ELC-18-2088Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. E;LC-8-18-2088
Permit Type: Electrical Commercial
Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 8/20/2018
Expiration: 02/16/2019
Parcel Number
Applicant
9600 NE 2 Avenue
Miami Shores, FL 33138-
1132060132510
Block: Lot:
PALAZZO LEONI LLC
Owner Information
Address
Phone
Cell
PALAZZO LEONI LLC
PO BOX 381703
MIAMI FL 33238-
PO BOX 381703
MIAMI FL 33238-
Contractor(s) Phone
CARLY ELECTRICAL SERVICE 305-970-6345
Cell Phone
Valuation:
Total Sq Feet:
$ 1,200.00
0
Type of Work: NEW MOTOR CONTROLLERS FOR WATER PUM
Additional Info: NEW MOTOR CONTROLLERS FOR WATER PUM
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.25
$2.00
$0.40
$150.00
$3.00
$1.60
$160.45
Pay Date
Invoice #
08/20/2018
08/06/2018
Pay Type
ELC-8-18-68457
Credit Card
Credit Card
Amt Paid Amt Due
$ 110.45 $ 50.00
$ 50.00 $ 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, 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. Fyt p ore, I authorize the above -named contractor to do the work stated.
August 20, 2018
Authoriz'edSignature: Owner / Applicant / Contractor / Agent
Date
Building Department Copy
August 20, 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 ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS:
cr6eo N€ 2 Akiq,
City: Miami Shores County:
Folio/Parcel#: 11113 206 lw/ 3 2.510
❑ REVISION
RECEIVED
AUG 06 2018
FBC 20 I'R
Master Permit No. PI C k8 r 12-2-
Sub Permit No. E 1 C 208 8'
❑ EXTENSION
❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Dade Zip: 33 ( 3g ✓
Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder):
Address:
NALA-Zzo iFON I (lc
PC) 13DK 3$703
City: v 1 `/4c
State:
BFE: FFE:
Phone#:
05� 11 11- )(
Zip: 33 L�
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: cl C%1., ,C` s l�V (.c6
/
Address: A aobii U)r(,A-GACMA v L_
City: AAAA State: r� C L
Qualifier Name: CA Los � �N " c'&z
LC43005142
Phone#: 306 `r7b-6's
zip: 33 l�((
Phone#:2O c Io-63J
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ %? D 0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
El New Repair/Replace ❑Demolition
Description of Work: VgMoro Cot/TN-AO-5 Qok Wd,i'Pouts is
cos iuc - WLL5
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ (.474 Ot> CCF $ CO/CC $
Scanning Fee $ Radon Fee $ ' " <no DBPR $ Z • 2-5 Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 1 (O ' 45
(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 seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not approved and a reinspection fee will be charged.
Signature "
OWNER or AGENT
The foregoing instrument was acknowledged beforemethis
6 day of /4// VS7 , 20 %lJ , by
%DD/O , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLI
Sign:
Print:
Seal:
ANDREW-VOGEL
MY COMMISSION # FF919683
EXPIRES: November 25, 2019
GyAns .k.k6
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of U , 20 Z5 , by
who is personally known
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
I
eliE=i , NANCY HERNANDEZ
__ Commission # FF 166011
j . Expires February 6, 2019
°... Bonded Thru Troy Fein Insurance BW 3B5.7019
i
************************************************************************************************************
APPROVED B
, -)
R Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
Signature
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