EL-17-2811Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. EL-11-17-2 11
Permit Type: Electrical - Commercial'
Work Classification Addition/Alteration
Petmit StatusAPPROVED
Issue Date: 2/28/2018
Expiration: 08/27/2018
Parcel Number
Applicant
1064 NE 97 Street
Miami Shores, FL 33138-
1132050170200
Block: Lot:
MARIE ROBSON
Owner Information
Address
Phone
Cell
MARIE ROBSON
1064 NE 97 ST
MIAMI SHORES FL 33138-2556
Contractor(s)
SOUTH DOM ELECTRIC INC
Phone
(305)626-5904
Cell Phone
Valuation:
$ 1,800.00
Total Sq Feet: 251
Type of Work: INSTALL 5 SMOKE ALARMS PER FBC INST
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DBPR Fee
DCA Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$0.00
$3.38
$0.00
$2.25
$0.40
$225.00
$9.00
$1.60
$242.83
Pay Date Pay Type
Invoice # PL-11-17-65758
02/28/2018 Credit Card
Amt Paid Amt Due
$ 242.83 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Final
Review Plumbing
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 the 'to 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 E - ICAL, PLUMBING, NjE HANICA NDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS A
construction
IDAV
d zon
T. I certify that al the forego
Futheerf ce, 1 rize t
forma
ove-n.
Au j orized Signat e: Owner / Applicant /
Building Department Copy
n is accurate and that all work will be done in compliance with all applicable laws regulating
ed contractor to dn.Nie..work stated.
Contractor
February 28, 2018
Date
February 28, 2018 1
BUILDING
PERMIT APPLI2 TION
❑ BUILDING
ELECTRIC
❑PLUMBING ❑ MECHANICAL
JOB ADDRESS:
City:
Folio/Parcel#:
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
❑ ROOFING
Master Permit
Sub Permit No. — 2b t
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
i fob NL 91 Sr.
Miami Shores County:
11 320S-0I1-0200
Occupancy Type: Load: Construction Type:
Address:
Miami Dade
❑ CANCELLATION ❑ SHOP
DRAWINGS
Zip:
Is the Building Historically Designated: Yes NO
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ''l R-0,75OtJ Phone#: i `i • 36`)
to(,4 'QC 9-1 S-"
City: kt (Fr S 6 o 1LES
State:
Tenant/Lessee Name: `-'
bN IQUICEr1Di, rn-)c-A-T'Tt, lJOr
Email: I`1'
CONTRACTOR: Company Name:
Address:
# ro u 1 ct 2__rs
City: ►' 4 (1- ` '\ ' State: -F'
Qualifier Name:
V Cwe Mirros
Phone#:
Zip:33 0 k3
Phone#: -DOlJ 91t5•
Phone#:
State Certification or Registration #: I (-2f Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address:
QUCs7 1. olvS
610C.
2L -7 • z 3.2,�,6
RECEi/ VED08:_.
No F4.11
Eftlfo IS
No.2C -7 - 1 10
as- NY
Zip: 3 ! ®!
City: State: Zip:
1
Value of Work for this Permit: Sit/ So 0 • Square/Linear Footage of Work: 2sip
Type of Work: ❑ 'Addition Er Alteration Description of Work: • .1 NS Tip LL S S M 0 C
- f i PCX rec. gCt J;(�
& F ► l N Icl -r-c(-1-e-(o ` - 3 1 N g.9 7-t-jS
❑ New ❑ Repair/Replace ❑ Demolition
Specify color of col r thru tile:
Submittal Fee $ `"1) Permit Fee $ f arm o CCF $
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $
Structural Reviews $
CO/CC $
Notary $
Training/Education Fee $ Double Fee $
Bond $
TOTAL FEE NOW DUE $ 4 2 $J3
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City t r State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City ' • ` ) . State Zip
i +•r• i
,r
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 standardsofall 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. 4-�' ,."; 's 1
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS -TO'' YOU'R'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 estiniated.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 pro: rty 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 wi
Signature
spection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
pproved and a reinspe• ion fee
0
charged.
•
i n tune Ckti0, Orrkido,5
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
A.-1 day of
2_1 . day of Ni o.1 , 20 n , by
5,�,, S% f ,rru. ros
r1rl��fV1 �, is pers a y cn to ri., C Y) QZ!'Iwho ids personally known to
me or who has produced as me or who has produced (v�allia-- as
identification and who,did take‘an oath.
i
,20 (l ,by
identification and who did take an oath.
NOTARY PUBLIC:
st
Sign:
Print:
Seal:
1111111
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Y"�•e!IWybe ti
=o • 09Ln564p.
•OP
'l.
• Oi
NOTARY PUBLIC: k., g 0 11111I111// /b
• q9<<c 4,i
11
Sign: a cf'<<,. ��~
r : . ��'�
eb
Print:
Seal:
n:rS
***************************** �j�lb 40r**************************************************************
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3°pvvlY
APPROVED BY
=•—
�•N �•
•
i `Cy O 0*.cj •
s
Plans Examiner
Structural Review
Zoning
Clerk
•75
(Revised02/24/2014)