DS-19-23Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
if if IR 6 tS
Permit No.: DS-01-19-23
Permit Type: Driveways/Sidewalks/Slabs
Work classification: Addiftion/Alteration
Permit Status: Approved
Issue Date: 01/25/2019 Expiration: 07/02/2019
Location Address Parcel Number
161 NE 108TH ST, Miami Shores, FL 33161 1121360090220
Contacts
JOHN & REBECCA MURRAY Owner
161 NE 108 ST, MIAMI SHORES, FL 33161
Mobile: 8122230540
ALL QUALITY ELECTRICAL SERVICES, INC Contractor
SAMUEL LIGHTBOURNE
14500 NW 16 CT, MIAMI, FL 33167
Business: 3059687832
Description: CONCRETE PAD FOR NEW 22 KW NATURAL GAS Valuation: $ 600.00 Ins ection Requests:
49
GENERATOR WITH 200 A WHOLE TRANSFER SWITCH.
TotalSq Feet: 13.50
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
Concrete/asphalt/pavers, slabs, dways,
$50.00
swalks
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Planning and Zoning Review Fee
$35.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$145.30
Payments
Date Paid Amt Paid
Total Fees
$145.30
Credit Card
01/03/2019 $50.00
Credit Card
01/25/2019 $95.30
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.
0 RS AF AVIT: I cent' that th all oregoing information is accurate and that alllwowill be done in compliance with all applicable laws
re ulating con uctio�nd zo ng. th ore, I authorize the ab e n d contracto to d the ork s� ted.
rGer\j
Authorized Signature: Owner / Applicant / Contractor / Agent Date
January 25, 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
FBC 20
BUILDING Master Permit No.�
PE MIT APPLICATION Sub Permit Now
BUILDING ELECTRIC ❑ ROOFING REVISION EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP
�� CONTRACTOR DRAWINGS
JOB ADDRESS: 6
Occupancy Type:
OWNER: Name (I
Simple
City: AA cam/;.► I
Tenant/Lessee Name:
Email:
Is the Building Historically Designated: Yes NO
Load: Construction �Type: S Flood Zone: -� BFE: FFE: '
Tixleholder):A Phone#:.�'�' `� -33 /
//S.14M
CONTRACTOR: Company Name;,
Address:�7 Sd �•`
City: /
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit. $
Type of Work: ❑ Addition ❑
Descriptio of Work:
>� ��c,.,O- 11"-V
55�j
_ State: /L L Zip: •� / `� 40
Phone#:
a i
r
Phone#:
id�c- r c— .
n Zip>
Phone#: fr%
Q QCertificate of Competency #:
Phone#:
ity: State: Zip:
quar /Linear Fgotage of work:
n A New ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile. -
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $ CO/CC $
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 Lenders Address
City
State
Zip
Zip
Applitation 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 on 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 th& 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.
i
Signature_
OWNER or Af ENT
Th f
Signature ,
CONTRACTOR
e oregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
29 day of )0412 � QW . 20 (D by day of / 20 f1i by
Jc__ lf' 1
who is personally known to � 1who is personally known to
Me or who has produced as me or who has produced \ as
Identification and who did take an oath. i enti ication and who did take an
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NOTARY USLIG� �����P�MTigqINE ii���'/ NOTARY PUBU
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Sign: - _ <c°'
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Print: 1 -f5 ; *FF%4740 : Q rint: r
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Seal: %ice-_:j�ea±deetn�.� OQ�
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APPROVED BY Z Plans Examiner
y_ L.IJIDNY ABDCFIET
g* P✓rti' COrorAISS70N v FF948634
53 Ftr�r
Mallo�a. vServ¢e con
Zoning
Structural Review
(Revised02/24/2014)
Clerk