EL-17-2324Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. EL-3-17-2324
Permit Type: Electrical -Residential
Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 10/6/2017
Expiration: 04/04/2018
Parcel Number
Applicant
551 NE 102 Street
Miami Shores, FL 33138-2454
1132060170980
Block: Lot:
DAVID OBREGON
Owner Information
Address
Phone
Cell
CORY & LISA GITTNER
551 NE 102 Street
MIAMI SHORES FL 33138-2454
Contractor(s)
MV ELECTRICAL SERVICES
Phone
(305)216-0677
Cell Phone
Valuation:
Total Sq Feet:
$ 6,000.00
0
Type of Work: ELECTRICAL WORK NEW OFFICE AND GARA
Additional Info: ELECTRICAL WORK NEW OFFICE AND GARA
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$3.60
$3.38
$2.25
$1.20
$5.00
$225.00
$3.00
$4.80
$248.23
Pay Date Pay Type
Invoice # EL-9-17-65179
09/27/2017 Check #: 8022 $ 50.00 $ 198.23
10/06/2017 Credit Card $ 198.23 $ 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 sume res sibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRI, PLUMBI IG MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDA
construction and z
certify that
thermor
ormation is accurate and that all work will be done in compliance with all applicable laws regulating
named contractor to do the work stated.
October 06, 2017
Date
Authorized Signat re: Owner / Applicant / Contractor / Agent
Building Dep - rtment Copy
October 06, 2017 1
,0\131Y1
BUILDING
PERMIT APPLICATION
❑BUILDING LECTRIC
JOB ADDRESS:
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
RECEIVED
P 2 7 ZII�,11
o
BC 201LA
Master Permit No. l� IS 19
Sub Permit No.e.,1 f- 2 3 a q
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL 0 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
551 Pr_ / 0 S 7- /A/ /k-w(( FL- 33 13�`
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): (a2q CTrA%E-I(
Address: .c5I A172 / 62 S T
City: 1,111A-014,( S / Q
State: ��--
NO
BFE: FFE:
Phone#: 34 0 I
Zip: 33 / 3e
Tenant/Lessee Name: I' Phone#:
Email: CQrl @ wted.��aFe fitaLt.'wKc . CoB
CONTRACTOR: Company Name:
Address: I-2 3 ( \ w a- h of C) •
City: State:
Qualifier Name:
Zip: 3 .3a (
$` (04 Yr p v01 (C:cg S Phone#: . .
� � r
State Certification or Registration #: FC 300'560-9 Certificate of Competency #:
DESIGNER: Architect/Engineer:
/
, Phone#:
Address: City: State:
Value of Work for this Permit: $ G d OQO �•
Zip:
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration n New
Description of Work: /.eGtre(:f.-- I :1
- OH
n: ,c SA[ y7r�,.1
oee\aee pen,w'
❑ Repair/Replace n Demolition
- ( 11 (O j.;
Specify:colorof co/or'iliru tile:
Submittal Fee $
Scanning Fee $
I V. Net frt.' CDt S6r) Ces ►✓►e- Phone#: `S`a-(.5'2.
Permit Fee $ 0.6 CCF $ CO/CC $
DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
Radon Fee $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ "
1��.3
Bonding Company's Name (if applicable)
Bonding Company's Address
,ii)'>, 7 s i?
City es. State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
-Cityr
i
State Zip
J)
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
RESULTIN 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 b approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
d��__
ay of SCP-A— , 20 l , by
` CCr (4 6� 11 "�Y , who is personally known to
me or who has produced ttCQ i1(
- as
identification and who did take an oath.
NOTARY PUBLIC:
**********************
APPROVED BY
Signature
NTRACTOR
The foregoing instrument was acknowledged before me this
day of SC P4 , 20 , by
V1 CI r (D U 0(1 D 10 is personally known to
me or who has produced -0 t ( CS12
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: _a
, Seal:
as
•MAHARIU K. GONZALEZ
?* • '•; �4 MY CO ..
0.
EXPIRES: Bond 2020
•'°',✓„;°P'�� November 2, 020
Bonded Thru Notary Public Underwriters
************************************************************************************
95 P /7 Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)