EL-18-1780Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. EL-6-18-1780
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 6/28/2018
Expiration: 12/25/2018
Parcel Number
Applicant
1263 NE 101 Street
Miami Shores, FL
1132050250040
Block: Lot:
CLAUDIO RODRIGUEZ
Owner Information
Address
Phone
Cell
CLAUDIO RODRIGUEZ
1263 101 Street
MIAMI SHORES FL 33138-
1263 101 Street
MIAMI SHORES FL 33138-
Contractor(s)
CPS ELECTRIC, INC.
Phone
305-607-8221
Cell Phone
Valuation:
Total Sq Feet:
$ 9,500.00
0
Type of Work:
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
Permit Fee - Additions/Alterations
Total:
Amount
$332.50
$332.50
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-6-18-68085
06/28/2018 Check #: 1519 $ 332.50 $ 0.00
Al I
Available Inspections:
Inspection Type:
Review Electrical
i
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 con - tor to do the work stated.
Authorized Signature: Owner / Applicant / 'Contract' / Agent
June 28, 2018
Date
Building Department Copy
June 28, 2018 1
•
BUILDING_...!
PERMIT APPLISATION
JOB ADDRESS:
Miami Shores Village
-Building Department
100.50 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION UNE PHONE NUMBER: (305) 762.4949
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2 8 2018 1(
.FBC201C5
Master Permit No. 8 -
Sub Permit No.``(._ (9 ` ' (4 8-0
E E
❑BUILDING. ; LECTRIC ❑ ROOFING ❑. REVISION I , E EXTENSION, [V(RENEWAL
-! C. n ,
❑PLUMBING ❑ MECHANICAL [PUBLIC WORKS 'CHANGE. OF ;❑ CANCELLATION Q SHOP
CONTRACTOR DRAWINGS
1'263 NE 101 s
City:• - ,-MiamiSifores-.
Folio/Parcel#:
Counts:: 1 Miami Dade _ .. _ Zio;
MIIY�. -Miami Dade 1
.: r •. a. a T.
Is the Building Historically Designated: Yes NO
•• Occupancy Type: • Load:: - Construction :Type:
OWNER: Name (Fee Simple Titleholder): C I Z 4 i°c
Address: . i 2- ,, , /Y.f� 1-eD f s
rt'l. _` S'
•
Tenant/Lessee Name:
Email:
State:
Flood Zone::- BFE:
FFE:
i�Z� "`Phone#:3�5_Z l 6_2 Z 21/.
' Zip: 7") 2
• Phone#:
CONTRACTOR: Company Name: C es Phone#:
Address: l (D •Q D /VU.)'-_.
• •i trn ��� I State: lr��
Qualifier Name: A-i Jf L : Y1 a eLQ
State Certification or Registration#: E CA- 3oo J T`O I- Certificate of Competency #:
DESIGNER: Architect/Engineer: •1y t� t ✓i r 1 e- Phone#: �' 6 - S - ? Sss
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Address: � � � L 1a- 1 v�-- 1 , �t S � --City: • ^ � State: Zip:
Value of Work for this .
Pernnit: $ ' T )O • 00 Square/LIngar-Footage Wocic:
City:
Type of Work: ❑ Addition ❑ Alteration ❑ New
Description of Work: •. i - -f W �.rvr� 7
( 23
> epair/Repiaca
P�tic Glr
. .0 i1.ar'''
LIR. J —J / Cr
Phone#:3 kr 3 7o
❑ Demolition
Specify color Of color thiii tile:
.• Submittal fee $ .. Permit Fee $33 Z ' SO CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ - '" Trainlng/Education Fee $ Double Fee $
Structural Reviews $ Bond $ - 7�
_ -TOTAL FEE NOW DUE $ 332S
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(Revlsed02/24/2014)
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4-Fin-05741
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.Bonding Company's Name (if applicable) --
• • ;11 • '
-
Bonding Company's Address
L . L 114••;,. ft4.1f “.141, 1.
City -re -State k %P. 0.11. I. V r•-•r Zip
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Mortgage Lender's Name (lialsitilitc131414 •.('''''.1.11:2i“:1
Mortgage Lender's Address
r4,!,;..P'trIttti;:;!::.-- Rite , City ' Zip f:),3fr.tti3 if :AV
• _
Application is hereby made to obtain a permit to:do the work and installations as indicated: I certify that no work or installation has
onered prkii'th:ticia' issuance of a 'perinit 'land -that all wOrkiviIll performed 1Tht'!'he standaidsof: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 • -)) )8, ) r ),„„• ,
. 31, r 1:1i •
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.
;U7C AILL
"WARNING TO OWNER:47trifOURFAILURE TOYRICORD-A- NOTICE OF tOMMENCENIENT MAY
RESULT IN10PAYiNG TWItt kikIMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
-----T6 OBTAIN ANANCINGTCONSULT-WITH YOURUNDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
tols.ri; r 1:3; • urn Ariel *I
---Notice to Applicant: As aconditIon.tothe Issuance of,a building permitW!th an estimatedvalue_exceedin-g $2500,-theopplIcant must
promise in good faith,that a copy of the notke of commencement und construction lien luw brochure will be delivered to the person
hiiei�pirtyifitibjeif tb-attifthineht7Also,iftertified-cOOV"Otthe'reccitried notice of commencement muit.be postid at the job site
.---for.the first inspection Whkh. occurs .seyen (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.
•••
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me or who has produced 4---1 11 t-eLf--) s, me or who has produced
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identification and who did take an oath. • identificaation and who did an nth
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, — , 20 by
by e" I . day of Lly) e
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NOTAKY PUBLIC:
A r" NOTARYPUBLIC
Sig
Print:
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APPROVED BY
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Structural Review Clerk
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Priit
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Signature.
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LSignature7
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OWNER or AGENT ONTRACtOR
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The foregoir% instrument was acknowleOged before mc The foregoing Instrument was acknowledged before me this
day of
Cv ‘2.„ WI; 34.7k
w e so n o (in .eL---/(-41/Y1 eize) , who is personally known to
as
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Plans Examiner, Zoning
,11ffite.A.
(Revised02/24/2014)
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