EL-18-3125Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
.rIJ IJ1PJf �.
Issue Date:10/24/2018`
Location Address Parcel Number
101 NW 102ND ST, Miami Shores, FL 33150 1131010220050
Permit No.: EL-10-18-3125
Permit Type: Electrical - Residential
Work Classification: Pool
Permit Status: Approved
Expiration: 04/08/2019
Contacts
JACQUES BARBARA Owner STATE ELECTRICAL CONTRACTOR LLC Contractor
101 102 ARMANDO OJITO
1100 SW 97 AVE, MIAMI, FL 33174
Business: 7862567068
Description: NEW POOL WIRING, ROUGH ELECT HOOK UP Valuation: $ 2,000.00 Inspection Requests:
30S-762-4949
Total Scl Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Payments Date Paid
Amt Paid
Total Fees
$111.10
Check # 15140 10/10/2018
$50.00
Credit Card 10/24/2018
$61.10
Amount Due:
$0.00
Building Department Copy
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
requ!aWq copgr—uctioK and
that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
. othermore, j4uthsyize the above named contractor to do the work stated.
A i ri e i n re: O / licant /�- Contractor / Agent Date
^� O i
October 24, 2018 Page 2 of 2
L. 1. 4
10 018
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
FBC 20p
BUILDING Master Permit No. b?? (O - 3) Z:5
PERMIT APPLICATION sub Permit No. �_J JOO- S ZS
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRES0 0% O Uu lua -5� . C
City: Miami Shores County: Miami Dade Zip: 3313p
Folio/Parcel#:1E1"?Ll;)1"O.W'OorJ0 Is t e Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 7 SIL` Pb.<<'bEit£1 Phone#: J—'q3Q'91j
Address: %Q1 tv.V.9. b90 .
City: K%am 1 State: 41— Zip:
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
Address:
7ii
�G.Ti 7`• LGL
City: / 14— State: Zip: :3 5 E -7L�
Qualifier Name: Phone#: •� �s"C ^ 7C ��
State Certification or Registration #: FC l 30 d l 5-4 3 Certificate of Competency #:
DESIGNER: Architect/Engineer:
ne#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration.— ❑ New ❑ Repair/Replace ❑ Demolition'' '.11
Description of Work: /�D
Specify color Of color thru tile:
l � "'...�.• •, ...�.... �„^"_;it` �r�ismwz®....�„�pr:'.ewe+�,....}<:+11w.+nyy,vrxy.�,
Submittal Fee $ Sd } Permit Fee $ JjInPi ea CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 2_ Q 0 DBPR $ 2 l Notary $
Technology Fee $,
Structural Reviews $
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) _
Mortgage Lender's Address
City State
Zip
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. a j
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PRC�PERTY.: If `YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR'CENDER 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`subiect to attachment. Also, a certified copy of the 'recorded notice of commencement must bre 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
OWNER or AGENT s
Signature A�;?
Oe
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day
//oof���� &)CAV� 20 It by ZZ % tday of �i/�/ - 20 (S by
�Gt7Gl 3� fbCACI:J4tT{k , who is personally known to I[l�fQ�i� �J �2�, who is personally known to
me or who has produced
identification and who did ke an oath.
NOTARY P BLI
Print:
Seal:
Notary Public - State of Florida
Commission # GG 250751
My Comm. Expires Feb 14, 2021
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign.
Print: $y'i:"
ANUELA.DIANA
i
Sea l: = • ' •yy^'
NotaryPub,i - tt*nfH, ids -
Commission A GG 112857
i
My Comm. Expires Dec 15, 2019
: cP ;::•
Bordedthrough NatloaalNotaryAssn.
as
APPROVED BY/ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)