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EL-16-2558 Permit No. EL-9-16-2658 Miami Shores Village Permit Type:Electrical-Residential 10050 N.E.2nd Avenue NW ' Work Classification:Low Voltage Miami Shores,FL 3313&0000 Permit Status:APPROVED F^. ,,,• Phone: (305)795-2204 FXOR11D Issue Date:9122/2016 Expiration: 03/21/2017 Project Address Parcel Number Applicant 10616 NW 2 Avenue 1121360020060 Miami Shores, FL 33150- Block: Lot: CRISTINA CRUZ ESCALONA Owner Information Address Phone Cell CRISTINA CRUZ ESCALONA 619 E CROSBY Avenue EL PASO TX 79902- 619 E CROSBY Avenue EL PASO TX 79902- Contractor(s) Phone Cell Phone Valuation: $ 150.00 DANCE ELECTRIC INC (954)236-8824 Total Sq Feet: 0 Type of Work:LOW VOLTAGE FOR SFR RENOVATION 3 PH Available Inspections: Additional Info:LOW VOLTAGE FOR SFR RENOVATION 3 PH Inspection Type: Classification:Residential Review Electrical Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-9-16-61362 DBPR Fee $2.00 DCA Fee $2.00 09/16/2016 Credit Card $50.00 $63.60 Education Surcharge $0.20 09/22/2016 Credit Card $63.60 $0.00 Notary F e $5.00 PermitFee�-Additions/Alterations $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total:.:_:; $113.60 r. a` r r� 4 � r�l S 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.ttiis permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required f&ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFF AVIT: I c rti that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction' zo ng. t rmore,I authorize the above-named contractor to do the work stated. w t, September 22, 2016 Authorized S' nature:Owner / Applicant Contracto / Agent Date Building Department Copy September 22, 2016 1 Miami Shores Village g r .D L� � 1 Building Department 4SEP6 2016 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 $Y INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 - V BUILDING Master Permit No. P PERMIT APPLICATION Sub Permit No. f,L 9—16 -2 g ❑BUILDING ECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP / /� CONTRACTOR DRAWINGS JOB ADDRESS: l 0Gl4 AlW 2 '"9y< City: Miami Shores/ County: Miami Dade Zip: .73�3d� Folio/Parcel#:T� �, �- b Cn Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type:/ Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): C rid/' ��u2 Gros Phone#: Address: 6'15 ' -T 1 / L Closl 4f City: �� 4-J, State: / eX--,f Zip: Tenant/Lessee Name: Phone#: Email: �- CONTRACTOR:Company Name: � �'N�76 � y`�� V�C.: Phone#: Address: City: �' Cv L� State: \ Zip: Qualifier Name: ��L. Phone#:(9) 234q,&&2�1 State Certification or Registration M E4_�0CD©CD � ] Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ CSy Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration EJNew ❑ Repair/Replace ❑ Demolition Description of Work: LC V'dLThS e i�o2. �c�V��l afta Specify color of color thru tile: ,s 2!n+aX3 r.R10 i Y'1 4�Alcmmo; r,( Submittal Fee$ Permit Fee$ /��d 'dam CCF$ ME Scanning Fee$3 � Radon Fee$ �� DBPR$ hjt$ TechnologyFee$ Q - Training/Education Fee$ •�� '� '��` Old? "�Q°q yr'au+ 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 the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature CASignature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this / day of SP A.,5e✓ 20 16 by / 6'dayof � r-� eM)0 20 by who is personally known to PayL -N . 1 TJC�K��.who is personally known to me or who has produced 0&- as me or who has produced n HV'2,Y as identification and who did take an oath. identification and who did tak n oath. NOTARY PUBLIC: NOTARY P LIC: Sign: Sign: 0 Print. �- \ �� Print: Seal: � • OEM APO, h '.`�� Notary Public•Stai: Seal: YANADYPRIEfO Y �°Y,�'• sa... - My Comm.Exorn Mei :° MY COMMISSION#FF 214031 P' Com iaon I ff 02, F , EXPIRES:March 25,2013 _ 9 Bonded Thru Notary Public Underwriters, DEBBIE APOLMMIO /� / v1Notary Public•State of v Plans Examiner Zoning My Comm.Expires May 27,2611 Commission N FF 021536 Structural Review Clerk (Revised02/24/2014)