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EL-19-1433Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: Location Address Parcel Number 1420 NE 103RD ST, Miami Shores, FL 33138 1132050310030 Contacts Permit No.: L-06-19-1433 Permit Type. Electrital - ResiderMai work clossykation: Alteon Permttatus: Approved Expiration: 02/03/2020 MARC AND ANNE LITZENBERG Owner YORK ELECTRICAL CONTRACTOR CORP. Contractor 1420 NE 103 ST, MIAMI SHORES, FL 33138 LORENZO TORRES 10871 SW 188 ST UNIT 25, MIAMI, FL 33157 Business: 3059620759 Description: INSTALLATION OF 3 NEW AWNING SHADES. Valuation: $ 1,020.00 Ins ection Requests: INSTALLATION OF 2 ELECTRICAL OUTLETS ON CEILING3DS-762-4949 Total Sq Feet: 552.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $161.35 Payments Date Paid Amt Paid Total Fees $161.35 Check # 4784 06/21/2019 $50.00 Check # 4801 08/05/2019 $111.35 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 regula)6 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date August 05, 2019 Page 2 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 RECEIVED JU 21 2019 BY: �7� FBC 20 R BUILDING Master Permit No- Lit - Uk" Fl- i 32 - PERMIT APPLICATION Sub Permit No LTJ ❑BUILDING ELECTRIC ❑ROOFING ❑REVISION ❑EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I `-1 LO J`I C_ 'A10) City: Miami Shores County: Miami Dade zip: 3313 Folio/Parcel#: 1 — J2� S —��1 �Oj0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): inn e �lVZeY)bere Phone#: 0512055672 Address: `��/�� City: \Y 11 G m 1 G(noire-5 State: 1 Zip: 33 13 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: �GIeay ical Q-0 rAC-TOr Phone#:(*� 2a S 24,78 Address: kdb7I 5-� 4S City: M1A'M\ State: I Zip: 3_M(05 Qualifier Name: \_O r e nso T0't f'e-S Phone#: State Certification or Registration #: TC_ U5 6 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ �� �� Square/Linear Footage of Work: S-76 <:F Type of Work: ❑ Addition �] Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 1 ncfi1-,l 1Ckr\ O r\ Q�_ \ S ) P+\J r1-1 Specify color of color thru tile: n' e Ic&f't o vfi1a-I S -co Submittal Fee $ Permit Fee $ �✓'�1�! Q CCF $ Scanning Fee $ Technology Fee Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ CO/CC $ 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 after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a inspection fee will be charged. ct Signatur Signature_'0 V O o GENT CONTACTOR The foregoing instrumentwas T knowledged before me this day of 120 �� by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Seal: ' MY COMMISSION # GG 234692 EXPIRES: July 15, 2022 Bonded Thru Notary Public Underwriters The foregoing instr ent was acknowledged before me this day of 20 (� by L o rL 1 10 r i'e.S � who is personally y knflwn to me or who has produced 'by, vcr'S Lt cv%cn as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: P' KRYSTAL CARDONA G 234692 Seal: o: EXPIRES: July 15.2022 Bonded Thru Notary Public Underwriters APPROVED BY r41ans Examiner Zoning Structural Review Clerk (Revised02/24J2014)