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EL-17-2181 Permit NQ. EL-8-17-2181 sK°REs L,� Miami Shores Village Permit Type:Electrical-Residential 10050 N.E.2nd Avenue NE Im Work Classi�icafiorr:Low Voltage Miami Shores,FL 33138-0000 :Per - ate Permit Status:APPl2#31/Ea Phone: (305)795-2204 . .. �ORtOp' s issue Date:91512017 Expiration: 03/04/2018 Project Address Parcel Number Applicant 1255 NE 99 Street 1132050090100 Miami Shores, FL 33138-2642 Block: Lot: JOSH WOLLOWICK } Owner Information Address Phone Cell JOSH WOLLOWICK 1255 NE 99 Street (305)531-0970 FL 33142- 1255 NE 99 Street FL 33142- Contractor(s) Phone Cell Phone Valuation: $ 6,000.00 MEP CONTRACTORS (786)930-7700 Total Sq Feet: 0 Type of Work:PRE-WIRE FOR LOW VOLTAGE Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning: 1 i Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.60 DBPR Fee Invoice# EL-8-17-65017 $3.15 08/29/2017 Credit Card $ 50.00 $178.90 DCA Fee $3.15 Education Surcharge $1.20 09/05/2017 Credit Card $ 178.90 $0.00 Permit Fee-Additions/Alterations $210.00 Scanning Fee $3.00 Technology Fee $4.80 Total: $228.90 r i In consideration of the issuance to mp 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 respp/nsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,P UMBI f ,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. i OWNERS AFFIDAVIT: I >bertify t at II the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. �uth ore I authorize the above-named contractor to do the work stated. September 05, 2017 Authorized.Signat rW1, ner / Applicant / Contractor / Agent Date Buildin Depaent Copy Septenner 05,2017 1 IVlldl i II JI IUI CJ V IIIdge Building Department JAUn292017 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax: (305)756-8972 BY: INSPECTION LINE PHONE NUMBER:(305)762-4949 _ FBC 20 t4 5�" BUILDING Master Permit No. A(— 1(z' <3f> °, PERMIT APPLICATION sub Permit NoT.L )_�- 2 )e) ) ) ❑BUILDING 21ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 12. f5 /U� S'/ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: ST-6—Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): je> 4600//0411tr_�— Phone#: Address: t'La AJ-C- 99 � City: l7/a/ZI ��a ��> State: Zip: Tenant/Lessee Name: Phone#: Email: —} CONTRACTOR: Company Name: P 604rA.c4o 5 Phone#: !�6 3y 77`� Address: 13G, G( A� /5- City: JCity: State: F4_ Zip: 3 Qualifier Name: Phone#: State Certification or Registration#: 13 c1 4"Y Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New / ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile:C Submittal Fee$ ; ,0• Q Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE S ( c� Bonding Company's Name(if applicable) t nding 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 approved and a reinspection fee will be charged. Signature Signature WNER or AGENT CONTRACTOR The foregoing instr ent was ac l nowledged before me this The foregoing instrument was acknowledged before me this /L//day of G 20 17 byday of /�/y1 hili 20 /7 by .Jl,Ji6 who is personally known to .�/`�� IOT� who i ersonally kno_;n o me or who has produced f<- pf-we-1 as me or who has produced as oup identification and who did take an oath's NUN Canto identification and-Vh'o d�icaitake,an.oath, ' .� �iuP3 ;X129133 NOTARY PUBLIC: ° ?SSi�i��r rFt29133 k z5 �, s EXr'I`iES: SURE 4, 2018 NOTARY PUBLIC June 4, 2018 ;.. ,h . °� O:J"'10TARY.Com ,°Q}R!�! www.AARoNNOTARY.COM unt��!` ��// Z.f � Sign: /7 ../�/;1Sign: "I -1cvLGd Print: 14 C- 4,V7'f Print: 4AJ4 Seal: Seal: APPROVED BYPlans Examiner Zoning Structural Review Clerk A B C D E F G H I J K L .�;•.. 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