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EL-17-703Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. EL -3-17-703 Permit Type: Electrical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 4/3/2017 Expiration: 09/30/2017 Parcel Number Applicant Owner Information PABLO NUTA Address 77 NE 95 Street MIAMI SHORES FL 33138-2706 77 NE 95 Street MIAMI SHORES FL 33138-2706 Contractor(s) Phone Cell Phone FOSTER & SON ELECTRICAL CONTR (305)644-5869 ()_ Phone Cell Valuation: Total Sq Feet: $ 800.00 0 Type of Work: ELECTRICAL WORK GARAGE CONVERSION Additional Info: ELECTRICAL WORK GARAGE CONVERSION Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Work without Permit Fee Total: Amount $0.60 $3.38 $3.38 $0.20 $225.00 $3.00 $0.80 $225.00 $461.36 Pay Date Pay Type Invoice # EL -3-17-63324 04/03/2017 Check #: 187 03/16/2017 Check #: 992 Amt Paid Amt Due $ 411.36 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W. W. 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. April 03, 2017 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date April 03, 2017 1 r BUILDING PERMIT APPLICATION 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 MAR 15 2017 FBC 20 Master Permit No. k 1 , - -> Sub Permit No. E l I ' ' /05 ❑ BUILDING f ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11 14 e al City: Miami Shores Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: County: Miami Dade Zip: 7j 315 O OWNER: Name (Fee Simple Titleholder): --?t-'C•\, R*.Phone#: Za 2 7 a Address: —7 Z R-1- 9 - Sit City: A P -. ). i, State: 1p 9--e* Tenant/Lessee Name: Phone#: Email: Zip: \30 CONTRACTOR: Company Name:�bJ.p) ASO 1.l 14Z--C1146/1-- Address: `Z 4-ci i,tVCl 3 6-01:-vr" Phone#: (3) • *31`'�� City: t-/111>,MI State: '"Fl -'0 'DA` Qualifier Name: S -c L Zip: 33121 Phone#: (3) 3 ti -S- • 134 - State Certification or Registration #: 00151 440 Certificate of Competency #: 1 1 OcX 9 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: tyalu foe foe Wo'rk:for:this•Permit:.$. Type of Work: ❑ Addition ❑ Alteration Square/Linear Footage of Work: pi New Description of Work: dsro 1V201J ❑ Repair/Replace ❑ Demolition r . Specify color of color thru tile: Submittal Fee $ Permit Fee $ Z7-3_ ✓rG1ma CCF $4- 0r' "' CO/CC$ " Scanning Fee $ Radon Fee $ DBPR $ • •".6 Notary $...• r r .. Technology Fee $ • -O Training/Education Fee $ - 2_ a Double Fee $ 2- Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ _ U. (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 appr.�ed and a reinspection f will be charged. t11 /// r Signature / g �`-) �� Signature (�� _/� ' WNER-or A / ANTRA ' � R The foregoing instr 1.1 -I was acknowledged before me this The foregoing instrument was acknowledged before me this S day of V /act C -6S , 20 rl , by � S day of t'k iL.2C , 20 \ Z , by t� , who is personally known to : ©Veva t -c V'a_a_ , who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. NO UBL'IC: Sig Print: Seal: FERNANDO ARIAS JR Notary Public - State of Florida • My Comm. Expires May 19. 2018 ,� ; Commission # FF 106782 APPROVED BY (Revised02/24/2014) identification and who did take an oath. NOTARY PUBLIC: Si Print: Seal: a' FER •O AR AS JR E* PW110 , 11-Fil My Comm. Expires May 19, 2018 ; OF f�P' Commission # FF 106782 24"A -r/ -/L ,V Plans Examiner Zoning Structural Review Clerk