EL-18-3348Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138 _ �— _;
�.
305-795-2204
Issue Gate:
Location Address Parcel Number
295 GRAND CONC, Miami Shores, FL 33138 1132060133600
Contacts
Permit NO.: EL-11-18-3348
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 05/28/2019
NEIL HART Owner
ELECTRONIC CONTROL SYSTEMS INC Contractor
295 GRAND CONCOURSE, MIAMI SHORES, FL 331382852
NEIL HART
Other: 3059624547
6175 NW 167 ST G9, HIALEAH, FL 33015
Business: 3058231374 ECSHART@AOL.COM
Other:3059629547
Description: REMODEL BEDROOM AND BATHROOM Valuation: $ 3,210.00 Inspection Requests:
Total Sq Feet: 0.00 1305-762-4949
Fees
Amount
Application Fee - Other
$50.00
CCF
$2.40
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee
$62.35
Scanning Fee
$3.00
Technology Fee
$2.81
Total:
$125.36
Payments
Date Paid Amt Paid
Total Fees
$125.36
Credit Card
11/29/2018 $75.36
Credit Card
11/01/2018 $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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
mqulatipg constrycpori;and zoning. Futhermore, I authorize the above named contractor to do the work stated.
SignaturdV OWNer / Applicant / Contractor / Agent Date
November 29, 2018 Page 2 of 2
Miami Shores Village RECEIVED
Building Department NOV 01 2018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 0"'?
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
F`
BC 2011-4
BUILDING Master Permit No. QC C V—'���
PERMIT APPLICATION Sub Permit No.£ 1 l CS —��u
❑BUILDING �kECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �Pi1 l �olcJ -a Ph one#._j0Z7q6 �_ Q _( T I
Add
Tenant/Lessee Name:
Email
(✓ Zip: a3139
Phone#:
CONTRACTOR: Company Name: PEOTTZON (G 41&-7iZ(/1— Y Phone#:Ua-G(��"l
Address:
lt`i�,ti� W [0 L� ;'�q
City: Ti7�,�1� Gfi�- State:/7if�—
Qualifier Name: fuii j 1 K �_ Phone#: 2cS0� _W!;'?_
State Certification or Registration #: �',�; Z 1+ Certificate of Competency #: rr
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ 3 r Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New ElRepair/Replace ❑ Demolition
Description of Work: V_'La44,6 t/) � 4 a*VV1 Ql tn
Specify color of color thru tile: I t 2 .35
Submittal Fee $ Permit Fee $`7�-� CCF $ CO/CC $
Scanning Fee $
Technology Fee $,
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $
Notary
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
m
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 reinspection fee will be charged.
Sig rature—_lL�► �,��. ♦. i ���
OWNER or AGENT
The foregoing instrument was acknowledged before me this
\ d + day of j�[, , 20 ) V , by
Nei L Q who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
CONTRACTOR
The foregoing instrument was acknowledged before me this
,1O j
da1,
y'of_ ) , 20 ff , by
k)l (f- / J't�-1 }- , who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seal: 4".
,IDELL SHORTT Seal:
:State of Florida -Notary PulCommission # GG 143708 c' My Commission Expires
Septem er 1
***s*ssssss*s*rs�es*ss**�ss+rs •******tss*•ss*•see
APPROVED BY �% . �l�yl� Plans Examiner
as
IDELL SHORTY
r.
�� U%:State of Florida -Notary Public
* Commission # GG 143708
-� My Commission Expires
� 11? OP, ;d``.
September 17, 2021
ssss*s
Zoning
Structural Review
(Revised02/24/2014)
Clerk