609 DBPR Fee $17.58 DCA Fee $17.58 05/02/2016 Check#:7866 $50.00 $ 1,214.56 Education Surcharge $6.80 05/06/2016 Check#:7901 $ 1,214.56 $0.00 PermitFee-Additions/Alterations $1,172.00 Scanning Fee $3.00 Technology Fee $27.20 Total: $1,264.56 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 i be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-named contractor to dot works t . May 06, 2016 Authorized Signature:Owner / Applicant / Contractor / AgWn Date Building Department Copy May 06, 2016 1 • r Miami Shores Villagec - Building Department MAY 0`2 2010 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 gY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 7� FBC 2014 BUILDING Master Permit No.F-\Qj5 V 3 29 PERMIT APPLICATION Sub Permit No. E1-1G--j ❑BUILDING q ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING Ej MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP /�2 i- CONTRACTOR DRAWINGS JOB ADDRESS: -I J() (� S Yl Di( City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11 ' 51S- 017 C)5(20 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE:: FFE: OWNER: Name(Fee Simple Titleholder):�1 U LOf 1CIAAd SK-► Phone# �:-? 1 b3 Address: P�30 1 N- T)_�(' City: i CkkA St1DState: F1, Zip: 33)-3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: tf 2 (C a cky-I C' 7--rn Phone#: 97© " Address: q 9 5b —,D7 City:-f"'v(( lA[1 D0(A State: �� Zip: 233 ©Z Qualifier Name: L-1 2m y1 �o-,? 1 a v--\ Phone#: ?)()'6 - �1�7� " qa) State Certification or Registration#: F_G- /Sinn5�6-7® Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for rtthis Permit:$ �_ Square/Linear Footage of Work: sP Type of Work: LJ AdditionAlteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: � lG t�'� �I 009c CJd l I�Q0 Specify colorofcolor thru tile: � Submittal Fee$ ) Permit Fee$ � `Od CCF$ 'DO , 4 co/cc$ Scanning Fee$ �J `0�3 Radon Fee$ ( 1 ' DBPRR$ 1 -�t' - -93 Notary$ Technology Fee$ �� - a� Training/Education Fee$ b` 63 Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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 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 he absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature S Signature IVER or'AGE T� V�NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrumentwasacknowledged before/me this day of 20 6 by ��day ofd, yN 9 20 t Ln by / who is personally known to J(11h\4-\ ,'A5�-1,V ,who is personally known to T4s who has produced as me or who has produced as b `Sl; ification and who did take an oath. identification and who did take an oath. x MOI kRY PUBLIC: NOTARY PUBLIC: - +-oo> 2 M r— r Cn C C n Sign: _.Zco Wr4I1 W G' Print: y "� tip:• ,o'..,.A ^n. YCi; iY PERAZA `°deal = 11YQ�iINl^ -r,: } Seal: WCOMMISSION ++E_7tn27b a EXPIRES Jung 21. 2016 BW*d Thu; w wwMwiMa (407):Ui t:153 Fnr:parl-)!ir Scrwc.e.cortn APPROVED BYS1 ! Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)