EL-17-410Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Parcel Number
`Permit NO. EL- 2-17-410
Permit T,pe"Electrical - Residential
Work Classification: Addition/Alteration
Permit Status:, APPROVED
Expiration: 09/25/2017
Applicant
170 NW 97 Street
Miami Shores, FL 33150-
1131010250030
Block: Lot:
Owner Information
Address
ROBERT ROSENWALD JR
Phone
Cell
ROBERT ROSENWALD JR
170 NW 97 Street
MIAMI FL 33150-
(305)790-8449
170 NW 97 Street
MIAMI FL 33150-
Contractor(s) Phone
PRECISION POWER & CONTROL, COI (305)345-2161
Cell Phone
Valuation:
Total Sq Feet:
$ 900.00
0
Type of Work: POOL PUMP & LIGHTS
Additional Info: POOL PUMP & LIGHTS
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$4.50
$4.50
$0.20
$300.00
$3.00
$0.80
$313.60
Pay Date Pay Type
Invoice # EL-2-17-62970
02/16/2017 Check #: 4364 $ 50.00 $ 263.60
03/29/2017 Check #: 4397 $ 263.60 $ 0.00
Amt Paid Amt Due
Available Inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
W. W.
Underground
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.
March 29, 2017
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
Building Department Copy
March 29, 2017
1
BUILDING
PERMIT APPLICATION
❑ BUILDING
j PLUMBING
JOB ADDRESS:
g ELECTRIC
MECHANICAL
170 NW 97 ST
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
FEB 16 2017
atm
FBC 20
Master Permit No. ?) P \ b . Z ` 55
Sub Permit NoE l_ 11 410
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#:11-3101-025-0030
Occupancy Type:
Load:
Is the Building Historically Designated: Yes NO X
Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Robert F Rosenwald Jr
Address: 170 NW 97 Street
Phone#: 305-790-8449
City: Miami Shores State: FL
Tenant/Lessee Name: Phone#:
Email: robertrosenwald@aim.com
Zip: 33150
CONTRACTOR: Company Name. r� (S( (�711 tbw,fJL �CilL�i�r>� Phone#: 30.S3ct.S216. (
Address:
City: _ % f I'i State: F?
Zip: 30/ D
Qualifier Name: k 2 V I ANDO /4-tv ci2.2__ Phone#: (305)5
State Certification or Registration #: _:2 G 3O q'! <--($ Certificate of Competency #:
DESIGNER: Architect/Engineer: Kenneth Pfeiffer Phone#: (786)235-2494
Address: 8754 S.W. 206th Lane City: Miami State: FL Zip: 33189
Value of Work for this Permit: $ 1 00 Square/Linear Footage of Work:
Type of Work: ❑ r Addition�❑ Alteration ( El New ElElRepair/Replace
Description of Work:i( OO \ ruyiviy
? (; I1 T-S eOe 1
Demolition
Specify color
�oyf�color thru tile:
Submittal Fee $ (/0 i IA Permit Fee $ ice, / DU CCF $ • C7 CO/CC $
Scanning Fee $ S,r� Radon Fee $ 1 • 5-0/i0 DBPR $ �-'• 50 Notary $
Sc -
Technology Fee $ • v �/ Training/Education Fee $ ° ZG Double Fee $
Structural Reviews $ - Bond $
coo
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
W.eink ?ca.usttii
OWNER or AGENT
Sig Lure
�.r
( NTR ' • R
The foregoing instrument was acknowledged before me this The fore oy'ng instrument was acknowledged before me this /Z 2
�
day of ���by j ;� +(day of `_^' C"9� 20�p , by /C
-(J It' /'S .ia) /a1, who is personally known to
1 jy..A' '-rt\: wh s personall y o n to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
,'
=';e-���A;� Commission #� EE 875428
''' '''' Bonded Through National Notary Assn.
- tate of Florida
identification and who did take an oath.
NOTARY PUBLIC:. 0 ///�
<,:.:4, t1/Z/Z-C_. 1-- . eST is O
Sign: r° - _14' _ s
Pr -frill --
Seal:
v-� IS -.0N
��'r'tiiitittt��
io
APPROVED BY %� xi /lvt1:27% /,)' Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk