EL-18-2532Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Location Address Parcel Number
601 GRAND CONC, Miami Shores, FL 33138 1132060172140
Contacts
Permit No.: EL-09-18-2532
Permit Type: Electrical -'Residential
Work Classification: Alteration
Permit Status: Approved.
Expiration: 04/01/2019
CARLOS FELIPE LEMOS Owner GRISTAN ELECTRIC LLC Contractor
601 GRAND CONC, MIAMI SHORES, FL 33138 DAVID GRISTAN
1451 SW 85 AVE
Business: 3053898700
Description: INSTALLL ADDITIONAL CIRCUIT FOR GATE OPENER Valuation: $ 1,500.00 Inspection Requests:
4949
TotalSq 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
Tota I :
$111.10
Payments
Date Paid AmjPaid
Total Fees
$1Credit
Card
11/28/2018 $1Amount
Due:
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. ,
,Ek L :�) P� 0 ,Dso vJ
Authorized Signature: Owner / Applicant / Contractor / Agent
November 28, 2018 Page 2 of 2
J
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
c6t_1N_
FBC 20 11
Master Permit No. r� � 8 - 25�7 _:q_
G
Sub Permit No. L(� V— 2 5 3 Z
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 6 of 6 j?,4 &Q Oelvev (_�A s r-
City: Miami Shores
County:
Miami Dade Zip:
_33138
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO
Occupancy Type: Load:
Construction Type:
Flood Zone: BFE:
FIFE:OWNER:
Name (Fee Simple Titleholder):
o?,revs /e cf
e L / e uS Phone#:3 cT
76,6 70577
Address: ,j01 le'PAtiD
(�uGoce -z'e_
City: m"Cr_—" S" T2 S'
State:
FL Zip:
3 3 /3 S,
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: _ r1eis- rAA1 c lE7E7-RI c , U L Phone#: 3or 3 ,9,7 8 �0 0
Address: 145-1 SW 8 S 41-e l'-' e-
City: pea, 6,- o ke P> rr vj State: FL Zip: 3 3 o 2 5-
Qualifier Name: Dom// A 6:�)e/s -r Aj Phone#:.305' 3
State Certification or Registration #: EC-/3 / OD `y 9q.5 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 0-0 Square/Linear Footage of Work: JrD f Lrk e z_�
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
❑Demolition
Description of Work: t-"M GPo a"4 �'/ r�ec""/ '4' /VCR ✓
64e 04M a 4e
Specify color of for thru tile:
Submittal Fee $ Permit Fee $ lrmt a d
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF
DBPR $
CO/CC $
Notary $
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
WE
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 rein ction fee will be charged.
Signature Signature
OWfsacrknowledged
AGENT CONTRACTOR
The foregoing instrument before me this The foregoing instrument was acknowledged before me this
�()-�--day of J 20 � _, by day of L 200 , by
ri (,� (j {- L-e (tit. O,�rho is rsonally know to I� i who is
personally known to
me or who has produced as me or who has produce /C� ant -
me as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:AA
Print:
Print:
Seal: .�.�Pa
`, 'rPo4'f KRISTINE ASCANIO
% Seal: ,..
Notary Public •State of Florida ::�.........
°P�6;:, ANA NA EST.; _ A
Commission # FF 953950 ?
• r . • _ Notary Public
My Comm. Expires Apr 25, 2020 =+� ono`: Commission=CG' ivr.'i
OF FV `
************s�+RvH.'***>��+�hr4UA(3�`�?4Qn?1kaS£eP
APPROVED BY
%Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)