EL-18-2267Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Per NO.:
-8-18-2267 Permit IVA Number: 614878
issue Date:10/09/2018
Permit Type: Electrical - Residential
Work Classification: Addition
Permit Status: Approved
Expiration: 02/2 5/2019
Parcel Number
Project
285 NE 103 ST, Miami Shores, FL 33138-2430
1121360130440
<NONE>
Contacts
KENNETH & DEENY LORBER
285 NE 103 ST, MIAMI SHORES, FL 33138
Owner
ATLANTIS ELECTRICAL CORP
FRANCISCO PEREZ
12803 SW 20 TER, MIAMI, FL 33175
Business: 3055514043
Contractor
Description: REMOVE AND REPLACE GFI OUTLETS AND LIGHT
SWITCH FOR GUEST BATHROOM REMODEL AS PER PLANS
Fees
Amount
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
$0.60
$2.25
$2.00
$0.20
$150.00
$3.00
$0.80
Total: $158.85
KENNETH & DEENY LORBER
285 NE 103 ST, MIAMI SHORES, FL 33138
Applicant
Payments
Total Fees
Credit Card
Credit Card
Amount Due:
Amt Paid
$158.85
$50.00
$108.85
$0.00
Inspection Requests:
305-762-4949
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: OwneL7
October 09, 2018
Apa'9licant / Contractor
('
Agent Date
Page 2 of 4
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ELECTRIC ❑ ROOFING
EPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
RECEIVED
AUG 2 3 2018
qV{
FBC20I-
Master Permit No. _ 2 (tlP
Sub Permit No.t 1 —22C0
❑ REVISION ❑ EXTENSION Li RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 2-3 Nf t v3
City: , Miami Shores County:
Folio/Parcel#: I '.2.1310. PIS. 04(40
Miami Dade tip: 3,3) 3'
Is the Building Historically Designated: Yes NO
Occupancy Type: _ Load: Construction Type: Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): n-(0ri' ,1 ` D ,e_h•\\j Lo1(ber Phone#:
Address: ?_$S E t, 03 I
City: i ,\G1ryt 5\aore6 State: Zip: ,Z8)3$
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: MACIakiS Corp.aYteR‘ Phone#:$(v �' 3Q 5 - !off 90
Address: 12-2O3 SW 2,0 --V-�iNr ee,
City: M 1U rx1�k State:
Qualifier Name: FrarlCaSCO PGrGZ
State Certification or Registration #: - -I 3 oc7 9// Certificate of Competency #:
Zip: 331-15
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $
Type of Work: ❑ A ition ❑ Alteration / ❑ New 0 Repair/Repla _ ❑ Demplition
(it}
De cription 9of Wor : Jl I t �w/
mot- s (cs
Phone#:
Phone#:
Address: City: State: Zip:
Square/Linear Footage of Work: 00
Specify color of color thru tile: y
Submittal Fee $ Permit Fee $ �.7 2'%e ml) CCF $ CO/CC $
Scanning Fee $ Radon Fee $ ' 2 ` Q DBPR $ 2 ZS Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ (OG 8`
(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 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.
"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 s• • days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved,�nd a re • - on fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
2_�-_� day of I'(�q�LS� ,20 (B ,by
Lrv( ppp�v\ L OY b-4'r , who is personally known to
me or who has prod �� ~�YLij Lft n' 0 as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
��'�` day of LAS-}' , 20 I? , by
r cA. 5 o Cz. , who is personally known to
f-
me or who has produced *Pi_ 0, .A U. as
identification and who did take an oath.
NOTARY PUBLI
Sign: t Sign: J
1,
Print: 2— Print: SU
Seal: � � 1 '%, Suyaila T. Vasquez Seal: .P�Y.Ffp4��
4 '•, `' Commission # FF942611 •=
°•s` 1 Expires: December 9, 2019 =" �'�r.
APPROVED BY
***Rnndea*thru Aaron NN * ******************. M'
Plans Examiner
Suyapa T. Vasquez
Commission it FF942611
Expires: December 9, 2019
*WSW tf *Mir9: Not*W.************
Zoning
(Revised02/24/2014)
Structural Review
Clerk