EL-18-2481�0
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
CORIDp
Phone: (305)795-2204
Project Address
1079 NE 96 Street
Miami Shores, FL 33138 -
Owner
JONATHAN FELDMAN
Permit No. EL -9-18-2481
Permit Type: Electrical - Residential
' Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 9/19/2018 1 Expiration: 03/18/2019
Parcel Number
1132060143670
Block: Lot:
1079 NE 96 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
RTC ELECTRIC CORP. (786)227-4180
of Work: REPAIR KITCHEN OUTLETS GFI(12) RECE
onal Info: REPAIR KITCHEN OUTLETS GFI(12) RECE
ification: Residential
Tina: 1
Fees Due
Amount
CCF
$1.80
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee - Additions/Alterations
$150.00
Scanning Fee
$3.00
Technology Fee
$2.40
Total:
$162.05
JONATHAN FELDMAN
Cell
(786)972-0336
Valuation:$ 3,000.00
Total Sq Feet: 120
Pay Date
Pay Type
Amt Paid
Amt Due
Invoice #
EL -9-18-68919
09/19/2018
Cash
$ 100.00
$ 62.05
09/19/2018
Credit Card
$ 12.05
$ 50.00
09/18/2018
Credit Card
$ 50.00
$ 0.00
Avartame ins
Inspection Type:
Final
Meter Box
Alteration
19
rm
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 assumesponsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLU BjVU,*ECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT:/ I c iiy� 1Ill the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoni t e r �e the above-named contractor to do the work stated.
September 19, 2018
Authorize AirAture:,Pwner / Applicant / Contractor / Agent uate
Building Department Copy
September 19, 2018 1
Miami Shores Village RECEIVED
Building Department � o zO19
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY.
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 t
�
FBC 0 ( �
"PG-_ (tel }52r!
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
❑BUILDING �LECTRIC ❑ ROOFING REVISION ❑ EXTENSION ER<ENEWAL
PLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF Ej CANCELLATION ❑ SHOP
�(__ CONTRACTOR DRAWINGS
i
JOB ADDRESS: ! h 71 IV E_a�,7 t t e j,
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: j'- ?2oa N_ v 7 d + Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): c TKvn
Address: W/ ti Aljl - q c S
Flood Zone: BFE: FFE:
hone#: 7M—q 7M—qL,2 — &?('
City: riza 4< >nor?_f i State: �L� Zip
Tenant/Lessee Name:
Email
a
Phone#:
13f
CONTRACTOR: Company Name: P%T(— L_jP_CJ i Z[�`. l.z�f P Phone#: IRL02
L02
Address: , ( 5LJ 1), At &, /
City: _M[/I�i i State: �L Zip:
Qualifier Name: gob" TC,N n Phone#: c
State Certification or Registration #: a S Cer Te oftMintency M '
DESIGNER: Architect/Engineer: Phone#:
Address: /qA— City: State: Zip:
Value of Work for this Permit: $ I �'b 0 OSquare/Linear Footage of Work: &D Sf^
Type of Work: ❑ Addition ❑ Alteration
Description of Work:
❑ New
❑ Repair/Replace
❑ Demolition
K. �i9::.ti5a.�:w.rNt. J-t'..s'ru:..i� .....i,"t�.»Y, r�:,•?�+...i",w.rur c ��' �,vtt'...� �..,..x.�f!..::�..a�..,.±"s .,i7R:.. a3a.,,✓ �.,n7�,,. yH�:
e
Specify coldt of color thru tile:
6J ,
Submittal Fee $ `( Permit Fee $,
Scanning Fee $ / Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
S Ja
CCF $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
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 yter the building permit is issued. In the absence of such posted notice, the
inspection will not be approve nd a reinspection f will be charged.
Signature Signature
Zue
N orENT CONTRACTOR
The foregoing instacknowledgedbefore me this The foregoing instrument was acknowledged before me this
d
day of 20 by 2 d dayof20 by
'
who perso alr�no n to Olen n who i ersonal=know o
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: --E
Print: i
Seal:
**********
(A
;��ir ►u ~•,: JASMIN MAllARESE
Notary Public - State of Florida
Commission p GG 346758
orn° My Comm. Expires Jun 19, 2023
APPROVED
(Revised02/24/2014)
Print�—
Seal:
****************
Plans Examiner
Structural Review
fn
JASMIN MAllARESE
?4 Notary Public - State of Florida
Commission K GG 346758
-?OF— My Comm. Expires Jun 19, 2023
*************
Zoning
Clerk