EL-19-2735Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date:11/26/2019
Parcel Number
10634 NE 11TH CT, Miami Shores, FL 33138 1122320280440
Contacts
Permit No.: EL-11-19-2736
Permit Type: Electrical - Residential
Work classification: Alteration
Permit Status: Approved
Expiration: 05/26/2020
JENNA RASSIF Owner
10634 NE 11 CT, MIAMI, FL 33138
Other: 3053084774
CARABALLO ELECTRICAL INDUSTRIES INC Contractor
GEORGE CANCIO
5810 SW 113 CT, MIAMI, FL 33173
Business: 7867156056
Re
Description: KITCHEN GFI (2) BATHROOM GFI'S FAMILY ROOM Valuation: $ 3,600.00 Requests:
Inspect Ins ection Re
OUTLET, KITCHEN STOVE, OVEN, OUTLETS.
Total 5q Feet: 2,000.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$2.40
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee
$76.00
Scanning Fee
$3.00
Technology Fee
$3.15
Total:
$139.35
Payments
Date Paid Amt Paid
Total Fees
$139.35
Credit Card
11/26/2019 $89.35
Credit Card
11/15/2019 $50.00
Amount Due:
$0.00
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIpAVIT: 1 qethat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating car
,Wjruction oning. Futhermore, I authorize the above named contractor to do the work stated.
-21,,-(1
re: Owner / Applicant / Contractor / Agent
November 26, 2019 Page 2 of 2
Miami Shores Village
N04 15/2019
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
\, INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING / Master Permit No. C"bg - 1 .1
PERMIT APPLI TION Sub Permit No. l' I I A � s
❑BUILDING LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: bI4 1)F A ii
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �211 / j SJr 7 Phone#:
/
Address: ! �3 y c N &-aG4
/ ` C�
City: Z ft ( ) `e-s State: �� Zip:. 3 /3 v
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Ca d6hu e:',ItLA4A 1n&SY'(� Phone#: ;IAC, 4K SSG
Address: S810 5W 11,E CT
City: "roll State: Zip: S*D1_43
Qualifier Name: CITE 4.uao Phone#:
State Certification or Registration #: �CIIW$l?) Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
State:
Value of Work for this Permit: $`C UC7C.$quare/Linear Footage of Work:
Type of Work: ❑ Addition Alteration
Description of Work:
0
Zip:
❑ Demolition
5
Specify color of color tru We:
Submittal Fee $ d Permit Fee $ CCF $ cO/Cc $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
iRevisedo2/24/20141
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
State 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 charge
Signature
—eL
OWNER or AG
The foregoing instrument was acknowledged before me this
day of
, 20 by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Notary Public State or Florida
Ana Maria Perez
My Commission GG 191084
$a Fri Expires 0212&2022
APPROVED
as
d.
-'---4�
Signatu e-
CONTRACTOR
The foregoing instrument was acknowledged before me this
1b day of 1 20 j4 by
GQpMP, CrJAAGiO , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: tkW
Print: 1 I, iS ' Acikl ,ez
?y%u��
Seal: Miref1S L. Ma firleZ
*. COWSS100/86166403
EXPIRES: Docembor 7, 2021
BondeA Thru Aaron (dots
rVi!!f!
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)