ELC-20-8565t � -L-)C)
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-W9
RECEIVED
I R� 9 1�20
ay;
Op
FBC 20 I'�
BUILDING Master Permit No. 9 - 9&o p I
PERMIT APPLICATION Sub Permit No - `4- X�
❑BUILDING ffELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING [:]MECHANICAL PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
10B ADDRESS:
City: Miami Shores County: Miami Dade Zia: Sv3x3>y
Folio/Parcel#: Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: . Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 4EAPO - 0r713 NE /1 AyG 4/_C- Phone#:CK G049.
Address: I A� CA) t 4-(o
City: 01lC['--I
State: -Z
Zip: 3-vp1 (4:'
Tenant/Lessee Name:
Phone)h
Email: MVAZ.C3tJFZ
e !1--eAjW1 N11. Gv�
��j;� Z.( q- 6-72
CONTRACTOR: Company Name:
C� (_1i6C� ✓�
. C 4�wj 1Y��at Phon #:
Address: l CId-a i Nt)
92Z t_CVRV
City: VAU24 - l
State: V--
Zip:
Qualifier Name:
`-I YG.4L AV JL-
Phone#:
State Certification or Registration #: '*G 1 �)0a Fl +51
Certificate of Competency M
Bl
_
DESIGNER: Architect/Engineer:
J
�r I Phone#:�
Address: (0ll91 Gt) !`Jsc%9l
�vrf-
City: State:�Zip:333/%
Value of Work for this Permit: $
04706 - CJ`7
Square/Linear Footage of Work:
Type of Work: ❑ Addition
❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: &0ew
"->'L 41 C7
(
wi\ t��! 'J � - Li G. i cA
Specify color of color thru tile:
Submittal Fee $
Permit Fee $
CCF $ CO/CC $
Scanning Fee $
Radon Fee $
DBPR $ Notary $
Technology Fee $
TraIning/Education Fee
$ Double Fee $
Structural Reviews $
Bond $
TOTAL FEE NOW DUE $ ! 1 ( 10
(Re,ised02/24/2014)
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."
i
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 faithrthat 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 certifled copy of the recorded notice of commencement must be posted at the job site
for the first ins ection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will rbe approved and a reinspection fee will be chained.
OWNER or AGENT
The foregoing inst ment was acknowledged before me this
day of r 20 by
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC: Miles ` f��uez
�/
t�MMISSIOM # GG291823
Sign;
Print: � � R Jhfu A9rDli NoM,
Seal:
as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
'Z day of �/i�` L 20 �W by
1-4/�i�T /�Q4,� , �, who is sonaly known
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
. , , Mike Vazquez
Sign: - _ # GG29182,1
i, r , L,'
Printhimf
Seal:
!!#itiKttttittiKtiKi#t##i#tiR•ilititiyi'itfR�#/it#t##RiiiiiRRRifilRitt!litiititR!liiiiRRRtlRliiitiltRRtRR!!!i!!t
APPROVED B� �7� J` �ans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
EG SERVICE AND REPAIR'S INC
8766 NW 140TH LANE
MIAMI LAKES, FL 33018
(305)776 0657
Name/Address
GATOR 214 -216 NE 98 ST
MIAMI SHORE
Estimate
Date Estimate No.
Project
03/23/20 697
GATOR 214 -216 NE 98 ST
Description
Quantity
Cost
Total
- INSTALL GROUND WIRE TO EXISTING OUTLETS NEW
200.00
200.00
OUTLTS AS SHOWN PLAN
-REPLACE EXISTING CLOTH WIRE IN EXISTING OUTLETS
FOR LIGHT
- REPAIR PANEL BREAKER
380.00
380.00
- REPLACE BREAKER TO ADD MORE SPACE, BASED ON
CIRCUITS REPRESENTED IN PLAN
- RELOCATE CIRCUITS (PIPE AND WIRE) ONCE THE
380.00
380.00
DOOR THAT WILL COMMUNICATE THE TWO SPACES IS
OPEN
- RELOCATE OUTLET TO A/C IN FRONT DOOR
240.00
240.00
- TRACK LIGHT INSTALLATION
420.00
420.00
- REPLACE EXISTING EXIT AND EMERGENCY COMBO
150.00
150.00
- COST EXIT AND EMERGENCY COMBO
196.00
196.00
- NOTE;
- CITY PERMIT COST NOT INCLUDED
- TRACK LIGHT COST NOT INCLUDED
Thank you for your business.
Total $1,966.00