EL-17-297 ,
r
Permit AfO. EL-2-17-2,9'
Miami Shores Village P€It'l0#Type I lemic ) Rest O)"', d(
p 10050 N.E.2nd Avenue NE " IrkCja5zsiaticditili�Alterorl
Miami Shores,FL 33138- r0000 Permi �� �!RC3tlED
Bio Phone: (305)795-2204
it
issue2/712017 Expiration: 06/06/2017
Project Address Parcel Number Applicant
1036 NE 95 Street 1132050120060
Miami Shores, FL 33138- Block: Lot: DANIEL JORGE AGUTAR
Owner Information Address Phone Cell
DANIEL JORGE AGUTAR 1036 NE 95 Street (786)797-4041
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 750.00
YD TECH INC (305)525-2355
..... _, _......_... . .. Total Sq Feet: 0
Type of Work:REPLACE OUTLETS CONNECT LIGHTS INST Available Inspections:
Additional Info:REPLACE OUTLETS CONNECT LIGHTS INST 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 $0.60 Invoice# EL-2-17-62845
DBPR Fee $2.25 02/06/2017 Credit Card $50.00 $109.10
DCA Fee $2.25
Education Surcharge $0.20 02/07/2017 Credit Card $ 109.10 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
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.
February 07, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 07,2017 1
t Miami Shores Village ` ' �-
FEB 6 2017
Building Department
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 20VA
BUILDING Master Permit No. 17- 0
PERMIT APPLICATION Sub Permit No. El I--'� Z-0
❑BUILDING [4 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING F] MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: q 5✓
City Miami Shores County: Miami Dade Zip: ��)
Folio/Parcel#: 3 u s--®1 Z "CSO(PIS Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): P20-1i eI ,A,.oy Phone#: 7856'21 —g01A
Address:(t-,-10 B b NE 4511 SVS"
City: s6/e.S State: Zip: '3313 $
Tenant/Lessee Name: Phone#:
Email: _\14) �` �r�
CONTRACTOR:Company Name: " �"" s� n c Phone#:
Address: C4)
City: State: Zip:
Qualifier Name: `75 Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State Zip:
Value of Work for this Permit:$ 7 5b Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work: �'�Q Qo a hth 1' -�� v
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ 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 the absence of such posted notice, the
inspection will not be ap ed and a reinspection fee will be charged.
I
Signature � �" Signature
OW ER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
daLofLI
1 20��by 30� day of C^tk 20 n by
01 who is aersonally known to V&C who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
PL
Sign: Sign: „u,n, T PHER COSTAS
42Print: 4 N to of Florida Print: 4 Y 1 - t e of Florkla
_• Commission 0 FF 954327 = c tdty Comm.Expires Apr 8,2020
Seal: Seal:
��. My,Comm.Expires Apr 8,2020 ••'` S to h NowatNol&y
" u'�;• ` B=M throtto Nel0naFlatary Assn.
APPROVED BY Co lc �/ �' Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)