ELC-17-1152 � ;ro 162
Miami
Miami Shores Village Pet 4 T)o wec' 081 coC�FrtierGlal
10050 N.E.2nd Avenue NE WorkCtao AddItion/.Attiration
Miami Shores,FL 33138-0000 � � Bl71�i P PROV
�eN � Phone: (305)795-2204 status:AP
FLORIO
'IDII'
51112017 Expiration: 10/28/2017
77
Project Address Parcel Number Applicant
9022 NE 8 Avenue Number: 2Q 1132060420370
HAYDEE RAMIREZ
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
LHAYDE.ERAMIREZ 9022 NE 8 Avenue
MIAMI SHORES FL 33138-
9022 NE 8 Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: _ $ 900.00 ..._..._ _
MAX ELECTRIC CORPORATION (305)498-5422 (786)277-6278
Total Sq Feet: 0
Type of Work:CHANGE PANEL 100 AMP Available Inspections:
Additional Info:CHANGE PANEL 100 AMP Inspection Type:
Classification:Commercial 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# ELC-4-17-63823
DBPR Fee $2.25 04/26/2017 Credit Card $50.00 $109.10
DCA Fee $2.25
Education Surcharge $0.20 05/01/2017 Credit Card $ 109.10 $0.00
Permit Fee $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: rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. thermore,I authorize the above-named contractor to do the work stated.
May 01,2017
Authorized re:Owner / Applicant / Contractor / Agent Date
Building Department Copy
May 01,2017 1
Miami Shores Village RECEIVED
Building Department pR 67017
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC 200
BUILDING Master Permit No.
PERMIT AP=ON Sub Permit No.
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: ci0 Z Z wa 2 - a
City: Miami Shores County: Miami Dade Zip: 331 a.
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): ��Ay D Le 12&X-A` Phone#:
Address: C4o4w+►0 2 t-3C S &.3L
City: � �koQ g S State: Zip:
Tenant/Lessee Name: Phone#:
Email: � 4 .4 CONTRACTOR:Company Name: Phone#:
Address: gG zG S kc.E- �••. �{
City: State: Zip: 33l SJR
Qualifier Name: Phone#:
State Certification or Registration M 1l94�e. Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: �I�n .k-1 i�Yna�l- 1.00 4.
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ jF'2*1 40 464 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 approved and a reinspection fee will be charged.
Signature `N Signature
OWN ROrAGENT NTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument wast acknowledged before me this
2 S ay of r A. 20 %' ,by ZS day of —` - 20 kq ,by
who is personally known to L' who is personally known to
me or who has produced n2_54-f0/ 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:
Sign: Sign:
Print: a Munoz Print:
17""' Olga Prdia rAuMz
Seal " s10'dFF037B31
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EXPIRES:JULY 21,2017
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•AAP,ONNOTARY.cvm 'EX°IBES:JULY 21,2017
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shares CondanflWum Amclation, Inc
June 16,20-17
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