EL-18-863Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit No. EL -4-1-863
Permit Type: Electrical - Residential
em tr i Work Classification: Pool - Private
Permit Status: APPROVED
issue mate. 4/912018 1 Expiration: 10/06/2018
Contractor(s) Phone Cell Phone
MESA BROTHERS INC (305)345-1974
Type of Work: CONNECT NEW POOL AND LIGHTS
Additional Info: CONNECT NEW POOL AND LIGHTS
Classification: Residential
Scanning: 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:
$312.10
Valuation: �$ 600.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL -4-18-67025
04/09/2018 Credit Card $ 262.10 $ 50.00
04/04/2018 Cash $ 50.00 $ 0.00
Avauaoie ins
Inspection Type:
Final
Light Niche
Bonding
Review Electrical
Alarms
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 AFFIDA'
construction and_zc
all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
I aut rize the abov -named contradtori o do the work stated.
Sy l VR,4 April 09, 2018
Owner / Applicant /
Building Department Copy
April 09, 2018
/ Agent
Miami Shores Village
Building Department APR p,�20iB
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 C l
INSPECTION LINE PHONE NUMBER: (305) 762-4949 J
FBC 201q
BUILDING Master Permit NoBpp 5 1 Q I2 -
PERMIT APPLICATION Sub Permit Nod I _ . U (-03
r-] BUILDING XELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I4(g)y � � O � j
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): t>\/i Phone#:_
Address: 14 �e (D N (E- ' p'a'
M
City: pr'`l Jjf t U(eo S State: f (_ Zip:
Tenant/Lessee Name:
Email
Phone#:
CONTRACTOR: Company Name: Ho Q (A nA-� �4 T Y)C . Phone#: 3 � G.'� O ) 119
Address: 5 2) 1 S tli 1 � Q�
City: 01 State: G, n d Zip: 3 I b
Qualifier Name: 20 u � l\A P.3 o, Phone#: 3 ('T — S '1'5 -
State
SState Certification or Registration #: Ce (2, ) 3 U o f 1 V Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address:
Value of Work for this Permit: $ � oo
Type of Work: "❑ "Addition .,:0: Alteration
Description of Work:
Specify color of color thru the:
City: State: Zip:
Square/Linear Footage of Work:
New epair/Replacei ❑ Demolit
Submittal Fee $
Permit Fee $®
CCF $
CO/CC $ _
Scanning Fee $
Radon Fee $' �A
DBPR $
Notary $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ aGa, Ib
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 iss :n: bsence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Sign atu Signature
OWNER or A ENT
The foregoing isn trument was acknowledged before me this
day of 4prl L 20 a by
�1t CA SAV;15- , who is personally known to
me or who has produced
CONTRACTOR
The foregoing instrumentwasacknowledged before me this YI
day of aA cc �) , 20 1 8- , by
RgO5,4 who is personally known to
as me or who has produced
identification and who did take ar l'T Tv ANAIESQUIVEL
*gr * MY COMMISSION # FF 145850
NOTARY PUBLIC: PIRES: July 28,2018
0
ANBudgetNotary Servim
Sign:
Print:
Seal:
identification and who did take an oath.
NOTARY PUBLIC: �`".": `°fig ANNESQUNEL
* * M COMMISSION i FF 145850
EXPIRES: July 28, 2018
F�ye`O' Borded Thru Budget Notary Service
Sign.
Print:
Seal:
as
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)