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)