EL-18-2102Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Issue Da
Permit No. EL-8-18-2102
Permit Type: Electrical -Residential
Work Classification: Alteration
Permit Status: APPROVED
811512018
Expiration: 02/11/2019
Parcel Number
Applicant
9879 NE 13 Avenue
Miami Shores, FL
1132050090490
Block: Lot:
JACQUELINE BARRANTES
Owner Information
Address
Phone
Cell
JACQUELINE BARRANTES
9879 NE 13 Avenue
MIAMI SHORES FL 33138-
(917)698-2863
9879 NE 13 Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
SOUTHERN MARINE CONSTRUCTION 305-861-2764 (305)613-6377
LONGMAN ELECTRIC INC (305)758-1211
Valuation:
Total Sq Feet:
$ 2,200.00
0
Type of Work: POWER TO BOAT LIFT
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$o.00
$o.00
$o.00
$o.00
$150.00
$0.00
$0.00
$150.00
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-8-18-68470
08/15/2018 Credit Card $ 150.00 $ 0.00
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 anstrict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this per assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELEC ' ALA; LUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFI
construction an
Authorize
that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
mor I authorize the above -named contractor to do the work stated.
re: • er / Applicant / Contractor / Agent
Building 1 - partment Copy
August 15, 2018
Date
August 15, 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 j ELECTRIC ❑ ROOFING
FBC201l
Master Permit No. DOCK `�18 - I " I 0
Sub Permit No. EL \ 8 - LI 0 a
❑ REVISION ❑ EXTENSION RENEWAL
n PLUMBING n MECHANICAL ❑ PUBLIC WORKS n CHANGE OF
� Q ^ i CONTRACTOR
Q
JOB ADDRESS: ` v � � t 1 �" /1 '%
CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade Zip: 3 3 I 0
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): geUNJ Pr( <iOk 4 ,.lAaiik.elAKI Y°41C°' F one#: g(-} 3 - l5 e•c:'
�
Address: 1 oi j L 37a co/5-
City: /I/1l PA11 5 lifyl,j, S State: Zip: 33I-
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Z14/4 &/ iet)
Address: 93.-
Alb. 46'44 S _T
Phone#:.3° %J g.
City: ✓v/ /4t ' / - F -S State: Fr__ Zip: 3 3 / 6 2-
Qualifier Name: /CH/4/C2 LU/1/ •4/1/47 y
Phone#:
/U;A
/ `3 '
State Certification or Registration #: C'G/ ;boa 37Certificate of Competency #:
1 ,
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $
Icoc,
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ri New ❑ Repair/Replace n Demolition
Description of Work: T Q r 1CkC9
Pow-cY sBoa-1- Uq4-
Specify color of co/or;th.4ru tile: c,L,
Submittal Fee $`s".`M'vr.,Peilmit`Fee'$"'4' 162.b6 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 2 - O C- DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE 0-6 2.
* I ° ''C
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding,Company's Address
-J
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
r
• r + f
1:. T.i
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 'ch occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be . pp o �. and a reinspection fee will be charged.
Signature ." Signatu
NER or AGENT
CONTRACTOR
The foregoing in ent was acknowledged before m this The foregoing instrument was acknowledged before me this
7-4 day of N `V , 20 by 7 day of 4+ 1.5 L.' f , 20 1 g , by
�YJJ
A—{U Lt , who is personally kno n to Nil e 4gel ie,15'74A , who i ersonally known o
me or who has produced as
me or who has produced t— A
f I C9.Arl`
identification and who did take an oath.
411( ‘\
IC'
NOTARY PU
Print:
Seal:
MAH
as
MY COMMISSION # GG 044602
"rf,Frai°..` Bonded Thru Notary Public Underwriters
identification and who did take an oath.
NOTARY PUBLIC:
Seal:
****************************************************************
APPROVED BY
49(,(e-./6 Plans Examiner
Structural Review
**************** ** * * * *********
Zoning
Clerk
(Revised02/24/2014) -• t