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EL-18-802�,yHort�sL� 'ayE !'QyO F�OR1Op Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit No. EL-3-18-802 Permit Type: Electrical - Residential Per Work Classification: Pool - Private Pettit Status: APPROVED Parcel Number IssW Date: 5/15/201`8 1 Expiration: 11/1112018 Annlicant 286 NE 99 Street 1132060134310 Miami Shores, FL 33138-2435 Block: Lot: SUZANNE FAITH n Owner Information Address Phone Cell SUZANNE FAITH 286 NE 99 Street (305)520-1355 MIAMI SHORES FL 33138- 286 NE 99 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone F JIMENEZ ELECTRICAL CONTRACT( 305/556-5759 ype of Work: ELECTRIC FOR POOL dditional Info: ELECTRIC FOR POOL lassification: Residential tanning: 1 Fees Due Amount CCF $0.60 DBPR Fee $4.50 DCA Fee $3.00 Education Surcharge $0.20 Permit Fee - Additions/Alterations $300.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $312.10 Valuation: $ 1,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-3-18-66951 05/15/2018 Credit Card $ 312.10 $ 0.00 mvauaoie inspections: Inspection Type: Final Light Niche Bonding Review Electrical Alarms In consideration of the ' uan to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and ' s rict onfo mity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit a u e res onsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECT CA , P LIMB G, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS, DA IT: I c rtify at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and z nin . F the ore, I authorize the above -named contractor to do the work stated. May 15, 2018 Aut d , ner / Applicant / Contractor / Agent Date Builds g Department Copy May 15, 2018 1 k v Miami Shores Village PET` D Building Department MAR 2�`3 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 79S-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING 01ELECTRIC ❑ ROOFING (F�BCp�2&1 q ` Master Permit No. IV� I` o ` Sub Permit No. �. �V Flo (— ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [_]PUBLICWORKS [:]CHANGE OF �CONTRACTOR JOB ADDRESS: Z Q V (o N, j ` C/ ` 5 T ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: 3 31 3 9 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: Z'�� N � 1 ' - -s C FFE: i OWNER: Name (Fee Simple Titleholder): 5Q T" Phone#: 3 J � 1 0` s� Address: Zg 6 N£ Q q S-r t�1A*A1 (2S City: � State: ti- Zip: Tenant/Lessee Name: Phone#: 33 1 316 Email: 51CA l TVA C LC-M eak, S C-t COOL • ©Q- 6- CONTRACTOR: Company Name: �' ��tA �� n�� Phone#: �� Z� 7 Zt �b Address: 1 -2- qo l W oc_%( <_ftGEFC 1-C) City:'' -' 1JGPA O deel/S State: fl- Zip: Qualifier Name: 1: L PC" S 1 s C,0 --:5 1'NA G-jj5-2 Phone#: State Certification or Registration #: ISC- 1 00 2-7-7 q Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: _ Value of Work for this Permit: $ ITy� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration O'New ❑ Repair/Replace Description of Work: t_' Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Zip: ❑ Demolition Permit Fee $ _;669' ^o CCF $ CO/CC $ Radon Fee $ 3 , o3 DBPR $ TNotary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) L 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 Zi 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 reinspe,fee will be charged. Signature — Signature V J w� wcov�- OWNER or AGENT CONTRACTO The foregoing instrument was acknowledged before me this K u 4K day of 4fxk 20 1`( by SU ZAWtJE i"ni who is personally known to me or who has produced 0 L— as identification and who did take an oath. NOTARY PUBLIC: Sign: PO Print: �¢ISWV14 POJq—qXn= Seal: ------ --- **************** APPROVED BY CRISTINA RODRIGUEZ Notary Public - State of Florida Commission # GG 105164 Bonded through National Notary Assn. The foregoing instrument twwas iacknowledged before me this Z� day of 20 , by 'RINNSi50 'Y1-Gtj E?who is personally known to me or who has produced -PL— as identification and who did take an oath. NOTARY PUBLIC: Sign: �OJMLOl�— Print: C9 I& 1 I A PO 8, 9A J \J67— Seal: Plans Examine Ab- oir��Po CRISTINARODRIGUEZ "*�"�*>�it41r>y:�Whi{�blalenfFktFida�* * ' - Commission 4 GG 105164 9�QF��oP:' My Comm. Expires May 16, 2021 r Bonded through National Notar ami n (Revised02/24/2014) Structural Review Clerk