EL-19-1250Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit No.: EL-05-19-1250
1j Permit Type: Electrical - Residential
Work Classification: Addition/Akeration
Permit status: Approved
Issue Date: 06/18/2019 1 Expiration: 12/16/2019
Parcel Number
1168 NE 101 ST, Miami Shores , FL 33138 1132050190240
Contacts
CHRISTOPHER & MARGARET SMITH Owner CHRISTOPHER & MARGARET SMITH Applicant
1168 NE 101 ST, MIAMI SHORES, FL 33138 1168 NE 101 ST, MIAMI SHORES, FL 33138
HI -TECH ELECTRIC & FIRE CORP Contractor
EDMUNDO I JARQUIN
1500 SW 101 AVE, MIAMI, FL 33174
Business: 7863260931
Description: REPLACE PANEL 200AMPS, 7 RESESSED LIGHT 6 Valuation: $ 3,200.00 Requests:
Inspection 305-4949
OUTLETS, 4 SWITCH
TotalSq Feet: 300.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$2.40
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee
$62.00
Scanning Fee
$3.00
Technology Fee
$2.80
Total:
$125.00
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$125.00
Credit Card
06/18/2019 $75.00
Credit Card
05/31/2019 $50.00
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 AFFI VIT: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating cop��g. Futhermore, I authorize the above named contractor to do the work stated.
Signature: Owner
/ Applicant / Contractor / Agent
Date
June 18, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
Miami Shores Village
M
Building Department 4AY12 19
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBCIn�c20
Master Permit No. — W '
Sub Permit No.
❑BUILDING 9ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
0
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION [:]SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: " v 4lr
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: ��'�{ BFE: FFE:
OWNER: Name (Fee Simple Titleholder): f��i�2��9'��7- 10ne#: C 3 0W
Address: //ly 29' /� . /t` �� /s
City: State: �� • Zip: , 2913 9-
Tenant/Lessee Name: / Phone#:
Email:
=�ecln �leck�c 4- P(✓t Qb Phone#: —,)-Ib
CONTRACTOR: Company Name: 13g3 -J2
Address: 15 �Q. �A4 6OS-' 98 3 fj
City:ml'mi State: Zip:
im�r33 li
Qualifier Name: eA u,hd0 ZQYn�'bt.l ipFl
o /► Phone#: 1
State Certification or Registration #: �e, I3bO nl 0 8 Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
Add
Value of Work for this Permit: $ .110 y Square/Linear Footage of Work:
State: Zip:
--Type of Work: ❑ -Addition- ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
!.{ Description'of Work �/������4NCL .loo
�i 'r.I'T
Specify color of color thru tile:
n
Submittal Fee Permit Fee $
Scanning Fee $
Technology Fee $,
Structural Reviews $
Radon Fee $
Training/Education Fee $
All ..�v..na•,,,e�ie. .• x�4 i s
CCF
DBPR
j
Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ Q
(Revised02/24/2014)
. ± 1 •,/ t -I
Bonding Company's Name (if applicable)
Bonding Company's Address
City * s
State 1
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City,
� 1
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.
Signatur
ell
OWNER or AGENT
The foregoing instrument was acknowledged before me this
3o*L day of 20 r/ 9 , by
who is personally known to
me or who has produced /�/fi 9� .�M/7�/ as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: A06 i�c%roe
Print: #i O CNN CeC7 00 VALE -NO !a
Seal:
APPROVED BY
(Revised02/24/2014)
AMM CECLIA1p1LMA BORJA
E MYCOMMNSSIO 0003106
€ EXPIRE& Apr11, 2023
t
Signature
464WQ t
ONTRACTOR
The foregoing instrument was acknowledged before me this
O day of MQ� 20 I by
rN
Gf�.myJ V) who is personally known to
me or who has produced L as
identification and who did take an oath.
NOTARY PUBLIC:
�p1►'s'",. EDUARDO BARRETO
Sign: MY COMMISSION # GG 150246
�= EXPIRES: October 10, 2021
Print: �`" V BondedThru
Seal:
%4111 Plans Examiner
Structural Review
Zoning
Clerk