EL-16-1143Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
1208 NE 95 Street
Miami Shores, FL
Parcel Number
1132060144100
Block: Lot:
Applicant
PEDRO DE MELLO
Owner Information
PEDRO DE MELLO
Address
1208 NE 95 Street
MIAMI SHORES FL 33138-
1208 NE 95 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone
SS POWER & LIGHT ELECTRIC INC (305)607-5636
Cell Phone
Phone
(305)753-5504
CeII
Valuation:
Total Sq Feet:
$ 800.00
0
Type of Work: LOW VOLTAGE TV AND TELEPHONE
Additional Info:
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.25
$2.25
$0.20
$150.00
$9.00
$0.80
$165.10
Pay Date Pay Type
Invoice # EL -4-16-59572
05/03/2016 Credit Card
Amt Paid Amt Due
$ 165.10 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Electrical
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. Futhe u - - r above-named contractor to do the work stated.
ignature:Owner / Applicant / Contractor / Agent
Building Department Copy
May 03, 2016
Date
May 03, 2016 1
Miami Shores Village
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 201'1.51
BUILDING Master Permit No. ri -- 647r'
PERMIT APPLICATION Sub Permit No. — I 14
❑ BUILDING ) ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING L MECHANICAL DPUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /2 D 8 %IC 61S-
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): PeJYV GI( P`'ii✓JL
Address: / ®ir /11t: /rill kr
Phone#: Sof - 7 r3 SSD y
City: frvU API/Lt S'1,VD✓LS State: Pi- Zip: 3 3
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
Address: -) `h (g Sw VT
Phone#:
Phone#: .30.rofl7 s423c
City: U-4.1' 6 _�14�.^-^ State: � Zip: 331 Yr
Qualifier Name: l A.0.41 1 D� I-9-rtPhone#:
State Certification or Registration #: E - (3 b 031 r) Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#: 3 °S 24 4 D(, %
State: Zip:
Address: City:
Value of Work for this Permit: $ 5300°L)
— Square/Linear Footage of Work:
Type of Work: ❑ Addition/r4 Alteration ❑ New ❑ Repair/Replace
Description of Work: L0 '10 I -U & CT' -t.tk P koui ?e
❑ Demolition
Specify color of color , u tile:
Submittal Fee $ 1 Permit Fee $ /,Sec &''c' CCF $ • coicc $
Scanning Fee $ Radon Fee $ 2 - DBPR $ 2. 29 Notary $
Technology Fee $ 0 ' 2 0 Training/Education Fee $ 2-® Double Fee $ Y6
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE$ 66 (5
•
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 oftherecorded notice of commencement must be posted at the job5ite
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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 1 .p
e.Avt. ae McX`o
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
,20 lL ,by OSA day of lL
to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
c5,
Print: ! urs
P`;;;Ik CLARA E RODRIGUEZ
MY COMMISSION #FF138588
"''•'�ocw.:,` EXPIRES July 5, 2018
(407'•.• .1 ,r
.111
go"/6
Plans Examiner
Seal:
***********
APPROVED BY
(Revised02/24/2014)
, who is
me or who has produced PIdso ".
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
cZ-
,20
°,(._ 8 .
by
to
as
Structural Review
CLARA E RODRIGUEZ
ۥ )*I MY COMMISSION #FF138588
„i / EXPIRES July 5, 201a,
(407) 398.0153 FloridallotarySerViCe.COm
aa......e**********************************
Zoning
Clerk