ELC-18-1644 Permit NO, ELC-6-18-1644
Miami Shores Village Permit Type:Electrical-Comilnercial
10050 N.E.2nd Avenue NE
tWdfkClassificatiorr:Addition/Alteration
Miami Shores,FL 33138-0000 PenPermit Status:APPROVED
Phone: (305)795-2204
coRrvA Ex iration: 12/16/2018
Issue fl�ite:611 J/2018 P
4
Project Address Parcel Number Applicant
11300 NE 2 Avenue Number: Adrian Hall 1121360000050-09
Miami Shores, FL 33138-0000 Block: Lot: BARRY UNIVERSITY INC
I
Owner Information Address Phone Cell
BARRY UNIVERSITY INC 11300 NE 2 Avenue
MIAMI SHORES FL 33161-6628
11300 NE 2 Avenue
MIAMI SHORES FL 33161-6628
Contractor(s) Phone Cell Phone Valuation: $ 850.0 0
MIKES CUSTOM ELECTRIC SERVICE (305)969-5460 (305)297-7269
_.. _._ ...... .. ._... Total Sq Feet: 0
+
Type of Work:CONNECT POWER FROM EXISTING PANEL F Available Inspections:
Additional Info:CONNECT POWER FROM EXISTING PANEL F Inspection Type:
Classification:Commercial Final
Scanning: 1 Meter Box
Alteration
Relocation i
Fire Alarm ,
Service Change
Review Electrical
Underground
W.W.
i
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# ELC-6-18-67939
DBPR Fee $2.25
DCA Fee $2.00 06/19/2018 Check#:4301 $ 113.85 $50.00
Education Surcharge $0.20 06/14/2018 Check* 178 $50.00 $0.00
Notary Fee $5.00
Permit Fee $150.00 t
Scanning Fee $3.00
Technology Fee $0.80
Total: $163.85
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 that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated.
12
�/ June 19, 2018
A—UthodAd Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 19,2018 1
{
Miami Shores Village
DECEIVED
Building Department JUN 14 1018
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 20t"A
BUILDING Master Permit No. IMC-- _31 -I 8- 3�
PERMIT APPLICATION Sub Permit No. C
F-IBUILDING ELECTRIC ROOFING REVISION ❑ EXTENSION RENEWAL
EIPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR r , DRAWINGS
JOB ADDRESS: l l A/ W 2 V �i%01 V l C
City: Miami Shores County: Miami Dade Zip: sz)
r Folio/Parcel#: ` Is the Building Historically Designated:Yes NO
s Occupancy Type: toad: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): U ( 1_S I+q Phone#: UY .31 D U a 0
Address:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email: L-1�' ( 1
CONTRACTOR:Company Name: �(�Ct.S �� S--Lwl '�e C{J L Phone#: C ��'
Address: C,j
City: zon 1` State: Zip: ���t� -
Qualifier Name: 4 G / n GyL(9 fes` Phone#:• "�, 2
State Certification or Registration#: Certificate of Competency#: -� r 66 y l 7
A!
DESIGNER:Architect/Engineer: - IV ilk. Phone#:
Address: �' 4 City: State: Zip:
Value of Work for this Permit:$ O�J Square/Linear Footage of Work:
P t
13
Type of Work: ❑ Addition F-1Alteration
(r ❑ New [Repair/Replace ❑ Demolition
Description of Work: coiner - ppigQ_, -fom ex) S-h 4)G i2(1(�I r PPI I nGl'
60 01C ' -(1060121Ps�U�
Y S:'^I"•'tr 1/fi�1tl�`1yafld!'tt K?�Y `�^1•��✓w%� 4yny n'�hk F
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Specify color of color thru tile: ti E- ",
Submittal Fee$ Permit Fee$ %✓'`r�� �� CCF$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
+
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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Bonding Company's Name(if applicable) tj I
Bonding Cornpany;sAddress I _
City State Zip
Mortgage Lender's Name(if applicable) [�1
s'
Mortgage Lender's Address
City I 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 ino Signature
OWNER or AGENT + CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
l3 ayL of %l Wy 6 20 by , day of� U Alf 20 �l a by
-SV1W RbS�N�IAy who is personally known to M Q i( OTVArsho is personally known to
me or who has produced as me or who has produced YiV�.v 1 C�QMI a as
identification and who did take an oath. identificati an who id take an th.
NOTARY PU �—� NOTA Y P BLIC:
Sign: Sign:
Print: - Print: O
Sea + Notary Public State of Florida Seal: ?'e Y Y PRIETO
Jeffry J Yao , Ml'COMMISSION#FF 214031
My Commission FF 168481 EXPIRES:March 25,2019
yry, Ex fires 71/17J2018 "•', "
•of A:
P �F ;, Bonded Thru Notary Public Underwriters
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APPROVED BY J4JA
,L Plans Examiner Zoning
4
Structural Review Clerk
a (Revised02/24/2014)