EL-17-1024 Perrnit 11lo. EL-4-17-1024
Miami Shores Village Permit Type:Electrical-Residential
10050 N.E.2nd Avenue NE PerV Work Classification:Alteration
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Miami Shores,FL 33138-0000
Phone: (305)795-2204 Permit Status:APPROVED
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Issue Date.411712017 Expiration: 10/14/2017
Project Address Parcel Number Applicant
289 NE 102 Street 1132060134970
Miami Shores, FL 33138-2426 Block: Lot: ALFRED& NANCY DOWSON
owner Information Address Phone Cell
ALFRED&NANCY DOWSON 305 NE 91 ST
MIAMI SHORES FL 33138-3129
Contractor(s) Phone Cell Phone Valuation: $ 1,900.00
TEAC ELECTRIC
Total Sq Feet: 72
Type of Work:GUT BATHROOM RETILE AND NEW VANITY Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Review Electrical
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
Invoice# EL-4-17-63681
DBPR Fee $2.25 04/12/2017 Check#:3503 $50.00 $ 110.70
DCA Fee $2.25
Education Surcharge $0.40 04/17/2017 Check#:3508 $ 110.70 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $160.70
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 LUMBING, MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDA I ce ify that all the foregoing information is accurate and that all work will be done in compliance with all'applicable laws regulating
constru n they rize the above-named contractor to do the work stated.
April 17, 2017
uthorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
April 17, 2017 1
Miami Shores Village
Building-Department"'c rr, fRF-CF or�a,
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 R 12117
_ __ �._._� { .TeL•(305)795-2204 Fax:.(305)-756-8972 t .
INSPECTION LINE PHONE NUMBER:(305)762-4949,1
FBC
...BUILDING _ +'y ___ __ ._ ._ .__ __ . Master;Permit No.�G
PERMIT APPLICATION Sub Permit No. :F -7 LO2�A
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'; ❑BUILDING is ELECTRIC !9-,i ❑ ROOFING;); i ❑ REVISIONj c t( . iel EXTENSION°I ')r' ❑RENEWALSi
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r❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑'CHANGE OF ❑CANCELLATION ❑ SHOP'
,, CONTRACTOR DRAWINGS
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OWNER:Name(Fee Simple Titleholder): U Lr/ }PhoF ��✓
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Tenant/L"essee�Name. r'1`� �. � i•±`► -� Phone#: 1 :��..� �,. �t� ,. `•�,�,
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CONTRACTOR:Company Name: C�JT cLc �,� Ph e#:
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City: State: Zip:
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Qualifier Name: / fs
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State Certification or Registration#: 33 D Certificate of Competency#:'+"
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DESIGNER:Architect/Engineer: Phon�
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Address: ` City State Zip:
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value of Work frthiS'Pdrmd:•$ 'I��� (7�7 Square/Linear Footage of Work:
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'Type of Work , ❑' Addition ❑ AI eration ❑ New r+ ❑ Repair/Replace Demolition
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Description ofworli~
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Specify colorrof,color#hru t►le:'a .at.
,'Submittal Fee$ Permit -CCF,$._..
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ ` - . _.__ Training/Education Fee$ - "' -'Double Fe((e$
Structural Reviews$ Bond$
Bonding Company's k,ahie(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicabler)s''_`-;3'� --'Nil fl aeK Sxif 3 WJ vir!VrJ<1c-01
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Mortgage LendeK,`Addressl
City. L P 4�i*f, �'l -SthtefA Zi
Application is'hereby made-f6 obtain a permit to do the work and installations as indicated. I certify that-no work or installation has
commericei!_prior toll the igj6jnc"e46f,-iiFpermit and that'611N6_rk will bd:performed-1Co meet thg-.stihd6rd9 of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERSi,HEATERS,TANKS,AIR CONDITIONERS,ETC..... 'il Att.t. i, gg
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OWNEWSiAFFIDAVrr: I certify that all the for"eQoing information is accurate and that all work will be done in compliance with all.
applicable laws regulating construction and zoning. %
"'WARNING-TO.-OWNtR:.,--YOUR--'FAILURE-TO RECORWA NOTICE-OF COMMENCEMENT-:MAY
RESULT-T-IN`YOUR;PAYING`!TWICE; FOR11VIPROVEIVItNTS "TO YOU R'PROPERT.Y.' IF.YOU.-INTEND
TO OBTAIN FINANCING,CONSULT,WITH YOUR LENDER OR.,AN ATTORNEY BEFORE-,RECORDING
YOUR NOTICE OFtOMMENCEIVIENT.
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Notice.to Applicant:,As a condition to the issuance of P.building permit with on estimated value exceeding$2500,*the applicant.must
promise in good faith that a copy of the notice of commencement and construction lien law brochurewill be delivered to the person
'is subject" ' ' I
whose property bject to attachment. Also;a certified copy pithe'recorded'notice'6fcommencement must tie`p'os;iidotthe j'o'i?site
for thefirst inspection which'occurs seven (7) days after the building permit is.issued In the,absence of such.posted noticerthe
7.
inspection will not be appy d and a reinspection fee will be charged.
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signatu'r-w- Signatur
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fQV!��LRE _or�_AGENT ' -CONTRACTOR'
The-foregoing instrument was acknowledged before me this -The-foregoiffg-ihstr-d-m-i-ntWa-!�-idk-howledged before me thisj'
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by
day id 1:2 'by 20
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L I who 1-N VC1 bUl WHY r.1 1UW1 I LU
ri i ;peMonally knd!
me or who has produced as s
identification and who did take an oath.-
i;, _ 'identification arfdwho did take an-oath.-
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Sign: .:M= Sig
Print: Print.
TERESA M
_SeaI,:_ Sea[:-- commission#FF 966629
My Commission Expires
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APPROVED BY i Iz:APWlk Plans Examiner Zoning