EL-19-1223Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
P (� id- W-- A --� K,
Issue Date:05/31/2019
Location Address Parcel Number
89 NE 102 ST, Miami Shores, FL 33138-2322 1132060131690
Contacts
Permit No.: EL-05-19-1223
Permit Type: Electrical - Residential
Work Classification. Addition
Permit Status: Approved
Expiration: 11/27/2019
PALOMA TEPPA Owner PALOMA TEPPA Applicant
89 NE 102 ST, MIAMI SHORES, FL 331382322 89 NE 102 ST, MIAMI SHORES, FL 331382322
Business: 7862084005 Business: 7862084005
M & C ELECTRICAL INC Contractor
ROBERTO RODRIGUEZ
9250 FONTAINEBLEAU BLVD APT 205, MIAMI, FL 33172
Business: 7866832536 mycelectricalinc@gmail.com
on Re
Description: ELECTRICAL WORK FOR GARAGE ENCLOSURE Valuation: $ 7,500.00 quests:
r-
762-494Ins ectioe
Total Sq Feet: 850.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.80
DBPR Fee
$3.94
DCA Fee
$2.63
Education Surcharge
$1.60
Permit Fee
$212.50
Scanning Fee
$3.00
Technology Fee
$6.56
Total:
$285.03
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$285.03
Credit Card
05/31/2019 $235.03
Credit Card
05/29/2019 $50.00
Amount Due:
$0.00
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating constnq n and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized
Owner / Applicant / Contractor / Agent
Date
May 31, 2019 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
MAY 9 2�019
BY.
FBC 20
BUILDING Master Permit No. I—c - i -l6. 2- 46b.
PERMIT APP ICATION Sub Permit No. -'dS-' 19. - Z3
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /�%(� ��� a /
City: Miami Shores County Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type:
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �j�}/,01444
� 4e& T Rb
Address:�ci IV'G (67- S
—Phone#:`
�n
City: I %,aln 1 S � (�4 State:
i��)' Zip:
Tenant/Lessee Name:
Phone#:
Email:
CONTRACTOR: Company Name: /A,64C �
rA� L NL Phone#: ��6 -G&3 " Z 536
Address: Z$ O ` C U V
2 o f-
City: State:
Zip: l 2
Qualifier Name: i 6 ve- L Phone#:
State Certification or Registration #: /Z. 46dOU Z$ r
Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $i-� 5Dd Square/Linear Footage of Work:
Type of Work: M, Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: £Ac & e a,,d,-r'
Specify color of color thjru tile:
Submittal Fee $ sip �I U Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
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 foregoi nformation is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning. (CX-nQ
"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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charge
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 20 �J by
1q 1tYNC. Ttyi:P (� , who is personally known to
Ro
me or who has produced ) /C�� 1� `V� � S CI as
'C" loci � (p� � • `} � •-�,a,1, �
identification and who did take an oatTi.
NOTARY PUBLIC: xc , f` o
Sign: --^ - t � r�ur�a�g7y•.
Print: V G F1 ( is, 2`o?z A .0
Seal:
f. NL 1
tpF�Sl$PIxa81``
d.
Signature
TRACTOR
Theforegoinginstrument was acknowledged before
me this
day of am 20 I I by
Dy�U� Z who is p rsonally known to
me or who has produced MI R4 as
identifi 'on nd did take an q11?"""'Y"1�/////
N A Y PU LIC: ���Xg\`
Sign: 4.••
•may � �
Print: kA mv i A'
'•
Seal: ST/1TE����
APPROVED BY M I � Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)