EL-19-1078Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 05/17/2019
Location Address Parcel Number
11100 NW 5TH AVE, Miami Shores, FL 33168 1121360210700
Contacts
Permit NO.:
Permit Type. -E ectrical - Residential
Work Classification: Service Change
Permit Status: Approved
Expiration: 11/13/2019
SONY CHERRELUS Owner METRO ELECTRIC SERVICE INC
:C:ontractor11100 NW 5 AVE SAMUEL AZUZ
15050 NE 20 AVE, Miami, FL 33Business: 3059451991com
Description: METER REPAIR Valuation: $ 1,400.00 Inspection Requests:
49
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.10
Cash
05/14/2019 $50.00
Credit Card
05/17/2019 $61.10
Amount Due:
$0.00
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.
Authorized Signatur wner / Applicant / Contractor / Agent
Date
May 17, 2019 Page 2 of 2
BUILDING
I`` � �` IV
Miami Shores Village MAY 4 20
Building Department BY: Gk.
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
PERMIT APPLICATION
❑BUILDING M/LECTRIC ❑ ROOFING
FBC 20
Master Permit NoLL OS_ 11 — _M8
Sub Permit No.
REVISION EXTENSION RENEWAL
[PLUMBING F-1 MECHANICAL PUBLIC WORKS [—] CHANGE OF CANCELLATION [] SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
�I
City Miami Shores County: Miami Dade Zip_:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load:2 eo n Construction Type: Flood Zone: BFE:// FFE:
OWNER: Name (Fee Simple Titleholder): Sop. •� Phone#: �fbu 4 �✓� �✓
Address: I I tF ® a w
City:
State:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: (�Company Name:: /_
Address: 13� � 1/
City:%
Qualifier Name: U
State Certification or Registration #:
Zip:�31i / Gj/
Phone#: �hl i0l e?/ _
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address:
Yr � - city:�l,1kggi State: F/_ -zip:
Value of Work for this Permit: $ !� Square/Linear Footage of Work:
Type of Work: ❑ Addition ElAlteratiopi ❑pew Repair/Replace F-1 Demolition
Description of Work:
Specify color of color thru tile:
1r
Submittal Fee $ GI1 Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ rr
TOTAL FEE NOW DUE $ ( l o
(Revised02/24/2014)
P
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,dothe-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.t tat aft utak wilt 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 noticeof-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
Signature
OWNER or AGENT
CONTRACTOR
The foregoing instrument was acknowledged before me this
The foregoing instrument was acknowledged before me this
O day M 201 by
day f by
1 r � who is personally known to
w ► 'L-- who s personally kno to
me or'whi 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:
1,111111 1, in- n,rmnr
Sign:
Notary Public - State of Florida r
Print: 1 r l
Print:
V
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1' IC Sgg* of sw►im
cFF� 111 My Comm. Expires May 4, 2020
11111111111
Seal:
Seal: . � MtrNs B�
�j MY COMM18 ion OG 223726
w ExPb s 05/31/2022
APPROVED BY S 6 Plans Examiner Zoning
Structural
Review Clerk
(Revised02/24/2014)