EL-17-1900 (2),gNORES
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. EL-7-17-1`900
Permit Type: Electrical - Residential
Per it
Work Classification: Addition/Alteration
Permit Status: APPROVED
Parcel Number
Issue Date: 8/1/2017 1 Expiration: 01/28/2018
Applicant
205 NE 101 Street 1132060480030
NENA CHIONG
Miami Shores, FL 33138- Block: Lot:
Owner
NENA CHIONG
Address
205 NE 101 Street
MIAMI SHORES FL 33138-2400
Contractor(s) Phone Cell Phone
LS CURTIS INC (305)892-6501
1pe of Work: NEW UNDER GROUND ELECTRICAL FEED AN
dditional Info: NEW UNDER GROUND ELECTRICAL FEED AN
lassification: Residential
canning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$6.60
$2.25
$2.25
$2.20
$5.00
$150.00
$3.00
$8.80
$180.10
Phone
Cell
Valuation: $ 10,270.00
Total Sq Feet: 30
Available Inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
Underground
W. W.
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-7-17-64680
08/01/2017 Check #: 6082 $ 130.10 $ 50.00
07/26/2017 Check #: 6080 $ 50.00 $ 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 AFFIDAVI - I cat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and ino. Futhermbre, I authorize the above -named contractor to do the work stated.
August 01, 2017
Au iz Sign ure:Owner / Applicant / Contractor / Agent uate
Building epartment Copy
August 01, 2017 1
Miami Shores Village RttWo
Building Department JUL 2 1017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 201Q
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. 61
❑BUILDING 'ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 7 QS N i✓ 1 C'% 1�
City: Miami Shores County: Miami Dade Zip: 3-5 1-55?
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Nt; N ck I tO AJ G? Phone#:
Address: Z-05 N C
City: '�7� _ State: C.. Zip:
Tenant/Lessee Name:
Email:
Phone#:
CONTRACTOR: Company Name: Z^St�/L �i Phone#: /d6 Z 6
Address: c2a � ,� O lye, �#Zaf
City: &-ei /1- State: Zip: 'm g& _
Qualifier Name: zezvli Phone#:
State Certification or Registration #: 14'C O Q U ?/ 2 Certificate of Competency #:
DESIGNER: Architect/Engineer: flQinoOt li'd n.\ Phone#:g
Address:DO �� City: (�P_State: 4'L zip:�p
Value of Work for this Permit: $ f 00?70 Square/Linear Footage of Work: 30
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
DeAription of Work: M4VV li N'jZF� (ZOy/�7 EL�r Yjd cAt _ F-Gep Ally h
(&)5'TA-11LPQhQN OP NGW j`t5T4;_JL Cm(`(go 'P1ScoLw6c..�-
Specify color of color thru tile:
Submittal Fee $ CA Permit Fee $ 4 O i d 4> CCF $ ro. GO_ CO/CC $
Scanning Fee $ - Q Radon Fee $ ?� 2S DBPR $ 2- ' Notary $ ; , Q
Technology Fee $'9 " � Training/Education Fee $ 20 Double Fee $ ® _
Structural Reviews $ Bond $ ,97
TOTAL FEE NOW DUE $ 15Q' (
(Revised02/24/2014)
Bonding Company's Name (if applicable) _
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) b� L t_
Mortgage Lender's Address
Zip
City State 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 and a reinspection fee will be charged.
Signature ` \ Signature
OWNER or A ENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of 1U .20 by
N eha Ch i Can . who is personally known to
me or who has produced 1- 1 (1 � l as
identification and who did take an oath.
�iLe�7T3'1�I3�
The foregoing instrument was acknowledged before me this
r day of �z, %,C 20 / % , by
GGc,i j (2,11401'! ,who is p�sartat y mown
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: Sign:
Print:
Print:
CASSANDRA NEBBIA
ry Public - State of Florida
Bonded through National Notary Assn.
Seal: Seal:
•,g;s`?q"�., MAHARAI K. GONZALEZ
t MY COMMISSION A GG 044602
e'�P'�f'�`ru flu` �u U 0 w*n
APPROVED BY 1 f Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)