El-19-2263Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
LJ
ftim'O'V
Issue Date: 0/0212019
Parcel Number
74 NW 108TH ST, Miami Shores, FL 33168 1121360110150
Contacts
Permit NO.: E-09-1
Permit Type: Electrical - residential
Work Cfossifica ion: Alteration
Permit Status: Approved
Expiration: 03/30/2020
Cory Mullinare Owner ATLANTIS ELECTRICAL CORP Contractor
74 108 FRANCISCO PEREZ
12803 SW 20 TER, MIAMI, FL 33175
Business: 3055514043
Inspection Requests:
Description: ELECTRIC SERVICE REPAIR TO REPLACE Valuation: $ 500.00 r05-761-494
PERM IT#E L-02-19-456
Total Sq Feet: 0.00
Fees Amount
Payments
Date Paid Amt Paid
50% Renewal Fee $50.00
Total Fees
$50.00
Total: $50.00
Credit Card
10/02/2019 $50.00
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
regulating construction and zoning. uthermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
October 02, 2019 Page 2 of 2
Miami Shares Village PFcE1VE1D
Building Department ,.r SERO -6 2019
- _ 1b0§0 N,E.2nd Avenue, Miami Shores, Florida 33138 -
_ Tel: (30S) 79S-2204. ax: (305) 756-8972 R" +` BY:
INSPECTION UNE PHONE NUMBER: (305) 762-4949
_ _ FBC.ZOiF�;
BUILDING _ _ _ Master Permit M.
PERMIT APPLICATION Sub Permit No. `
t !3 ",r.l!f `'1 1, 1 .., 1'r .r •: ,4,'� •4- 1"�. ,' '.f yr" > 4 r t ! ...i .. ! Y 10.) :` . • •�. i7
❑BUILDING.F LECTRIGt t❑rROOFING , ❑,REVISION, ,; ,❑ EXTENSION RENEWAL t:
C Y�('r ! /*S , :� •6X ..)I. ] ? !. ,.i: I), . ..•t , i F, , °, 14• (o , i. +T ; .2'
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION Q'SHOP'
CONTRACTOR „ ,.. DRAWINGS
it .1 7, i r' Y' i)', ,61 i '� '.•J -+.., .. r :f 7, 3C"' I_i t i , ,•,,e7 is ,_. ..
JOB ADDRESS: ! "1 J�U`} (OC\ �f�
/ City : 1 t Miami Shores, n nit a ,County J+-% _+n 1,% Miami Dade ._ i v r%) ' 0:i Zip:,eN
r, t r.�yit .I
Folio/Parcel# •.1�.=2\3� 1\ ��0� nr iv,, sthe Building,Historically,DesignatedsYesriitr. NOi -s�•
;;g;OccupaiicjrTy"pe :'' ' 'L"oatl:4�f:4 ?' G 9'C6n"tructi66Type:! Q1';1V ' "Flobd Zdne:�I fVt BFE^!d= "F i FFE:} r1•13
OWNER: Name (Fee Simple
hone#i:���0
'Address: '; a1 141—N �;,i t. i ,i! , ;u: F) t e 127 k,,l,, G,
City: �:wi.A ., . ... State:,h.__
Tenant/Lessee Name: l` e Phone#:�' *' r
Email:
QCT
6 S 6 �1 d
CONTRACTOR: Company Name:`S�� CC
c �- Phone#: , b (O l.0
_. _... _._.
Address:
City; State,
Qualifier Name:
Phone#:
State Certification or Registration #: t;;C _ ���C7 \�
�T_Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address:
City: State, Zip:
Value of Work for this Permit: $
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
❑ New ❑ Repair/Replace ❑ Demolition
Description of Work �LT( /-0 Ax
fin* •Ya ��q '` �, W
Specify color of color thru tile:
Submittal Fee $ Permit,Fee $, ,CCF $ CO/CC $; .
Scanning Fee $ _
Technology Fee $
Radon Fee $ DBPR $ Notary $
.J' F1 Eh ..I
Tr"airiing/Education Fee $ "�` DbUble Fee $-
Structural Reviews $ Bond S
V t
TOTAL'FEE NOW DUE'$ S;0' O'Z)
(Revised02/24/2014) L
{ x
, 1 i
Bonding Company's Name (if applicable). .g.
Bonding Company's Address .1 .I d ((`� � � �' � +"� � � 3
City State - Zip
Mortgage Lender's Name (if applicable)'*r' ','rr.+'03 :'`y'U'-
Mortgage Lender''s'Addreso
City r:'l *r :.;, 0P State. fit Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has
commenced=priorlto�,the issuance'of a permit and,4hattall:iv6r_k will be pefformed;toimeet W6,staridard_s'of all'•lavirsi'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...:
” _ I _.. L•_, G
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 TWICEFOR. 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 _wh.kh.occurs seven_ (7) days after the building permit is issued. In the absencem. of such posted notice,, the
inspection will not be approved and a reinspection fee will be charged.
it 11' 7)
4(1
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me ibis
tr
25 day of 12_ 20 f _, by
who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: - v ; a •a anIMAR7
JII�CS ..
Print: ` _ Lx' *`+
SSeal: T-fqABW MMY
Signature
CONTRACTOR
4_
The foregoing instrument was acknowledged before me this
day of 20 i 1 by
SCZ5- Z- who is ersonall known
me or who has pFoduced as
�� r4
identification and who did take an oath.
tri' int y.�, ; E, .,
NOTARY PUBLIC: _.
.. Sign:. _ _" -QWW JUM. s.ai z'r
Print:..Comm.603591001.
MIA11190. owl
Seal: "' TW � NOa
,' J7.4.,IC1 r: ; i fxi3i ;fid
APPROVED B 2_k'IFO/`0l9' Plans Examiner _ Zoning
-� r rry; ra . i' ,...J►l.a` _, l4 r+7.;i .. ,. _ t. 'J i, � .tom, t.i +t
Structural Review
(Revised02/24/2014)
Clerk