EL-17-1724Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. EL-7-17-1724
Permit Type: Etectrical - Residential
Work ClassifitatioifLP6o1..= Private
Permit Status: APPROVED
tsSue Date: Not Issued
Expiration: 01/01/2018
Parcel Number
Applicant
118 NE 102 Street
Miami Shores, FL
1132060131890
Block: Lot:
KARON COLEMAN
Owner Information
Address
Phone
Cell
KARON COLEMAN
118 NE 102 Street
MIAMI SHORES FL 33138-
(305)987-8422
i
118 NE 102 Street
MIAMI SHORES FL 33138-
Contractor(s)
MESA BROTHERS INC
Phone
(305)345-1974
CeII Phone
Valuation:
Total Sq Feet:
$ 600.00
0
Type of Work: SWIMMING POOL ELECTRIC
Additional Info: SWIMMING POOL ELECTRIC
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Return Check Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$4.50
$4.50
$0.20
$300.00
$30.00
$3.00
$0.80
$343.60
Pay Date Pay Type
Invoice # EL-7-17-64480
07/24/2017 Check #: 1544 $ 343.60 $ 0.00
Amt Paid Amt Due
Available Inspections:
Inspection Type:
Final
Light Niche
Bonding
Review Electrical
Alarms
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 fo -goi information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin : F , her:,. I au,�r.�:: ' bove-named contractor to do the work stated.
July 24, 2017
Authorized Si • natu e: • ne / A 1^ ant / Contractor / Agent
Date
Building Department Copy
July 24, 2017
1
BUILDING
PERMIT APPLICATION
❑BUILDING %ELECTRIC
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
ROOFING
RECEIVED
JUL 05 2017
S4\
FBC Zoiu
Master Permit No. in- i 3 —7
Sub Permit No. f 1
REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: i I b N /0 a 5i
City:
Miami Shores County: - Miami Dade
❑ CANCELLATION ❑ SHOP
DRAWINGS
Zip:
Folio/Parcel#:: l 1 " 3 20(o -0) 3 - 189 0 Is the Building Historically Designated: Yes
Occupancy Type: Load:
Construction Type:
OWNER: Name (Fee Simple Titleholder): k ( on Co) ern r7
Addres�'s:11 l (0 i E )02 S9 f�►
City: M(tir11 S1-t0)riS State:
Tenant/Lessee Name: h/✓4-
Email: kA,yon m►'fivnAve fi-koo - co?-4
CONTRACTOR: Company Name: j 4 SA 8to'-Hh-er s
Address: s al 6 Sc 103 rive
Flood Zone:
NO X -
BFE: FFE:
Phone#: '305 - 98 7 - 8kb.).
Phone#:
Zip: (3 8%
3os-(030-a5q9,
Phone#: -1.Sr(e— 73 '2 ' O (o l �
City: ).-t ice, m ( State: Pt • Zip: 3 3 i
Qualifier Name: RA-L) L 1 -e(314. Phone#:(OS) 4930 -.25
State Certification or Registration #: EC /3 G 6 / ( 70 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
cX�
Value of Work for this Permit: $ GOO, Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ra New ❑ Repair/Replace
Description of Work: S W, r..�n:tl ti !J 06 L ei-efr
c. C_
n Demolition
LL
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 'zc7 'do, if, CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 3 -3 • on
(Revised02/24/2014)
Ir
Bonding Company's Name (if applicable) N . •
Bonding Company's Address
I
City State Zip
Mortgage Lender's Name (if applicable) k4J ells
Mortgage Lender'sAddress . P.O c (9(Q o 3
City .AA A, S t r .' i State
t ( f- r� I, �� k r t E
i i_ t I . jk. ., %. {eF , it .
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 •
C.
zip %524,6 - 0a7er' I'
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
RESULTIN 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 6p'plicant 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 be approved and a r inspection fee will be charged.
Signature
Signature'
OWNER br AGENT CONTRACTOR
l t 4 3
The foregoing instrument was acknowledged before me -this The foregoing instrument was acknowledged before thethis
22 day of J tJ de , 20 I 1 , by day of - ' . J J r`1 2. , 20
,who is personally known to }�w L J-� eSi4• ,who is personally known to
kF}2pN CoLer-ij r
-r
me or=who has produced " as me or who has produced `
identification and who did take an oath.
+ s
NOTARY PUBLIC:
Sign
Print:
Seal: -
APPROVED BY
.t
2a`r,:.:74, AIDAPEGUERO
MY COMMISSION t FF 165583
`,T` EXPIRES: Dctouer 5, 20t8
` "l-,, fa„o f' Bonded Thru Budget Notary Senkes
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
Seal:
✓ . Ii Plans Examiner
as
4et AIDAPEGUERO
MY COMMISSION # FF 165583
EXPIRES: October 5,2018
`� ' Bonded Thru Budpt Notary 5.ryker
i? r
.S • v .�,,ry
Zoning
1 3
Structural Review Clerk
(Revised02/24/2014)