EL-18-3134Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
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Issue Date:10/25/2018
Parcel Number
Permit No.: EL-10-18-3134
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 04/08/2019
Project
289 NE 102 ST, Miami Shores, FL 33138-2426 1132060134970 <NONE>
Contacts
ALFRED & NANCY DOWSON Owner ALFRED & NANCY DOWSON Applicant
305 NE 91 ST, MIAMI SHORES, FL 331383129 305 NE 91 ST, MIAMI SHORES, FL 331383129
TEAC ELECTRIC Contractor
CARLOS MARTINEZ
1900 NW 16 TERR, MIAMI, FL 33125
Home: 7864262094
Inspection Requests:
Description: WIRE NEW KITCHEN Valuation: $ 1,500.00 Inspec ion Re
Total 5q 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
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$161.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$161.10
Check # 3954
10/10/2018 $50.00
Check # 3961
10/25/2018 $111.10
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 AFFIDAVI3' I certify that all the foregoin information is accurate and that all work will be done in compliance with all applicable laws
regulating con ci n ning. Futhermore I au o ze the abov na ontractor to do the work stated.
�l s�
Auth ignature: Owne -. /Applicant / Contractor / Agent Date
October 25, 2018 Page 2 of 2
Miami Shores Village r----- -_
b\ � Building Department 0 T 10 018 � g
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 I
V Tel: (305) 795-2204 Fax: (305) 756-8972 i y_ --_-- --
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No. RClb' 23b-7
PERMIT APPLICATION Sub Permit No._F—L 1� - 3134
❑BUILDING 2rELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
JOB ADDRESS:
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CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: �= 3 (%b ('13 `- 7 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder)
Address: 36-5
City: I / /. t 7YI
Tenant/Lessee Name:
Email: rn C. d i
State: / 6 - Zip:
Phone#:
0
CONTRACTOR: Company Name: /(��eiC C%I/°`j�K'C Phone#: 7�} ( _Z-��
Address: q(%d /tl-t,2 6 f!�_Z
City: Ifi State: 1� Zip: 3� 12— S
Qualifier Name: Ali mai,-'r/
State Certification or Registration #: �r11 /
DESIGNER: AAr-cchhjit t/Engineeer:640 ► `/Y
Address: 0
Phone#:
Certificate of Competency #: Phone#: 6n ,5v- 50 /o,l�
!/ Y/L
p
City: % G State: _E_ Zip: 3306�
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: Addition CPI)Alteration
❑ New ❑ Repair/Replace
Description of Work:
❑ Demolition
Specify color of color hru tile:
Submittal Fee $, S+�J ._ Permit Fee $ ls'�� o!i CCF $ CO/CC $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
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 the absence of such posted notice, the
inspection will not be approved} a reinspection fee will be charged.
PPW
Signature
SignatureZ(v
OWNER or AGENT
CONTRACTOR
The foregoing instrument was acknowledged before me this
The foregoing instrument was acknowledged before m this
l(rl { day of l iobq V 20 , by
-S day of �l��f Z) �D Q►� 20 ' by
llt)'CFO 0 , who is ersona� I known to
QGtV(OS kAf1U ho i personally kno to
me or who has produced as
me or who has produced as
identification and who did take an oath.
identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
'G��/�.'�
i
Sign: _,f
Sign:
)r�
Print:
i Print: `�'\ -�k 11C�
Seal: _+ ` .t'`: MINA W.-
NotaryPublic- StateofFlorida
• ' •= Commission k GG 090452
My Comm. Expires Apr 21, 2021
•�"" •. ANALUISAPARRILLA
Seal: ' 'Y"
"• : Not Public - State of Florida
5 ' Commission ti GG 090452
!„��.•° Bonded through Nabonai NotaryAssn.
'•' vr' My Comm. Expires Apr 21, 2021
Bonded through National NolaryAssn.
APPROVED B �� /S dam`/ZoPlans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)