EL-17-2690Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
1441 NE 102 Street
Miami Shores, FL
Pe
'mit
Permit ivo. EL -11-17-2690
Permit Type: Electrical - Residential
Work Classification: Addition/Alteration
Permit Status::APPROVED
Issue Date: 11/22/2017
Expiration: 05/21/2018
Parcel Number
1132050240170
Block: Lot:
Applicant
SUSAN & WILLIAM HOWELL
Owner Information
Address
1441 NE 102 Street
MIAMI SHORES FL 33138-2621
Phone
CeII
Contractor(s)
ELECTRICAL SERVICES JC INC
Phone
(305)244-8628
CeII Phone
Valuation:
Total Sq Feet:
$ 500.00
0
Type of Work: GUEST BATHROOM REPLACE IN SAME LOCA
Additional Info: GUEST BATHROOM REPLACE IN SAME LOCA
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.25
$2.00
$0.20
$150.00
$3.00
$0.80
$158.85
Pay Date Pay Type
Invoice # EL -11-17-65632
11/13/2017 Credit Card
11/22/2017 Credit Card
Amt Paid Amt Due
$ 50.00 $ 108.85
$ 108.85 $ 0.00
Available Inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
W. W.
Underground
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--ttt .II wor ill be
construction and zoning. Futhermore, I authorize the above-named cgptr�s�• •o the •rk shed.
Authorized Signature: Owner / Applicant / Con
Building Department Copy
gent
mpliance with all applicable laws regulating
ovember 22, 2017
Date
November 22, 2017
1
BUILDING
Miami Shores Village
_. -Building Department -
—10050 N.E.2nd Avenue, Miami Shores, Florida 33138'
__. - . Tel: (305) 795-2204 Fax: (305) 756-8972 _ 4` 1 r _
INSPECTION LINE PHONE NUMBER: (305) 762-4949
PERMIT APPLICATION
4 'i .../ :e r
BUILDING ELECTRIC ,; •q.
[PLUMBING 0 MECHANICAL
JOB ADDRESS: 1441 NE 1.02. Street
as t -e
0 , ROOFING..
RECEIVED
NOV 1 3 7017
FBC.20 4 -
Master
Master Permit No. RC (1 ZO I T
Sub Permit No.6 i� 0 q0
l i U-7
tel'. 3 ,'}! L, `, ,,. it
REVISION- • ❑;EXTENSION- QRENEWAL
a. Ns r
❑PUBLIC WORKS ❑ CHANGE OF Q CANCELLATION ❑ SHOP 41' ."
CONTRACTOR DRAWINGS.
r. -' 11 1 ,, k , •4- r..
City .• -.. Miami Shores .. County: — - Miami Dade • • - =.Zip: p. w -- - . 1
Folio/Parcel# 1,1-3205-024=0170 ` , „ r, ,- • t-Isthe Building Historically Designated: Yes • -NO X ,, r
Occupancy Type: - Y s- - Load., t /Construction Type: +ar -".:"1 Flood Zone: s -t' ` BEE:- In,FEE: 3, 0^- .r, T
OWNER: Name (Fee Simple Titleholder): William Howell
Address:1441 NE 102 Street ,
Phaine#.
t_ l
City: MiamiShores
Tenarit/Lessee Name:
State:'Flolida
J-6 T
Email: �� to . ..r,\
•
Zip:'33138
Phone#:
CONTRACTOR: Company Naea—me:.. vGUI �'+� *SC
c6t0.1 Su'u`� �l o;2f- Atit•
%6rv► cro
Address:
Phone#:
Ps* a-Vg862 °
City: ■t MN% i l 1 State:
rn
Qualifier Name: v VAfi fd3f T` `
�" zips ,3316$,
Phone#: ��S.) el -g9 g4.28
State Certcation or Registration #: t r p y Certificate of Competency #:
p
DESIGNER: Achitect/Engineer: . Phone#:
•
a
Address: City: ' - State: Zip:
Value of Work for thii
Square/Linear Footage of Work:
Typye of }Work: ,rO AdditionJ� � F Alteration ❑ New ❑■ Repair/Replace 0 Demolitions
t�' a .. ,. } i a 34 NO f• _ 4
Description, of Work Guest Bathroom,_,Replace in same location ectrical fixtures,
�`�f'w v_�'W �f�.�MfiK%�l�R'�QSI�•?ha'.�.'Sy1Mldi.w:o -
Specify color of color thru tile:
a9c).!y}1lI'i'r7a.301,-.00 •t'.•••,
h
Permit Fee $ /5769 r D a
Submittal Fee $ CCF $
DBP!2• 2-`D -Notary$
Technology Fee $ Training/Education Fee $ Double Fee $
Scanning Fee $ Radon Fee $ 2. W
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ ,� •
(Reyised02/24/2O14)
•t
Bonding Company's Name (if applicable) - -- -
Bonding Company's'Address
City
State
Mortgage Lender's Name (if applicable)
.A �r
Mortgage Lender's Address' -
City • •
. :— Zip
State r� Zip :
t,t ,fra `;S.
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. performmed'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..... , ,,c , is ?, c. ,# - r,- Ili '
OWNER'S AFFIDAVIT: I certify that all the foregoinglinformation 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 OBTAINFINANCING, CONSULT WITH YOUR LENDER OR'ANATTORNEY BEFORE -RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: Asa condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith'thata 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 • I • Ill ved anda reinspection fee will be charged.
0 17
Signature
ed
e1ore me this
Signature %'
.�1 CONTRACTOR
The foregoing instrumgnt • was ac o i c)ged before me this
� 20. ,by ("2'3- data! i e T ,20 J by
who iisnpelI p nail f knownn tt oo - .)GA I I Tilt , who is personally known to
-: m
1 e or who has produced et; 1 c3'I' 4 "t51 -0
me or who has produced / -/
identification and who did take an
NOT
Si
iaen-tifTcation and Who did tale an Oath-.
Print:
Sea l:e��"."•'.1: % CHANDRA L N TAYLOR
* MY COMMISSION f FF 192031
EXPIRES: March 16, 2019
."1.
11,0
4 �de`Oe Bonded Tiuu Budget Notary SeMces
NOTARY PUBLi
.i .J
c
Sign:
•
Print:
Seal:
i9fr
APPROVED BY 1,/,,,,f �. /`� �4d 7 l ( Plans Examiner - 4 Zoning
Structural Review
(Revised02/24/2014)
Clerk