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EL-17-1030Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. EL -4-17-1030 Permit Type: Electrical - Residential erlI I Work classification: Addition/Alteration Permit Status: APPROVED Parcel Number tssue,oate:4/24/2017 I Expiration: 10/2112017 Applicant 1460 NE 103 Street 1132050310060 Miami Shores, FL Block: Lot: CHRISTOPHER SAVITS Dwner Information Address Phone CHRISTOPHER SAVITS 1460 NE 103 ST MIAMI SHORES FL 33138-2626 Contractor(s) Phone Cell Phone F JIMENEZ ELECTRICAL CONTRACT( 305/556-5759 Type of Work: NEW LIGHTING & RECEPTACLES AS PER P Additional Info: Classification: Residential Scanning: 1 Fees Due Amount CCF $7.80 DBPR Fee $6.41 DCA Fee $6.41 Education Surcharge $2.60 Penalty Fee $100.00 Permit Fee -Add itions/Alterations $427.35 Scanning Fee $3.00 Technology Fee $10.40 Work without Permit Fee $427.35 Total: $991.32 Cell Valuation: $ 12,210.00 Total Scl Feet: 0 Pav Date Pav Tvoe Amt Paid Amt Due Invoice # EL -4-17-63687 04/13/2017 Credit Card 04/24/2017 Credit Card $ 50.00 $ 941.32 $ 941.32 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Relocation Fire Alarm Service Change Review Electrical Underground W. W. 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. April 24, 2017 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy April 24, 2017 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 f)� ELECTRIC ❑ ROOFING RR 13 2817 II'Y:- — 1tt FBC 20( Master Permit No. I �— )- S-C)o Sub Permit No.�`1— l 0 3'�) ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP OWNER: Name (Fee Simple Titleholder): C— 00 P i- � Phone#: Address: 14 6 U li�— � City: (au' -c SLd*PA State: Zip: Tenant/Lessee Name: 0 . Q= . Phone#: Email: Q r► Cz-5or"CLOfo 6LDI ' C4D(k� CONTRACTOR: Company Name: J I M,pav O T �J C - LtCZ l ,,,A G�O''r Xone#:,�G, _ Lit 5 218v Address: yq/ 0 � q `f -r 'to't City:' / �, State: r—&o P^, Wc- Zip: :g3Sf7 / , /Ool Qualifier Name: s F_4 C4 1j/ nde-�ee- Phone#:,(79c,-) ;��S^ .2-1,9c) State Certification or Registration #: /71 Certificate of Competency #: DESIGNER: Architect/Engineer: axf iaPPhone#: 3 oS ' S) t Address: City: to State: -� Zip: 3 30 (O Value of Work for this Permit: $ ©� jZ IZ4 quare/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: /Vpw`a �! c%�1 me Y'2 �'e� l'c.C/{_1 0 u Ped 10.5:.. �, ` • r !. .art Specify color of color thru tile: Submittal Fee $ SO Permit Fee $ ,�/� �'' �4 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ otary $ r%} Technology Fee $ Training/Education Fee $ DoubljFee)$ '42:3 XJ 4 /OD Structural Reviews $ Bond $ / 2 TOTAL FEE NOW DUE $ / • 3 (Revised02/24/2014) CONTRACTOR DRAWINGS ,O JOB ADDRESS: 1.:YW 01= City: MiamiShores County: Miami Dade Zip: 3 313s Folio/Parcel#: -/" 3 "—A- 0.11 — (DO 6O Is the Building Historically Designated: Yes NO � Occupancy Type: Load: Construction Type: Flood Zone: W5:-- BFE: FFE: OWNER: Name (Fee Simple Titleholder): C— 00 P i- � Phone#: Address: 14 6 U li�— � City: (au' -c SLd*PA State: Zip: Tenant/Lessee Name: 0 . Q= . Phone#: Email: Q r► Cz-5or"CLOfo 6LDI ' C4D(k� CONTRACTOR: Company Name: J I M,pav O T �J C - LtCZ l ,,,A G�O''r Xone#:,�G, _ Lit 5 218v Address: yq/ 0 � q `f -r 'to't City:' / �, State: r—&o P^, Wc- Zip: :g3Sf7 / , /Ool Qualifier Name: s F_4 C4 1j/ nde-�ee- Phone#:,(79c,-) ;��S^ .2-1,9c) State Certification or Registration #: /71 Certificate of Competency #: DESIGNER: Architect/Engineer: axf iaPPhone#: 3 oS ' S) t Address: City: to State: -� Zip: 3 30 (O Value of Work for this Permit: $ ©� jZ IZ4 quare/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: /Vpw`a �! c%�1 me Y'2 �'e� l'c.C/{_1 0 u Ped 10.5:.. �, ` • r !. .art Specify color of color thru tile: Submittal Fee $ SO Permit Fee $ ,�/� �'' �4 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ otary $ r%} Technology Fee $ Training/Education Fee $ DoubljFee)$ '42:3 XJ 4 /OD Structural Reviews $ Bond $ / 2 TOTAL FEE NOW DUE $ / • 3 (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 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 einspection fee will be charged. Signatur Signature L,C* R or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this 3 day of / { ar• 1 20 11 by Nomcs Se"'.7's who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: ?:01 go., N ary Ilc - State of Florida + FF P PAR 4 QW Seal: %�+ do -?o' My Comm. Expires May 10, 2019 "° �� "`�� Bonded through National Notary Assn. The foregoing instrument was acknowledged before me this r day of ' 20 by L�S c ' r� [� �ispersonallyknown t as me or who has produced identification and who did take an oath. NOTARY PUBLIC: as APPROVED BY& Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)