EL-17-2818Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit No. EL-11-17-2818
Permit Type: Electrical - Residential
Arark Classification: Addition/Alteration
Permit Status; APPROVED
Issue Date:12f112017
Expiration: 05/30/2018
Parcel Number
Applicant
390 NE 104 Street
Miami Shores, FL 33138-
1121360130160
Block: Lot:
CHRISTIAN & DREIRDRE DUNK
Owner Information
Address
Phone
Cell
CHRISTIAN & DREIRDRE DUNHAM
390 NE 104 Street
MIAMI SHORES FL 33138-
390 NE 104 Street
MIAMI SHORES FL 33138-
Contractor(s)
BULLARD ELECTRICAL INC
Phone
(786)487-9505
Cell Phone
(305)804-2767
Valuation:
Total Sq Feet:
$ 6,000.00
0
Type of Work: NEW KITCHEN AND BATHROOM
Additional Info: NEW KITCHEN AND BATHROOM
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$3.60
$3.38
$2.25
$1.20
$225.00
$3.00
$4.80
$243.23
Pay Date Pay Type
Invoice # EL-11-17-65765
11/29/2017 Credit Card
12/01/2017 Credit Card
Amt Paid Amt Due
$ 50.00 $ 193.23
$ 193.23 $ 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
construction zone g. Futher .re,
at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
orize the above -named contractor to do the work stated.
Authorii d Signature: Owner / Applicant / Contractor / Agent
December 01, 2017
Date
Building Department Copy
December 01, 2017
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 [V(ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL OPUBLIC WORKS
JOB ADDRESS: 3[ V i V v I D1-4 s {�
City: Miami Shores County: Miami Dade Zip: 331 31
Folio/Parcel#: l ' 2A(e' 3 " d Q Is the Building Historically Designated: Yes NO
Occupancy Type:
Address:
Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder (iglictrof a4-cLre-iat. t\--+ YK Phone#:
0 N-' ffog- gt
City: / Y l ( Q nit) ShOlit-1 State:
rt.,-
305- eb d ' 2-1 Lei
Zip: -53) 3,k
Tenant/Lessee Name: Phone#:
Email: St r—t l @ y�'1 oa awx.
Address.
City: J
Qualifier Name: QAh0,e.,l l atl [(Orli
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: Vcoo City: State: Zip:
Value of Work for this Permit: $ ,—,/- {. r Square/Linear Footage of Work:
Type of Work: ❑ Addition I"I Alterration El New ElRepair/Replace 1-1Demolition
Descripti{on of Work: t�1t,V�J Ki- .-4\JL 1'1 [ b(CCL \
RECEIVED
6110_T 7017
nFBC20I LI
Master Permit No. 1C ` 1 5
Sub Permit No. e. 1 R' Zeta
❑ REVISION ❑ EXTENSION 0 RENEWAL
❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
CONTRACTOR: Company Name: -BW U r Ut e ' Phone#: 1 Stp ' ,4 0 ` ' 6—
I Lit*iz1 sv\I 1 1 '/ —re
is °
Zip: 331, 71
Phone#: 1Sco ' LI O 7
c00 1,
State: rt
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ V,` ®v
CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 193 3
1l3.23
(Revised02/24/2014)
BBondingtompany'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 be approved and a reinspection fee will be charged.
OWNER or AGENT
The foregoing instrument/�was acknowledged before me this
1t F�.J �` day of dabt/ 20 I/
j11 1 eL-1L , k 4 who is personally known
me or who has produced
identificatio a d who did take an oath.
NOTARY P BLI :
Si:
Print:
Seal:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
as me or who
identificatid
NOTARY P
*
o`; : P:;ge LORETTA COMES
* MY COMMISSION tt FF 954664
EXPIRES: March 21, 2020
+r ,c30" Bonded ThN Budget Notary Swims
day of
Sign:
Print:
Seal:
APPROVED BY jlans Examiner
r .2
s produced
n and who did take an oath.
BLIC:
rsi`;a •:::kb LORETTA COMES
* st_ * MY COMMISSION It FF 954664
om'° EXPIRES: March 21, 2020
41*OP fie° Bonded Thru Budget Notary Serves
ersonally known
by
as
Zoning
Structural Review
(Revised02/24/2014)
Clerk