EL-19-2028Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
278 NE 103RD ST, Miami Shores, FL 33138
Contacts
Issue Date: 09/04/2019
Parcel Number
1132060134860
Permit No.. EL-08-19-2028
Permit Type: Electrical - Residential
work clossiflcotion: Service Change
Permit Status: Approved
Expiration: 03/02/2020
HB Growth Properties LLLP Owner
278 103
KLEAN POWER ELECTRIC INC Contractor
GUILLERMO ALONSO
6601 SW 80 ST, MIAMI, FL 33143
Inspection Requests:
Inspection Requests:
Description: RELOCATE FROM OVERHEAD TO UNDERGROUND
Valuation:
$ 2,400.00
replace permit #EL17 2868
r-762-4949
Total Sq Feet:
0.00
Fees Amount Payments
Amt Paid
Date Paid
100% Permit Renewal Fee $150.00
Total Fees
$150.00
Credit Card
09/04/2019
$150.00
Total: T$150.00
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 d either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL INDO S,/600RS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing infofmation is and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authooze the above n a tractor to do the work stated.
Authorized Signature: Owner ! Applicant / Contractor / / Agent Date
September 04, 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
BUILDING
PERMIT APPLICATION
[:]BUILDING JN ELECTRIC ❑ ROOFING
FBC 201.-+
Master Permit No. — —I q
Sub Permit No.c-
❑ REVISION EXTENSION RENEWAL
[]PLUMBING [:]MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF [] CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
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:
Tenant/Lessee Name: Phone#:
Email
CONTRACTOR: Company Name: Y� �c��2h r��'L' ��G �T �— Phone#:
Address: 5/ 5 w /. U A,
City: S • C ,,' \ State: Pt 11
Qualifier Name: d /CAS G 6 u ! r l2 1*10 f9 A cI-e ( Phone#:
State Certification or Registration #: eGl 3 60 aG 6 e Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
Trip: 3 3 3 /
1-ac 3o3-c.�aG.;—
Address: City: State:
Value of Work for this Permit: $ �i(�(Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration ll ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: S �pf`% I C E e'`4x j& E
Specify color of color thru tile:
Submittal Fee $,
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
State 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.
Signature Signaturz 'a e—
OWNER or AGENT ` CONTRACTOR
The foregoing instrument was
day of
�h. 1 1141A M
me or who has
identificat n a
NOTARY P BU
4�y
Sign:
Print:
Seal:
n
— pg i
n 1stS�
edged before me this
The foregoing instrument
20by
day of A
is personally known to
as
me or wh has ro
NOTARY
Sign:_
Print:
Seal:
M
acknowledged before me this
A_, 20_, by
who id hers
ly known to
as
APPROVED BY S/ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)