EL-19-1881t
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue
Location Address Parcel Number
363 NE 98TH ST, Miami Shores, FL 33138 1132060135640
Contacts
Permit No.: EL -08-19-1881
Permit Type: Electrical - Residential
Work Classlfic€rtftrn: Label
Pemtstatus: Approvers
Expiration: 02/11/2020
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.
O „ 11'� c -
Authorized Signature: Owner / Applicant / Contractor / Agent Date
August 15, 2019 Page 2 of 2
Paul Simas TRS Owner
36398
HOME OWNER Contractor
HOME OWNER
Inspection Requests:
Description: ALARM LABEL > NEW SYSTEM
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.
O „ 11'� c -
Authorized Signature: Owner / Applicant / Contractor / Agent Date
August 15, 2019 Page 2 of 2
Inspection Requests:
Description: ALARM LABEL > NEW SYSTEM
Valuation:
$ 0.00
305-762-4949
Total Sq Feet:
0.00
Amt Paid
Fees Amount
Payments
Date Paid
Alarm Label Fee $40.00
Total Fees
$40.00
Total: $40.00
Credit Card
08/15/2019
$40.00
Amount Due:
$0.00
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.
O „ 11'� c -
Authorized Signature: Owner / Applicant / Contractor / Agent Date
August 15, 2019 Page 2 of 2
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 ❑ ELECTRIC ❑ ROOFING
AA 1 5/2019
ME
NI/L M
FBC 20
Master Permit No. 1�1, --08" � j —1�8 I
Sub Permit No.
REVISION [:] EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL 0PUBLIC WORKS [:] CHANGE OF D CANCELLATION D SHOP
CONTRACTOR: Company Name: h mkj� 0 Vim y- Phone#:
Address:
City: State: Zip:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address:
Phone#:
Certificate of Competency #:
Phone#:
City: State: Zip:
Value of Work for this Permit: $ I Do ,A, Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: IIN'ICkVrrl
VA \A LV S c VVI
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $Aol
it
CONTRACTOR
DRAWINGS
}
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q
JOB ADDRESS: _3/���
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City: Miami Shores
County: Miami Dade
Zip: 33�
Folio/Parcel#:
Is the Building Historically Designated: Yes NO
Occupancy Typeie_
Load:
Construction Type: C Flood Zone:
BFE: FIFE:
0Qyl
los- �JLirJ ��115�
OWNER: Name (Fee Simple
Titleholder):
-Phone#:
Address: 3 3 Ill
V7-*
City:
State:\
Z;p;33138
Tenant/Lessee Name:
Phone#:
Email: \', 'Si VACS iai
Vii r
C,0 V"-'
CONTRACTOR: Company Name: h mkj� 0 Vim y- Phone#:
Address:
City: State: Zip:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address:
Phone#:
Certificate of Competency #:
Phone#:
City: State: Zip:
Value of Work for this Permit: $ I Do ,A, Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: IIN'ICkVrrl
VA \A LV S c VVI
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $Aol
it
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 reinspection fee will be charged.
Signature R --r S Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument wa acknowledged before me this The foregoing instrument was acknowledged before me this
— S day of 20 by day of 20 by
-`Gi V L 'Si ovh S who is per, onally known to who is personally known to
me or \Vko has produced as me or who has produced as
identif cation and w did take an
NOTA P BLIC:
Sign: IA d
Print:
Seal: In
APPROVED BY
(Revised02/24/2014)
�. STA���. \`\0
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Plans Examiner
Structural Review
Zoning
Clerk