EL-07-2016 Permit NO. EL-8-17-2016
Miami Shores Village Permit Type:Electrical-Residential
10050 N.E.2nd Avenue NE
'Perill� wok Classification:Alteration
Miami Shores,FL 33138-0000 Permit Status:APPROVED
Phone: (305)795-2204
FCORtOp'
issue date:8/10/2017 Expiration: 02/06/2018
Project Address Parcel Number Applicant
9929 NE 4 Avenue Road 1132060171280
Miami Shores, FL 33138- Block: Lot: MARVIN R LIST&MARIA T MAN
Owner Information Address Phone Cell
MARVIN R LIST&MARIA T MANERBA 9929 NE 4 AVE Road (305)858-0204
— — -- - — —- --- MIAMI SHORES FL 33138-
9929 NE 4 AVE Road
MIAMI SHORES FL 33138-
1
Contractors) Phone Cell Phone
NOVOA ELECTRICAL CONTRACTOR (786)287-4220 Valuation: =5,200.00(305)824-2858Total Sq Fee
Type of Work:AS PER PLANS ELECTRICAL FOR ALTERAT Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Review Electrical
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $3.60
DBPR Fee Invoice# EL-8-17-64822
$3.38 08/09/2017 Credit Card $50.00 $200.36
DCA Fee $3.38
Education Surcharge $1.20 08/10/2017 Credit Card $200.36 $0.00
Permit Fee-Additions/Alterations $225.00
Scanning Fee $9.00
Technology Fee $4.80
Total: $250.36
i
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS, DOORS,ROOFING and SWIMMING POOL work. I
OWNERS AFF : I erti all foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructi d zoni .
=Ce the above-named contractor to do the work stated.
August 10, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
August 10, 2017 1
Miami Shores Village
RECEIVE-Q°'
o� Building Department
AUG 0 9 2017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit N -7_ 2$'9
PERMIT APPLICATION Sub Permit No. � L 1'- 201 So
❑BUILDING 0-rLECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
p (J,� CONTRACTOR DRAWINGS
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JOB ADDRESS: '[ �" ( �� L ^ -Ayle i�—� (, I
City: Miami Shores County: Miami Dade Zip: 7 3 ID g
Folio/Parcel#: t Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): Ay-Ay 1 h L ils+ Phone#: `fy q A(n T`o�
Address: 5IR (; 14 T�a
City: % CA UA fL State: lt-1 Zip: 3
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company',Name: CIAodbol, KG ' l Phone#:
Address:
City: State: A Zip: p
Qualifier Name: sem; O l�0 . /- n(/�, - Phone#: "q 75'!3S g
�— C' 771
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State Certification or Registration M-66 1 SO 6 7 7, Certificate of Competency#:
DESIGNER:Architect/Engineer: Feu k��(Aa l�Je�CI! Phone#:
Address: 3 7�LK. C'`Z.S, _ City: OAMW State-F L Zip:
Value of Work for
this Permit:$_ ������� 7"PSquare/Linear Footage of Work: �00
Type of Work: LTJ Addition L Alteration ❑ New ❑ Re air Re lacer
y, ( p / p ❑ Demolition
Description of Work: C+L }tip// % IC0- k qp'e-w7I e� vv ILC:e—, '
1^. eL.P✓ VQy r1 V r RJI. � P..GG,�/` O-_. ,� <}i
,�'�flrl��ll)j: ! n'l`:v.q,•r ,. ;w y��fCtp7�.we• 1 ...
Specify color of color thru'tile:
Submittal Fee$So' Permit Fee$ =fir�a CCF$ M CO/CC$
Scanning Fee$ - 1' Radon Fee$ - e3 DBPR$ ' 8- Notary$
Technology Fee$ U Training/Education Fee$ ' 2 Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Bonding Company's Name'(iftapplicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City .1 - 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.....
t �
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.
r
"WARNIN6`f0 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$2500,199 applicant must
promise in good faith-that,a copy of the notice of commencement and constructionlien law brochure will be delivered.to the person
whose property attachment. Also,a certified co o the'recorded notice o commencement mtsi be `ostedaat the job site
p p Y 1PY f f P 1
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.
4N .IF
Signature Signature r
_ OWNER or AGENT CONTRACTOR :
e r,. 'i, $. 1
The foregoing.instrum t.was acknowledged before me this The foregoing instrumt was acknowledged before me this
O
1 day of 20 1 by 4 d y of 20 C7 by
rl-o +. is � c
MA(LJ l tJ L 5� who is personally known to ho is personally known to
Y
me o-;who.hasproduced as meorwho has produced t _ as
identification and who did take an oaths �..r,�� identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: ✓k 't :Print:
Seal: r vue L1IURAF Y Seal: r°`� � LAURAF
ARM
�a' .. z� * MY COt+M�IISSION#FF 186027
+° ° MY COMMISSION t FF 1660
*
Ey o�ry ry , ' EXpIBES:Match 162019 Y
�►tOth iot�9 dThrw®adoalNaarY4etvice�
APPROVED BY Plans Examiner t Zoning
Structural Review Clerk
(Revised02/24/2014)