REV-17-1148 Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 APR 6 2017
Tel: (305)795.2204 Fax: (305)756.8972
INSPECTION'S PHONE NUMBER: (305)762.4949 BY:-0_ _0-VL'_
FBC 20
BUILDING Permit No. F_LC.-1
PERMIT APPLICATION Master Permit No` P)TV n - o 4 s,
Permit Type: Electrical
JOB ADDRESS: 11300 NE 2 AVENUE 0) p
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:
I
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: $ Square/Linear Footage of Work: �s
Type of Work: ❑Address Iteration ❑New ❑Repair/Replace ❑Demolitioon
Description of Work: _ 1 1 l� �h��� 1'a -vt-/ Un PT S
� • f
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ '��
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 of be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Con ctor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 17th
day of A L 20 fl by %5-AN M-MOA L— day of April 2p17 by CURTISS MORGAN
who 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. 17 as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUIL ,�:Y°�4; HILARY CLEMENTS
'c c
MY COMMISSION#FF038541
o? PIRES July 22.2017
Sign: Sign:
Print: YAO Print: HILARY CI ENTS
My Commission AP &N Notary Public State or Flodds My Commission Expires:
Jeffry J Yao
MY Commission FF 188481
or Expires 11/1212018
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)