EL-17-2501ortFs y,!
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
aFN-d°
Phone: (305)795-2204
COR1Od'
'roject Address
Permit NO. EL-10-17-2501
Pe
Permit Type: Electrical - Residential
rill'it Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 1112212017 1 Expiration: 05/21/201
Parcel Number Applicant
10555 NE 2 Court 1122310130600
Miami Shores, FL Block: Lot: JORGE LUIS RIOS
lwner Information
Address
Phone
JORGE LUIS RIOS 10555 NE 2 Court (786)202-6660
MIAMI SHORES FL 33138-
:ontractor(s) Phone Cell Phone
iUPER QUALITY ELECTRIC SERVICE (786)298-7282
Type of Work: ADDING LIGHTS
Additional Info: ADDING LIGHTS
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee /
Total:
In consider tion f a isl
pertaining ereto oan in st.
accepting his permit ass
required f r ELECTRIC L,
OWNER AFFIDAVIT: I c
constructi n and zoning. Fi
Pay Date
Pay Type
Invoice #
EL-10-17-65412
10/19/2017
Credit Card
30.�3_
11/22/2
Credit Card
Cell
Valuation: $ 5,000.00
Total Sq Feet: 0
Amt Paid Amt Due
$ 50.00 $ 140.63
$ 1 4,0-63—___$_Q.00
AvanaDie inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
Review Electrical
Underground
W. W.
m6,of this permit agree to perform the work covere ereunder in compliance with all ordinances and regulations
1 \ mity with the pla , drawings, statements or specific ns submitted to the proper authorities of Miami Shores Village. In
es p nsibility for a work done by either myself, my ent, servants, or employes. I understand that separate permits are
BIN MECHA AL, WINDOWS, DOORS, RO NG and SWIMMING POOL work.
t all the \egoing information is accu a and that all work will be done in compliance with all applicable laws regulating
lore, au nz� the above named c or
to do the work stated.
November 22, 2017
wnpf p t / Contractor / Agent Date
Building Depa
November 22, 2017
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
BUILDING
PERMIT APPLICATION
❑BUILDING XELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS
RECEIVED
OCT 19 zon
s fip-�4"1
FBC 2011.J
Master Permit No. P-4 162555
Sub Permit No. 61 1--, ' Z370 I
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I OS 5 5 N E 2 m h Cvc.tA
City: Miami Shores County: Miami Dade Zip: 3--M 3x
Folio/Parcel#: Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): In(G G Luis 9 , os S R Phone#: h 25 0\ W2 - 640 (00
Address: 10555 NE ZNf. CoLc-d
City: Vfi av+mj State: 1= L zip: 53138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: s U AC2 u 4 L r i� � aone#: ::?,f G 2 9,P 7 Ag
Address: G G 0 Z ULEG 7- 3 �� N C 7—
City: !, 0/r'N State: '- (- Zip: .53o4
Qualifier Name: j6k&C-- )ei'U0/20 Phone#:7,(G 25S 728Z.
State Certification or Registration #: C ra U d /1 �,34 Certificate of Competency #: 9 f C' 0 660 3P
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ b,000, Square/Linear Footage of Work:
Zip:
Type of Work: ❑ AcJAtio4' Q❑ Alteratioq 1 11 New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $.
(Revised02/24/2014)
Permit Fee $ l r�dy CCF $ CO/CC $
Radon Fee $
Training/Education Fee $
DBPR $
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 a ment. Also, a ertified copy of the recorded notice of commencement must be posted at the job site
for the first inspection h o urs a (7) d ys after the building permit is iss in the absence of such posted notice, the
inspection will not b a pro d nd a insp ctio fee will be charged. n
Signatur
WIor,The fore istru
,,�!yn
o
meor who has troduced
identifiXiBLIC:
n and who did take n oath.
NOTAR
CONTRACTOR
by I [ day of
me or who hakproduced
identification and who did take
NOTARY P
Sign: NIA RIOSSign:_
Print: = o`er P °`%'�. Notary Public - State of Florida print:
• Comm s
Seal: =N •' My Comm. Expires Apr 12, 2019 Seal:
' .'I!,.;Y� Bonded thta Nal MW Notary Assn.
«.*««*ss**.**.ss*«s«***s«•*ss*ssssssssss«ss*«s*:*sss*,
APPROVED BY 1 `l�� 1 Plans Examiner
acknowledged20`Wl7by
w isally kn n o
n oath.
4
Notary PubIR -State of Florida
Commhaloe I FF 21l1317
My Comm. Expires Apr 9
12. 201
Iorrda0 though Natkagl Notary Mari.
«ssssssssss*•ssssssss«ssss*ss*
Zoning
Structural Review
(Revised02/24/2014)
Clerk