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EL-19-2336Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 74 NW 108TH ST, Miami Shores, FL 33168 rnntarts issue Date:10/23/2019 Parcel Number 1121360110150 Permit NO.: L-10-18-2336 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Expiration: 04/20/2020 Cory Mullinare Owner 74 108 ATLANTIS ELECTRICAL CORP Contractor FRANCISCO PEREZ 12803 SW 20 TER, MIAMI, FL 33175 Business: 3055514043 Inspection Re nests: Description: REMOVE & REPLACE MASTER BATHROOM Valuation: $ 900.00 305-762-4949 REMODEL Total Scl Feet: 80.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 10/03/2019 $50.00 Credit Card 10/23/2019 $60.30 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. OWNERS AFFIDAVIT: I ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction ar; ning Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: (!rw ner / Applicant / Contractor / Agent Date October 23, 2019 Page 2 of 2 Miami Shores Village Building Department artment RECEIVED 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (30S) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20i" BUILDING _ Master Permit No. 9,.C' 10-[9-g3315 PERMIT APPLICATION Sub Permit No. 1,- 10 -)ter- v-1330 []BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL f ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [] CANCELLATION ❑ SHOP CONTRACTOR r DRAWINGS , JOB ADDRESS: l `( N W Ow 1�I City Miami Shores County: iviiami uaae i - uo:. •. "_2 1 5 C1, Folio/Parcel#;bAs the Building Historically`Designated: Yes NO _0Ecupancy,Ty0e;. Load: Construction Type: + Flood Zone: BFE: ' FFE: OWNER: Name (Fee Simple Titleholder): �CS f` �i A,11 /L� Phone#: (tb ` W q1 C Address: f , ,City: State: Zip: Tenant/Lessee Name: Phone#: Email: IF CONTRACTOR: Company Name: �T�G1 ��C C�L�C /iC— Phone#:'_ _ / � 7 U Address: 129t;� Sw r _ City:State: Zip:-J Qualifier Name: State Certification or Registration #: F—G ne#: 1 t H Certificate of Competency #. DESIGNER: Architect/Engineer: Phone#: , Value of Work for this Permit: $ 1 Uy " Type of Work: ❑ Addition [ 9 Alteration ' Description of Work: —City: State: Zip: Square/Linear Footage of Work: ❑ New ❑ Repair/Replace n ,❑ Demolition _I! i Spedfyc`oitor of color`thrru file: ' Submittal Fee S J� pi Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee Structural Reviews S Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ & 0, (Revised02/24/2014) ti r Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip I 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 thei 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..... , r 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 OWNER or AGENT The foregoing instrument was acknowledged before me this dayof0 � 201� by �rQ Ijkc�l (pr�9-(� who is personally known to me or who has produced l� 1-It- U N P le as ., identification and who did take an oath. NOTARY PUBLIC: Sign: Print: ARM Seal: �OIIOBO. r .. Signature f CONTRACTOR The foregoing instrument was acknowledged before me this -2— day of ©20 by who is personally known to me or who has produced 1Nl_ OD 1 A((' � as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: JUIN Seal: 20vow, - ThrtlNfty APPROVED B lGr/ �j Plans Examiner t r Zoning Structural Review (Revised02/24/2014) Clerk