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EL-16-1062Project Address Miami Shores Village 10050 N.E. 2nd Avenue N Miami Shores, FL 33138-0000 Phone: (305)795-2204 9290 N BAYSHORE Drive Miami Shores, FL 33138- Owner Information Permit Permit NO. EL -4-16-1062 Permit Type: Electrical - Residential Work Classification: Low Voltage Permit Status: APPROVED Issue Date: 5/3/2016 Expiration: 10/30/2016 Address Parcel Number 1132050270240 Block: Lot: 9290 N BAYSHORE Drive MIAMI SHORES FL 33138-2949 9290 N BAYSHORE Drive MIAMI SHORES FL 33138-2949 Applicant RICKI LONDON Phone CeII Contractor(s) Phone CeII Phone UNITED ELECTRICAL SERVICES INC (786)797-2188 Valuation: Total Sq Feet: $ 500.00 0 Type of Work: LOW VOLTAGE, TV, ANTENA Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Feed Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $150.00 $3.00 $0.80 $159.10 Pay Date Pay Type Invoice # EL -4-16-59475 05/03/2016 Check #: 824 04/20/2016 Credit Card Amt Paid Amt Due $ 109.10 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Review Electrical 1 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 pertainingthereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting pis permit I assume resp nsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMB G, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS; AFFIDAVIT: I certi that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furmore, J authorize the above-named contractor to do the work stated. Authorized S' nature: Owner / Applicant / Contractor / Agent Building epartment Copy May 03, 2016 Date May 03, 2016 1 (do (26‘‘o 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 BUILDING PERMIT APPLICATION ❑ BUILDING ELECTRIC ❑ ROOFING ❑ REVISION PRCRII APR 2 0 2016 ICY• 41 F BC 2014 �, Master Permit No.rP---C- 15 - ?-D Sub Permit No. PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: Z I V ON City: Miami Shores 0r, County: Miami Dade ELi CP - ic*2 ❑ EXTENSION ❑ RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS Zip: 7f)1:3 Folio/Parcel#: Is the Building Historically Designated: Yes NO V Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): j,LV.il I t AkaLUI Phone#: '1 O i Ga3 141,4 Address: Q 0(1'3 ,v f2D UW04`e... 0I' i "- City:iC. 51,\W -t. I State: R Zip: 33 L-5 r Tenant/Lessee Name: i .` ter,, Phone#: Email: () CIkt 3 1/tctivi Q el/ILcutA/N en -1- F (bct s. cum CONTRACTOR: Company Name: Address: Aid 24. c-/ 3 /� City: /5'v-/6-s7eaci Qualifier Name:Ao1/UO'/ tin,/To l7 Z /mc c r/ ge-uft «I Tod /as-- C State: L426frCt 2-"i( Phone#: 7K4 — 7j??- 2 //i State Certification or Registration #: /.a 0 ' /6 a," DESIGNER: Architect/Engineer: 786 - 9 zip: 33°3 � Phone#: 7f6 --?'7- 2/81 Certificate of Competency #: /2 Lr Decof9 /90 Phone#: State: Zip: Address: City: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Description of Work: 1,0k.) ie --N) t Qt, Noe ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ 0 Permit Fee $ 44 ©,PO Scanning Fee $ '� ' �y Radon Fee $ -' Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ GG coiccs DBPR $ • Notary $ Double Fee $ 0-!O Bond $ 0 TOTAL FEE NOW DUE$ L' ding 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. Signatur� ` C�5 I C\S J'tk V ,( Signature �--� OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 620 day of l 2Y .\ ,20LLD , by /7 day of olf% i/ ,20 fro by c ('i'• Lc AA 01 J who is personall known to 7`?.4-irvon / d cro , who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Sign: Print: Seal: PRIFT ci: EXPIRES February 21, 2017 (407)3;8-0153 Floridallota Service com ************************************************************************************************************ APPROVED BY (Revised02/24/2014) aze,Ar ti Plans Examiner Zoning Structural Review Clerk