EL-18-796Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Parcel Number
PermitNO, EL-3-18-796
Permit Type: Electrical Residential
Work Classification: AdditionlAlteration.
Permit Status: APPROVED
Issue. ateK:5/8/2018
Expiration: 11/04/2018
Applicant
144 NE 99 Street
Miami Shores, FL 33138-
1132060132260
Block: Lot:
ANDINO LIBERTAD HOMES LLC
Owner Information
Address
Phone
CeII
ANDINO LIBERTAD HOMES LLC
144 NE 99 Street
MIAMI SHORES FL 33138-
(305)989-7870
144 NE 99 Street
MIAMI SHORES FL 33138-
Contractor(s)
MG ELECTRICAL CONTRACTOR
Phone CeII Phone
(786)385-5637 (786)385-5637
Valuation:
Total Sq Feet:
$ 1,350.00
0
Type of Work: REPLACE GFI OUTLETS AT BATHROOM 20
Additional Info: REPLACE GFI OUTLETS AT BATHROOM 20
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$3.38
$2.25
$0.40
$225.00
$3.00
$1.60
$236.83
Pay Date Pay Type
Invoice # EL-3-18-66944
03/27/2018 Credit Card
05/08/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 186.83
$ 186.83 $ 0.00
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 AFFID VIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction a(nA z ning. Futhermore, I authorize the above -named ontractor o do the work stated.
Authorized Signature: Owner
Applicant / Contractor / Agent
May 08, 2018
Date
Building Department Copy
May 08, 2018
1
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
BUILDING
PERMIT APPLICATION
❑ BUILDING ® ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: I 4' Ns G S-
City: Miami Shores County:
❑ REVISION
❑ CHANGE OF
CONTRACTOR
DECEIVED
MAR 2 7 2018
FBC 201-4-
Master Permit No. is -.Zs
Sub Permit No lt3 ` W
❑ EXTENSION ❑RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
Miami Dade Zip:
331135c
Folio/Parcel#: 1•' - 3206 - A 3 - 226 0 Is the Building Historically Designated: Yes NO siO
Occupancy Type: Load: Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleelh�older):-P d CAO
Address:114 NC CM
City: N' (M"A S hYCS State
BFE: FFE:
;-c .(AeS 1. phone#: 3C%s o3c115
Zip: 331
Tenant/Lessee Name: Phone#:
Email: -i-a-kiC Wit IAS @ kW C& t•CONN
CONTRACTOR: Company Name:
Address: 14242 Sul)
City: ►U\ aVNI\'‘
M ( C c Cal CoM(c V Corp.
ASS
Qualifier Name: Mo V o
State: 1.
Phone#: &o -33
State Certification or Registration #: _ - 130 15O4"I
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address:
Value of Work for this Permit: $ -IS
Zip:
331ate)
Phone#: ' +-®6/�3 B �b 3 4
1`i V 000601-
City: State: Zip:
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
1 Ln New ❑Repair/Replace r ❑`/.Demolition
Description of Work: pep [aCQ (v ` l UJ- «`` a"� bQ- (11 (O17� .0
Specify colorof color thru tile:
Submittal Fee $"" '`
Scanning Fee $
•
4. / 9,
Permit Fee $ Z^� `� CCF $ CO/CC $
Radon Fee $ a • 5 DBPR $ 3' B Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 18 6. 93
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
1-
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 tandards\ df 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 $2500,• the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved •and a reinspection fee will be charged.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
It'
M t' day of I 1 cI CGL , 20 A , by
j\uu (as- f.uc$'v , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: /,
Print::,�, W�L�1
Seal:
TATIANA ISABEL HERNAt(DEZ
MY COMMISSION II FF 161007
* * EXPIRES: October 15, 2018
rj��Feo a 1 Bonded TM Budget Nam/ SeMM:es
***********************************************
APPROVED B
rttInd-t
,►*Y .b TATIANA ISABEL HERNANDE2-_.
* MY COMMISSION t FF 169007'-
EXPIRES: October,15, 2018;.
l BondedT BuddgetNotxySento
***************s********4 ad1?n s**** **** **** ****************
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
2 , day of(Gh , 20 (9 by
t O O �7v (j44( , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: y,
Print: 1,a
Seal:
e i3-/2 49 Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)