EL-17-2622Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO: EL-11-17.2622
Permit Type: Electrical - Residential
Issue Date:1116/2017
Work Classification: Pool - Private
Permit Status' APPROVED
Expiration: 05/05/2018
Parcel Number
Applicant
1116 NE 92 Street
Miami Shores, FL 33138-
1132050270420
Block: Lot:
VICTORIA NEWTON DUNN
Owner Information
Address
1116 NE 92 Street
MIAMI SHORES FL 33138-
1116 NE 92 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
F JIMENEZ ELECTRICAL CONTRACT( 305/556-5759
Phone
Cell
Valuation:
Total Sq Feet:
$ 1,000.00
0
Type of Work: ELECTRIC FOR SWIMMING POOL
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total: $312.10
Amount
$0.60
$4.50
$3.00
$0.20
$300.00
$3.00
$0.80
Pay Date Pay Type
Invoice # EL-11-17-65545
11/06/2017 Check #: 21322
11/02/2017 Check #: 21279
Amt Paid Amt Due
$ 262.10 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Light Niche
Bonding
Review Electrical
Alarms
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 assum= resp• • .': : work done by either myself, my agent, servants, or employes. I understand that separate permits are
requir r EL T ICAL, PL MBI WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNER r . • •
constr i • •
ID
on and
on and
Authoriz
IT: Ice
ning. F
Signat' Own
all the foregoin•
I authorize the a
••
accurate and that all work will be done in compliance with all applicable laws regulating
ve-named contractor o do the work stated.
licant / Contractor / Agent
November 06, 2017
Date
Building Department Copy
November 06, 2017 1
Miami Shores Village
r\����,0 Building Department
BUILDING
PERMIT APPLICATION
❑ BUILDING prCCTRIC
PLUMBING ❑ MECHANICAL
JOB ADDRESS:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
Master Permit No.
Sub Permit No.
❑ ROOFING ❑ REVISION
❑ PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
I I I Q rue qz S T
FBC261L-(ZZ9-o
Bf3P~ 6-11
❑ EXTENSION El RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores
County: Miami Dade
Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder):
Address:
ocfoeiA-iv. DUNN
i l I 1 NE QZ ST
BFE:
NO
FFE:
Phone#: 3a- 38 - 1 31 a
City: t111 4( S 11-02 s
Tenant/Lessee Name:
State: Zip:
Email: U/C,-'Oeletf•16-0-r01►IDU &PO • C d f'-k
CONTRACTOR: Company Name: f• 5 11.646 Z 0C.-1rel
Address: 1 Z -1/d�1, o �1 �W 'G14-0 66 CI,
City: 1'1y(/ hM 6A/4 Ar eA S State:
Qualifier Name: Kg/TO S 1 S Cj —S l f-'L 614 CZ --
Phone#:
Phone#:72-q5-21
Zip:
Phone#: ti
State Certification or Registration #: 6 L 13 0 0 Z7 1 ct Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ $ I / Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration r7 New ❑ Repair/Replace n Demolition
Description of Work:
1j1 -r21 C e Su-) 1M •`7
da 1-
Specify colorooff color thru tile:
Subimittal Fee $"re) ;':60 '"" Permit Fee $ JO 'dePU CCF Co Q ,_ CO/CC
Scanning Fee $ Radon Fee $ DBPR $ el • S O Notary $
Technology Fee $ v `3 Training/Education Fee $ v 2_0 Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE$ CalaZ
i0
•
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." t
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value`eicceeding $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
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
20 day of QG-r , 20 1 , by 2ofiti day of . OG70ge2 , 20 , by
VirFDtt(k N - PAIN) , who is personally known to itit61S l8 -1IMrjv, who is personally known to
me or who has produJ DL
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
*************
as
me or who has prod
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
''vr CRISTINARODRIGUEZ
; 4,-. Seal:
4 •`' Notary Public - State of Florida
i i i• Commission If GG 105164
,: My Comm. Expires May 16, 2021
°c�•'' BondedthrcughNaticnalNc Anil.
*****************************
APPROVED B
I J./L fW
AL ittirg,""f
*
as
f. pt;'••., CRISTINA RODRIGUEZ
�¢� = Notary Public - State of Florida
"_'•' • - Commission # GG 105164
.1r 0 My Comm. Expires May 16, 2021
Bonded through. habccallictaryAssr.
*******
* *
3/114D ' Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)