EL-18-1554Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Parcel Number
Permit NQ. EL-6-18-1554
Permit Type: Electrical - Residential
Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 6128/2018
Expiration: 12/25/2018
Applicant
1084 NE 97 Street
Miami Shores, FL 33138-
1132050170190
Block: Lot:
1084 MIAMI SHORES LLC
Owner Information
Address
Phone
Cell
1084 MIAMI SHORES LLC
1084 NE 97 Street
MIAMI SHORES FL 33138-
(305)767-9693
1265 SABAL TRAIL
WESTON FL 33327-
Contractor(s)
Phone Cell Phone
MAGD TECH ELECTRIC CORP (786)853-4767
Valuation:
Total Sq Feet:
$ 500.00
0
Type of Work: REPLACED FOUR GFI RECEPTACLES
Additional Info: REPLACED FOUR GFI RECEPTACLES
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Penalty Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Work without Permit Fee
Total:
Amount
$0.60
$3.38
$2.25
$0.20
$100.00
$225.00
$3.00
$0.80
$225.00
$560.23
Pay Date Pay Type
Invoice # EL-6-18-67827
06/06/2018 Credit Card
06/28/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 510.23
$ 510.23 $ 0.00
Available Inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
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, 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 —4fi r•. Futhermore, I authorize the above -named contractor to do the work stated.
A
Asfild Col/Rack)
Signature: Owner / Applicant / Contractor
/ Agent
June 28, 2018
Date
Building Department Copy
June 28, 2018
1
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
BUILDING
PERMIT APPLICATION
❑ BUILDING E ELECTRIC
❑PLUMBING ❑ MECHANiCAL
JOB ADDRESS: s? 1 .
City:
Miami Shores
Folio/Parcel#:
Occupancy Type: Load:
Miami Shores Village
Building ttepartment
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
fl ROOFING
❑PUBLIC WORKS
County:
❑ REVISION
Master Permit No.
Sub Permit No,
❑ EXTENSION
RECEIVED
JO062018(
Cs 4-1
FBc zo �
12-C 1 ce—k SSZ_
e 18-1 ss9
❑RENEWAL
fl CHANGE OF fl CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Dade Zip:
Is the Building Historically Designated: Yes NO
Construction Type:
Flood Zone:
OWNER: Name (Fee Simple Titleholder): /G' c S' 1 t ���-�� L,'' !r-'
Address: /2 G. .1
City:
- r
Tenant/Lessee Name: �� �`
Email:
State:
BFE: FFE:_
Phone::315 3t/2. UG''ly" Y
Zip: 333 Z .a1'
Phone#:
CONTRACTOR: Company Name:
Address: ` i(:r.‘" i f'= �� .1
Phone#: ":+ z' !`* .,i
City: .'./ / At/- / / State:
Qualifier Name: "-A`t d'`'C't Z-
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Zip:
3 "t.? (.
Certificate of Competency #;
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $
Type of Work: El Addition ❑ Alteration
oie
Description of Work:
Square/Linear Footage of Work:
C. Repair/Replace
❑ Demolition
Specify color of color thru tile:
Permit Fee $ / SCCCF/$ CO/CC $
Radon Fee $ �' a-S DBPR $ • Notary $
Training/Education Fee $ — Double Fee $ 2 • C73
Bond $
TOTAL FEE NOW DUE $ e `7 '
2J24J2O 41 (03
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
p
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_ 1 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 ail
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 roust
promise in good faith that a copy of the notice of commencement and construction lien low 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_-y_. =" Signature
q OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of LYlt
JQR 1, (A woef ,,1jwho is personally known to
me or who has produced £l v` 0-1I `I 7 I' 1 s
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Astrid Camacho
*. +_COMMlSSlON#FF141883
' '��' < Pt �BONDEDo{td
1-1 IRSut2ete****.******4. ..... .****wwww**************
'
,,,,, 1st FLORIDA NOTARY, LLC
APPROVED BY /// �%Z r yit Plans Examiner
CONTRACTOR
I The foregoing instrument was acknowledged before me this
,20 1 ,by 6 day of �u"''t' ,20 /8 ,by
_4A,.1,'41 iAT,Z•-2.y- who is personally known to
me or who has produced .Mr) Act( as
identification and who did take an oa
NOTARY PUBLIC:
Sign:
Print:
Seal:
EXPIRES J e 29. 2019
(47)348-0162 flontilietot w.rc..v*
Structural Review
.**********************
Zoning
Clerk
(Revised02/24,2014)