EL-17-2683Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
555 NE 93 Street
Miami Shores, FL
Owner Information
Address
P
Permit NO. E L-11-17-2683
Pen -nit Type: Electrical - Reeidential'
irk Classification. Addition/Alteration
Permit Status: APPROVED
Issue Date: 1'1/13/20'7
Expiration: 05/12/2018
Parcel Number
1132060141020
Block: Lot:
Phone
Applicant
VERONICA MOLINA FREDERICN
Cell
VERONICA MOLINA FREDERICK
555 NE 93 Street
MIAMI SHORES FL 33138-
(786)260-4901
555 NE 93 Street
MIAMI SHORES FL 33138-
Type of Work: NEW FOYER LIGHTS AND STAIRS LIGHTS
Additional Info: NEW FOYER LIGHTS AND STAIRS LIGHTS
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.25
$2.00
$0.20
$5.00
$0.00
$150.00
$3.00
$0.80
$163.85
Pay Date Pay Type
Invoice # EL-11-17-65623
11/09/2017 Credit Card
11/13/2017 Credit Card
Amt Paid Amt Due
$ 50.00 $ 113.85
$ 113.85 $ 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, MEC j NICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify t
construction and zoning. Futher
Author' ed Sig ; r
: Own
oregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
rize the above -named contractor to do the work stated.
/ Applicant / Contractor / Agent
November 13, 2017
Date
Building Department Copy
November 13, 2017
1
4v-)2'
BUILDING
PERMIT APPLICATION
❑BUILDING IZELECTRIC
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
PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS: 5 5 5 OE 5
❑ REVISION
❑ CHANGE OF
CONTRACTOR
RECEIVED
OV 0 !V.,/
F C 20IL-1
Master Permit No. 1? C R 1C-1
Sub Permit No. El R -2 085
❑ EXTENSION ❑ RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores
County:
Folio/Parcel#: 1 i ` 39-1°6 14 - 10 O
Occupancy Type: Load:. . Construction Type:
Miami Dade
Is the Building Historically Designated: Yes
Flood Zone:
OWNER: Name (Fee Simple Titleholder): 41 QAlu (CA W L1 /0A
Address: S5 5 ' t ol�J ed 51-
Zip: 331 '8
NO %(
BFE: ' FFE:
Phone#: -q-g 6 -abo -490 /
City: 1`i I Ate l S 14O S State: * (--
Tenant/Lessee Name: Phone#:
Email:
Zip: 3 31 �J8
CONTRACTOR: Company Name: 4)2-0N ( CA
Address:
5 5 5 (1\I 1 c?3rJ
Phone#: T Sr6 - Q 0 —490 I
City: Rl 4M-C I S State: Zip: -.5"1') t --)1E5
Qualifier Name: Phone#:
State Certification or Registration #:
Certificate of Competency #:
DESIGNER: Architect/Engineer: i N6 (N ' 12, 121-.LC 5l7Ahi ti0V4E00 Phone#:
Address: a.15 LAKE
City: ).JPO12A L State: -IL Zip: 331 667
Value of Work for this Permit: $ 500 , o 0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ,New
LI L2 HIS
Description of Work: A1eW 4'O/ gl(2-
❑ Repair/Replace ❑ Demolition
A STA( 12S U ,5
Specify colorofcolor thru tile:
Submittal Fee $ J° 'CC) Permit Fee $ l3-0/o 0 CCF $ G • .. c::;Q CO/CC $
Scanning Fee $ - Radon Fee $Q . �� DBPR $ 2 " 25
Technology Fee $ a • 90
Structural Reviews $
Notary $ B • C7�
Training/Education Fee $ 0 • 2-O Double Fee $ 32,
)27
TOTAL FEE NOW DUE$ \3 • G 5
Bond $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City ;;a. State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City I y t C State' Zip
L c !
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
The fforegoing instruments acknowledged before me this
"71 r^dayof/�N Vp�(t ,20 14 , by
. CQpyr on l E � wh�f's 4rrson�lly known to
me or who has produced FI l L. ,st as
identification and who did take an oath.
NOTARY PUBLIC:
S
Print:
Seal:
45 = MAHARAI K��
MY COMMISSIO ONZAL044EZ
O '� ` 20
BO SEXPIRES: Nov mber2 0 2
•
ru Notary Public Underwriters
************************************
APPROVED BY
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of , 20 , by
, who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
************************************************************
/ PAPvi kPlans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk