ELC-19-443Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Parcel Number
726 NE 92ND ST 12L, Miami Shores, FL 33138 1132060440500
Contacts
Permit No.: ELC-02-19-443
Permit Type: Electrical - Commercial
Work Classification: Addition/Alteration
Permit status: Approved
on: 09/23/2019
Inspection Requests:
Description: PAINT BATHROOM CEILING /WALLS AND INSTALL Valuation: $ 200.00 f 75 9 e
TILE OVER EXISTING TILED WALLS
Total Sq Feet: 0.00
Fees
Jeffery Rabalais Owner
726 NE 92 12L
Business: 9542619513 JOSH IN FTL@YAHOO.COM
FOSTER & SON ELECTRICAL Contractor
CONTRACTORS, INC.
JORGE FOSTER
2498 NW 3 ST, MIAMI, FL 33125
Business: 3056445869
$50.00
CCF
$0.60
Inspection Requests:
Description: PAINT BATHROOM CEILING /WALLS AND INSTALL Valuation: $ 200.00 f 75 9 e
TILE OVER EXISTING TILED WALLS
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
02/27/2019 $50.00
Credit Card
03/25/2019 $60.30
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
regulatipgNowstruc, io aed`;&inig. Futhermore, I authorize the above named contractor to do the work stated.
Auth
Date
March 25, 2019 Page 2 of 2
Miami Shores Village RECEIVED
Building Department FEB 2 7�f200119
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 T
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FFBC 20t��"
BUILDING Master Permit No.
PERMIT APPL ATION Sub Permit No.
BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Q `l Z �Y /� -! z. Jlj q.- j-2-1,
City: ((Miami Shores//���� County: Miami Dade Zip: � .ter 7-29
Folio/Parcel#: 1 I� t%7-0& - 004 — A<_00 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: \ Construction Type: f� I� Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 36 T trFP:j P,N�E/A� S Phone#: % SV ?-U/ q'5-1-!?
Ad
City: 1 V 1 rA-0 r 5 Ar=_S State: F -t— Zip: ';72'N 728
Tenant/Lessee{_ Name:(` Phone#:
Email: ��5� 1ir1 24600.(4)30
CONTRACTOR: Company Name:, `mw Eh!�L C4\1 Phone#: C"J) ��' 13�►
Address: �'�� �i.Vy �[ •�,
City: VA I hk M State: t GO94r2A Zip: 3 ✓'�F
Qualifier Name: O `ZC5 Phone#C---%>)
State Certification or Registration #: FT Ro- LW �✓ t 440 Certificate of Competency #: erg Qgpecco Z�
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $
.ifj!
ne#:
City: State: Zip:
Square/Linear Footage of Work:
Type of Work: ❑ Addition/ ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: r/]i�7 �' D/h (l�f/�C/ /li(i/� A& lk5fA(4 AOL
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ _.~;~,�eyr .'" CO/CC
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
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
-a
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 thp, 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 b approved and a reinspection fee will be charged. I . -f le
JSignature Signature y4eO ' r.0
OWNER or AGENT CONTRACT
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
20 V 6G1
� day of e-6- 20 �� by / 7 tday of d R 20 /4 by
2e- [-I1 I S , wh0 is nerconally aama to C-1 6 j6'�if-0-9�ao who i ersonally known
.me or who has produced
identification and who did take an oath.
NOTARY PUBL
1
Sign:
Pri t:
Seal:
APPROVED BY
(Revised02/24/2014)
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
I . M V, IAQS Print: w
Heady T. Farinas E>rp M *Nwy 30.2023
NOTARYFUSUC Seal: �ij01 y , ,Iwvbw
STATE OF FLORIDA
Ca nr # FF223454
Z Z1 Plans Examiner Zoning
Structural Review
Clerk