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EL-17-2560Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address ■ Permit NO. E L-' 0-17-25►60 Permit Type: Electrical - Residential WoricCtassification: Alteration Permit Status: APPROVED Issue Date: 10/31 /2017 Expiration: 04/29/2018 Parcel Number Applicant 501 NE 92 Street Miami Shores, FL 33138- 1132060141120 Block: Lot: LIZA ROSE CIRALDO Owner Information Address Phone Cell LIZA ROSE CIRALDO 501 NE 92 Street MIAMI SHORES FL 33138- (917)744-1879 501 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone J & M ELECTRICAL CONTRACTORS I (305)297-6428 (305)297-6428 Valuation: Total Sq Feet: $ 9,725.00 0 Type of Work: new panel, new wiring to fixtures, Additional Info: new panel, new wiring to fixtures, Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $6.00 $5.11 $3.40 $2.00 $340.38 $3.00 $8.00 $367.89 Pay Date Pay Type Invoice # EL-10-17-65476 10/27/2017 Check #: 001786 $ 50.00 $ 317.89 10/31/2017 Check* 1792 $ 317.89 $ 0.00 Amt Paid Amt Due Available Inspections: Inspection Type: Review Electrical 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. 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,,tFutfiermore, I authorize the above -named contractor to do the work stated. October 31, 2017 Date orized Signature: Owner / Applicant / Contractor / Agent Building/Department Copy October 31, 2017 1 ‘4,r BUILDIN PERMIT APPLICATION Miami Shores Village Building Department 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 7 N Master Permit No. gG' Sub Permit No. L�� 90 st-14 El BUILDING IFELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION El RENEWAL ❑PLUMBING El MECHANICAL El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: So( NG 9J2 grecer City: Miami Shores County: Miami Dade Zip: s Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 14 Ci &i b Phone#: Address: Zl' 1 Z 5 City: State: Zip: ji /6 Y Tenant/Lessee Name: Phone#: Email: (1 I CONTRACTOR: Company Name: ja M. Q V �ccA C.ou G `uC— Add ress: 11+0e) 14- 2"t• a11e_.. City: TO-A-La�c9X.�e State: Zip: 3 33 o 4 Qualifier Name: ` C "`ct t ` %fcx,, e Phone#: 309 �7 64249 State Certification or Registration #: EC-- �vI 0 3-70 2,. Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: cT, ,42S • GO City: State: Zip: Value of Work for this Permit: $ 3 f.( `- 0 Square/Linear Footage of Work: Type of Work: 0 Addition 0 Alteration 0 New ❑ Repair/Replace ❑ Demolition louv Pt R Li Wiei TI f =-K +. 2 Lc Gte(r5 ci-)Tc-(_1 S Description of Work: non Phone#: 30 2- 7 25 Specify color of color thru tile: Submittal Fee $ GO. ao Permit Fee $ 7A/Di L,'b CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 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 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 OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The forgoing instrument was ja�ck�nowledged before —me this Ciday ofA IIO Wi/ , 20 I F , by �,{ day of ato `oar , 20 J ( , by (/ ( u1AL) , who is personally known to M1 (( ".Pr C co ( , who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. NOTARY PUBUC: identification and who did take an oath. NOTARY PUBLIC: Print: Print: Seal: _': ': MY COMMISSION # FF993291 Seal: '•','ia„y- EXPIRES May 17, 2020 1)407) 398.0153 FlorideNotaryService.com ********************************************************************** APPROVED BY e9-c_%I i Plans Examiner ,��\IrY P ;,, lr� (/ „ MAGALI AROCENA Notary Public - State of Florida COminlssloe di FF 988358 \tra My Comm. Expires Ap"r`28' 2 0 Zoning (Revised02/24/2014) Structural Review Clerk