EL-17-2212Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. EL-8-17-2212
Permit Type: Electrical - Residential
Work Classification: Pool - Private
Permit Status:: APPROVED
Issue Date: 9/26/2017
Expiration: 03/25/2018
Parcel Number
1532 NE 104 Street
Miami Shores, FL 33138-
1122320320370
Block: Lot:
Owner Information
Address
SANDRA MILENA GIRALDO BOTERO 1532 NE 104 Street
MIAMI SHORES VILLAGE FL 33138-
1532 NE 104 Street
MIAMI SHORES VILLAGE FL 33138-
Contractor(s) Phone CeII Phone
SS POWER & LIGHT ELECTRIC INC (305)607-5636
Applicant
JUAN CAMILO SUAREZ RUBIO
Phone
(305)934-6115
Cell
Valuation:
$ 1,800.00
Total Sq Feet: 288
Type of Work: NEW ELECTRIC SYSTEM FOR A NEW POOL
Additional Info: NEW ELECTRIC SYSTEM FOR A NEW POOL
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
$4.50
$4.50
$0.40
$300.00
$3.00
$1.60
$315.20
Pay Date Pay Type
Invoice # EL-8-17-65055
08/31/2017 Check #: 1135 $ 50.00 $ 265.20
09/26/2017 Check #: 1143 $ 265.20 $ 0.00
Amt Paid Amt Due
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 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, rOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing informat .n is ' curate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-na ed c. tractor to do the work stated.
September 26, 2017
Authorized Signature: Owner / Applicant / C. tractor / Agent
Date
Building Department Copy
September 26, 2017 1
BUILDING
PERMIT APPLICATION
❑ BUILDING
O PLUMBING
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
ELECTRIC ❑ ROOFING
❑ MECHANICAL ❑ PUBLIC WORKS
/S3 2 VC /of J` .
RECEIVED
AUG 1 2017
BY:
FQBC 20 Q
Master Permit No. 1 PP /7 - % 9 v 4
Sub Permit No. EL t \ - 22_12.
❑ REVISION ❑ EXTENSION
❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City:
Folio/Parcel#:
Occupancy Type:
Miami Shores
//-2232
County:
032 -- 0.37v
Load:
Construction Type:
Miami Dade
Zip:
33/3g
Is the Building Historically Designated: Yes NO
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): eZeig4 't b St•ti 4.4);)
Address: 1 2. % 6 f (9 r!
City: OttiGf WA' .5144) State: F L
Phone#: 30C93)16//5-
Zip: 33i3(
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: SS POL✓Jv L.& .11't %nC—
Address: 7T/ r NW
City: 14,0 n1� _
vtos
Qualifier Name: K} A
State Certification or Registration #: J /3003, 7/
Phone#:) g ZV`ISy,L1.
State: Pt.
5 ?/L
3°S. 2 V'/fV1Z
Phone#:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City:
/b'00
Technology Fee $
Structural Reviews $
Value of Work.for.this Permit: $ - -
. At'A
Type of Work: , n Addition n Alteration
Description of Work:
New
State: Zip: f T
Square/Linear Footage of Work: 0209 O `i
F,.`
❑,Repair/Replace ❑ Demolition
(1-7( 4 0142-$4), Api, '
Specify color of color thru tile:
Submittal Fee $ 3Q p id Permit Fee $ 3041., m0 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Training/Education Fee $ Double Fee $
Bond $ _
TOTAL FEE NOW DUE$ /5
(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 i ;• '',• F. 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. + T ;•. ..• , ".
"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 vdlue 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
.OWNER or AGENT
The. foregoing,instrument was acknowledged before me this
t day of !-h.(�w,� , 20 11 by
.C- Co , who is personally known to
me or who has produced • ' ozco - 4%3 - 7 9 - 02.3 a
identification and who did take an oath.
NOTARY NUBLIC:
Sig
Print
Seal:
}
r"Signature
•
o�Y'`°� •_ CLARA E RODRIGUEZ
•=„i MY COMMISSION #FF138588
'''•'`o6n°P? EXPIRES. July.5, 2018
l071 3�t3-0153 FloridaNOra.ySPnrirP rom
******************************
APPROVED BY
S
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of rr.
Cc 4h 1 o � �T/ �n ' {
me or who has produc
,20 / ,by
ho is personally known to
identifica ' • n and who did take an oath.
J •
NOTA
i
Sign:
Print:
Seal:
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)