REV-19-2689Rr'CEIVED
A01 2 019
BY
FBC 20 F
BUILDING Master Permit No. RC-4-18-984 f rJ:V-16-( 91- 2y`y'L
PERMIT APPLICATION Sub Permit No. EL-10-18-3141 11?, V- (�?
❑BUILDING M ELECTRIC ❑ ROOFING Q REVISION ❑ EXTENSION [—]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 299 NE 99th Street
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Trevor and Krystle Hague Phone#:305-613-5978
Address:299 NE 99 Street
City
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
State: Florida Zip: 33138
Tenant/Lessee Name: NA Phone#:
Email: krysbar@aol.com
Miami Shores
CONTRACTOR: Company Name: Ballad Electric Inc Phone#: (754)400-8588
Address: 4725 Monroe Street
City: Hollywood State: FL Zip: 33021
Qualifier Name: Nigel Henry Phone#: ( 813) 362-6161
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Ralph Tait Phone#: 954-592-2841
Address:11820 Miramar Parkway, S 121 city: Miramar State: FL
Value of Work for this Permit: $15,000.00 no change Square/Linear Footage of Work:
Zip: 33025
Type of Work: M Addition ❑ Alteration ❑ New ❑ Re air/Replace p ❑Demolition
Description of work: Electrical Revision. Add misc. lighting & outlets to plan as per changes done in fiE
Updating the panel schedule as per work performed in field, Updating outlets in kitchen as per
appliances purchased/ to be purchased by homeowner
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee $,
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary
Double Fee $
Structural Reviews
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ 43, a�)
Bonding Cpmpany's Name (if applicable) NA
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) NA
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 reinspection fee will be charged
Signature G `
�WNER or AGENT
The foregoing instrument was acknowledged before me this
IZ day of 20 � 'fl by
who is personally known to
me or who has produced'�L7D( )eO- as
identification and who did take an oath.
NOTAR UBLIC:
Sign:
Print: l NI> P.
Seal:
*****************
APPROVED BY
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
,1 Z day of 20 �by
�CGt�J�LY �11G gQ�` Who is personally known to
me or who has produced L7121 V bEa l A C Ns as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
_ 4
Print: " �v� l r— W �,
SINDIA
_;�'29-••.F'," °FF4°P•°' e;' ALVAREZ SealBSINDIA—ALVAREZNIY CMINIISSIGN # GG 238273 FF
IWSEXPIRCo.beptebr3,2022 ,11SIGN#GG 238273
Bonded Public EXPIRES: Seot gymber 3, 2022
ondedT.Z N Pu "J i m�
********
` 'Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk