EL-18-3421Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit No.: EL 11-18-3421
Permit Type: Electrical - Residential
J 'IJ tj � work Classi ation: Addition/Alteration
Permit Status: Approved
Issue Date:11/19/2018 Expiration: 05/08/2019
Location Address Parcel Number
70 NE 99 ST, Miami Shores, FL 33138 1132060131050
Contacts
JAY YAGODA Owner JAY YAGODA Applicant
70 NE 99 ST, MIAMI SHORES, FL 33138 70 NE 99 ST, MIAMI SHORES, FL 33138
Other:3056577859 Other:3056577859
LONGMAN ELECTRIC INC Contractor
MICHAEL LONGMAN
844 NE 98 ST, MIAMI SHORES, FL 33138
Business: 3057581211
Description: ADDITION TO EXISTING STRUCTURE ELECTRICAL Valuation: $ 5,800.00 Inspection Requests:
ONLY 305-762-4949
Total Sq Feet: 216.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$3.60
DBPR Fee
$3.05
DCA Fee
$2.03
Education Surcharge
$1.20
Permit Fee
$153.00
Scanning Fee
$9.00
Technology Fee
$5.08
Total:
$226.96
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$226.96
Credit Card
11/19/2018 $176.96
Credit Card
11/09/2018 $50.00
Amount Due:
$0.00
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 constructionand zoning. Futhermore, I authorize the above named contractor to do the work stated.
�,
Authorized Siq ture: Owner
Applicant / Contractor / Agent
Date
November 19, 2018 Page 2 of 2
Miami Shores Village
Building Department
NOV 09Lrd
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 L i1
INSPECTION LINE PHONE NUMBER: (305) 762-4949 co
FBC W4
BUILDING Master Permit No. j C
PERMIT APPLI TION Sub Permit No.
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [-]PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: -1fjJ\1L ClCiS i
City: Miami Shores f� County: Miami Dade zip:
0 Folio/Parcel#: ) I 4 - / 5 - ! / 6 d Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction
(Type:
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simpl Tiholder):JA-y Q `/A` 0W 3 Phone#:
Address: 76 fib 6r "' S
City: AAIMA f State: 0- Zip: -5s' 2
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company me: t oti v//Q/1� GEC'-�1�� ,1�G Phone#:
Address: 16-Are Q'11 "' S 1
City: A41AMI..nn State: � Zip: Qualifier Name: Name: _1416n``,, �65L L6) G M� �Phone#: 56 ?SS . J.7, I
State Certification or Registration #:lrf 3 - l Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: I City: State: Zip:
Value of Work for this Permit: $ �r� Square/Linear Footaee of Work:
Type of Work: W Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: AyPrn 6 N -a EXIST )lei -5--rg cnnkQZL • yj,t)L
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $.
(Revised02/24/2014)
Permit Fee $ � 4��00 CCF $ CO/CC $
Radon Fee $ :2 DBPR $ 3 • 0 Notary
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _ (�ro • CI
Bonding Company's Name (if applicable)
Bonding Company's Address
s
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: 1 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.
Signature VA ,
OWtor AGENT
The foregoing instrument acknowledged before me this
q day of N Ovt4tt, , 20 19 by
�A�V A YA6 dJ who is personally known to
me or who has produced as
identification and who did take 'a���,% Ismael A POP
NOTARY PUBLIC: � `� ' '= Commission li` GG0821116�3
Expires: Ma h 13,
�Rcsr' Bonded ihtU \X
�,..
Print: i � smaelA. Pabon
• : Sea[:or' ii:
J.��!�I%1 AEt Q
_.....�� Uiiu e;::G;l Nota
Signature �--
CONTRACTOR
The foregoing instrument wa� acknowledged before me this
fh d yI-AY&WO
N)�°6 Nr,!e� 20 b
, y
G C who is personally known to
me or who has pr ed as
identification and who did take an oath.
NOTARY PYBLIC:I A n �1,1,1e1'I e ia�Ye �-
Sign:_
Print:
Notary Pudic State of FbrMa
ION
Seal: Michelle'Perez
My Commission GG 084089
OF Expires 04/08/2021
APPROVED BY F /�/l�l�f%/ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)