EL-18-3221Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:10/23/2018
Permit No.. EL-10-18-3221
Permit Type:: Electrical - Residential
Work Classification: Pool
Permit Status: Approved
Expiration: 04/17/2019
Location Address Parcel Number Project
1255 NE 99 ST, Miami Shores, FL 33138-2642 1132050090100 <NONE>
Contacts
JOSH WOLLOWICK Owner JOSH WOLLOWICK Applicant
1255 NE 99 ST 1255 NE 99 ST
Other:3055310970 Other:3055310970
STRONG DEVELOPMENT & Contractor
CONSTRUCTION COMPANY (EL)
EMIL BODDEN
9260 SW 120 ST, MIAMI, FL 33256
Business:3053211586 FFUERTES@STRONGDEVELOPER.COM
Description: RELOCATION OF POOL EQUIPMENT Valuation: $ 2,500.00 Inspection Requests:
305-762-4949
TotalSq Feet: 500.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Notary Fee
$5.00
Permit Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$122.90
Payments
Date Paid Amt Paid
Total Fees
$122.90
Credit Card
10/23/2018 $122.90
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 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. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: owner / Applicant / Contractor / Agent Date
October 23, 2018 Page 2 of 2
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
1�c'
ooll lk,�
lob
FBCC 20Ig
Master Permit Now' r ' �r q ^ yt
Sub Permit No.Qt—I �r - 3 22
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Ia 5 5 6J e- / / 5-7
City: Miami Shores County' Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
+J dS�
L.) 6 �/a "`� �� "�
�y� S J) — c�
Phone#: 0
Address: /1 113
57—
City: e 14 /1 / S- o rt-, State: TL axl')'Q Zip:
Tenant/Lessee Named Pnone;F:
Email:
CONTRACTOR: Company Name: I r0 /? 41 �e`��U P/� f'.n + �° r� Phone#: (3 a-5-J 3Z —15-74:�
Address: �U L3�X 665-9'0
City: l� / A!'i 1 State: f" �— Zip:
Qualifier Name:
ne#:
State Certification or Registration #: ZG /3 O °' d 6 `-'j Certificate of Competency #: _
DESIGNER: Architect/Engineer: FF�z2., i ���''"�"''"���` Phone#:
Add
City: State: Zip:
Value of Work for this Permit: $ �4-00. 6 � Square/Linear Footage of Work:
Type of Work: El Addition
/ ❑ /Alteration ❑ New 2-'Repair/Replace
otRepair/Replace ❑ Demolition
Description of Work: �e�oC,�► l"i r' �' �� j�� i�Qv�
Specify color of color thru tile:
Submittal Fee $ �k Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $ S
Double Fee $
Bond $ TOTAL FEE NOW DUE $ I �-q 4
(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.
"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 ee absence
/ �e of 1//y�ch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
O NER or AGENT
The foregoing instrument was acknowledged before me this
61� _ day of I O F le `--. , 20 , by
V�,JO�!-O i wno is personally known to
me or who has produced V!�- as
Signature
The foregoing instrument was acknowledged before me this
day of e�2C ? /3</t 20 / Y by
,L-74(L /3oI)C ,0'-J who is persallYknown to
me or who has produced
identification and who did take an oath. identification and who did take an oath.
as
NOTARY PUBLIC: 1.111111I1//� NOTARY PUBLIC:
.... AR4G9MMIssiopF ADA a. PANDO
Sign: • R,Y MaMhr�ss Sign: Y ,tti Notary Pow • s FF Sf1S W&
Print: _c �_B,� 0 �: Print: 3 it� I My Ca1wn. Expint SoPIft"�
'i C„> e-
Seal: -%; s ;`.,� 5';: Seal:
************************************************************************************************************
APPROVED BY 0��5%L 7.Z. D''Gl Ans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)