ELC-17-945 Miami Shores VillagePellr mwt
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�,►� 10050 N.E.2nd Avenue NW WorkClassIficatton LOW VoltaOO
Miami Shores,FL 33138-0000 PerMft Status:APPROVED
Phone: (305)795-2204
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Iss that 41111,2017 Expiration: 10/08/2017
Project Address Parcel Number Applicant
320 NW 115 Street Number: CENTER FOR C 1121360000060 BARRY UNIVERSITY
Miami Shores, FL 33138-0000 Block: Lot:
Owner Information Address Phone Cell
BARRY UNIVERSITY 190 NW 111 Street
MIAMI SHORES FL 33168-
Contractor(s) Phone Cell Phone Valuation: $ 4,000.00
TIRONE ELECTRIC INC (954)989-7162 Total Sq Feet: p
Type of Work:RELOCATION OF DATA OUTLET TO PODIUM Available Inspections:
Additional Info: Inspection Type:
Classification:Commercial
Review Electrical
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40 Invoice# ELC-4-17-63588
DBPR Fee $2.25 04/05/2017 Credit Card $50.00 $ 113.90
DCA Fee $2.25
Education Surcharge $0.80 04/11/2017 Credit Card $ 113.90 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $3.20
Total: $163.90
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 t he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning ut authorize the above-named contractor to do the work stated.
April 11, 2017
Aut orized ignature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
April 11,2017 1
��xt Miami Shores Village
16-4816 Building Department RECEIVED
IWO 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax: (305)756.8972 APR 0 5 1017
INSPECTION'S PHONE NUMBER: (305)762.4949
FBC 2014��
BUILDING Permit No. f CC`i "01TS
PERMIT APPLICATION Master Permit No.
Permit Type: Low <20 Voltage /r y,
3�v d -Podiatry Rm 107 �n " CoaMzo_& 1_2_
JOB ADDRESS: E � l �
City: Miami Shores County: Miami Dade Zip: 33161
Folio/Parcel#: 1121360010160-09
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder):BARRY__UNIVERSITY INC Phone#:
Address: 11300 NE 2 AVENUE
City: MIAMI SHORES State: FL Zip: 33161
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: TIRONE ELECTRIC INC Phone#: 954-989-7162
Address: 6151 PEMBROKE ROAD
City: HOLLYWOOD State: FL Zip: 33023
Qualifier Name: CURTISS MORGAN Phone#: 954-989-7162
State Certification or Registration#: EC0003059 Certificate of Competency#:
Contact Phone#: 954-989-7162 Email Address: CWMORGAN@TIRONE-ELECTRIC.COM
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $4,000.00 Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: RELOCATION OF DATA-OUTLET TO PODIUM
�x����xxxxxx:u�xxxx�xx�x�xx�x��x���xxx�:�Fees�xxx�x�xx�xx:xxx�xxx�xxxx�xxx������:��x:x���x�x
Submittal Fee$ c� Permit Fee$ l S-0 d CCF.$ 0 CO/CC$
Scanning Fee$ J Radon Fee$ � � DBPR$ a ' C Bond$
Notary$ Training/Education Fee$()—Technology Fee$ J
Double Fee$ Structural Review$ _
TOTAL FEE NOW DUE$ CI®
16
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 ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 Signatur
Owner or Agent Contracto
The foregoing instrument was acknowledged
pbefore
',m�e1this _ ' The foregoing instrument was acknowledged before me this 29
day of 2 U ,20 Q,by � KU,brV l ALJ , day of MARCH ,20 17 ,by CURTISS MORGAN
whg is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
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Sign: T Sign:
Print: .J Print: HILARY
...
ry e�=`: HILARY CLEMENTS
My Commission Expires:If,I2. a Jeffry J Yeo My Commissio ` x s:,
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My Commission FF 188481 s ori MY COMMISSION#FF038541
�ijaadtP Expires 1111212018 '9.'EOFr°P` EXPIRES July 22,2017
=071398.0153 Flor1dallotaryService.com
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APPROVED BY `G ��z J--A-7A
_/PPlans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
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