EL-17-2095Building
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Parcel Number
■
Issue Date: 8/
Permit No. EL-8-17-2095
Permit Type: Electrical - Residential
Work Classification: Pool - Private
Permit Status: APPROVED
I/2017
Expiration: 02/14/2018
Applicant
925 NE 95 Street
Miami Shores, FL 33138-
1132060143100
Block: Lot:
JUDITH H LEFFERDINK
Owner Information
Address
Phone
CeII
JUDITH H LEFFERDINK
925 NE 95 Street
MIAMI SHORES FL 33138-
(847)975-8540
925 NE 95 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
PEAL DEVELOPMENT GROUP, INC (786)302-9069
Valuation:
Total Sq Feet:
$ 1,500.00
0
Type of Work: NEW RESIDENTIAL POOL- ELECTRICAL WI
Additional Info: NEW RESIDENTIAL POOL- ELECTRICAL WI
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$4.50
$4.50
$0.40
$5.00
$300.00
$3.00
$1.60
$320.20
In consideration of the issuanc
pertaining thereto and in strict
accepting this permit I assu
required for ELECTRICAL
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-8-17-64924
08/18/2017 Credit Card $ 270.20 $ 50.00
08/18/2017 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Light Niche
Bonding
Review Electrical
Alarms
e of 4 his permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
h the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
y for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
CHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: ify t .t�th in ormation is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin authorize the above -named contractor to do the work stated.
.„14 f August18,2017
��� ��
Authorized • �. - >. ner / Applicant / Contractor / Agent Date
u:f •
rtment Copy
August 18, 2017
1
BUILDING
PERMIT APPLICATION
BUILDING jgELECTRIC
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS: IP•5 N.E ors%\
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
RECEIVED
AUG 2017
51.0M4
FBC 2010
Master Permit No.3'P\ R -184s
Sub Permit No. El CR 2-0C4-5
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: ` Miami Shores /� County: Miami Dade
! Folio/Parcel#: \ -� �.c®1o" ��� �" d d Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone:
Zip: 331.4eS
NO
BFE: FFE:
OWNER: Name �((Fee Simple Titleholder): TC) SSIA\A Le `CC LO � Phone#:
v� Address: 5 7 5 .Z1---
City: TA kk. \ State: — Zip: 331
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:7E,\-- SU6.2*) t''`C."A
Q o�p`7
Address: 4 ), 'W
City: i State:
Qualifier Name:
Phone#:�
State Certification or Registration #:
Phone#:
Certificate of Competency #:
Zip: 3 1
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 1 ECDO Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑New ❑Repair/Replace
i l kA 12,s't\•0 Ai./L '?aa ( ---
Description of Work:
..� VP;�
❑ Demolition
1•cAL
Specify color of colorthru tile`: ;_, !�
• CCF $ >..- n, CO/CC $'
DBPR $ Notary $
Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
Submittal Fee $ Permit Fee $ .FertD t ee>
Scanning Fee $
Radon Fee $
Technology Fee $
Training/Education Fee $
(Revised02/24/2014)
1 4 ,
Bonding'Company's Name (if applicable)
Bonding Company'sddress
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. r -',k t 2 e ` `; .,
"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
+r
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant:. As a condition to the issuance of a building permit with an estimated value
promise in good faith that a copy of the notice of commencement and construction lien law
whose property is subject to attachment. Also, a certified copy of the recorded notice of com
for the first inspection which occurs seven (7) days after the building permit is issued.
inspection will not be approved and a reinspection fee will be charged.
OWNE'^%AGENT
The foregoing instrument was a knowledged before me this
- 11 I'day of''~ Af1U d' , 20 f by
jdi 1'( Le.�idr , who is personally known to
J_
me or who has producdd P'IOil, b'Jef 1 itemise as
identification and who did take an oath.
NOTARY PUBLIC:
Sign.y�.;
L� )
Print:
Seal:
�—ars.
,�•* .0"u'i�', FERNANDO MARTINEZ
,1 _ Notary Public - State of Florida
T. ��� ?mac Commission # FF 924008
**************** s�fr'.IE **IIhY AI R41SD1rii5g1:Gte44b42Aa
0, the applicant must
elivered to 'the person
e posted at the Job site
such posted notice, the
p ACTOR t , 't _ M
The foregoing instrument was acknowledged before me this
Al yvay of rn ! .L.) q, a • 20 1�- , by
?CA ib � k .-7
Iwho is personally known to
me or who has produced .- $( 1 CQm 3v.,_ as
identification and who did take an oath.
� Y
NOTARY PUBLIC:
Si
Print:
Seal:
•
•
MAHARAI K.
MMISSION # GO 044602
P EXPIRES: November2, 2020
•, fai.4t• Sondes' ': •u Notary Public Underwriters
Limb
********************************************************
APPROVED BY Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)