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EL-20-207Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 �u U Issue Date: 01/31/2020 Location Address Parcel Number 10400 NE 4TH AVE, Miami Shores, FL 33138 1121360130150 Contacts Permit NO.: EL-01-20-207 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Expiration: 07/29/2020 Edelman Lopez JR Owner 104004 FERREY ELECTRIC CORP Contractor MICHAEL LENIN PEREZ 1745 W 37 ST 15, HIALEAH, FL 33012 Business: 3053318367 Description: ELECTRICAL WORK FOR KITCHEN NEW LOCATION Valuation: $ 3,800.00 Inspection Requests: AND OTHER ELECTRICAL PLANS E-1 305-762-4949 Total Sq Feet: 300.00 Fees Amount Application Fee - Other $50.00 CCF $2.40 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.80 Permit Fee $83.00 Scanning Fee $15.00 Technology Fee $3.33 Total: $158.53 Applicant Copy Payments Date Paid Amt Paid Total Fees $158.53 Credit Card 01/31/2020 $158.53 Amount Due: $0.00 For Inspections, Call (306) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. January 31, 2020 Page 1 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Eli Issue Date: 01/31/2020 Location Address Parcel Number 10400 NE 4TH AVE, Miami Shores, FL 33138 1121360130150 Contacts Permit NO.: EL-01-20-207 Permit type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Expiration: 07/29/2020 Edelman Lopez JR Owner 104004 FERREY ELECTRIC CORP Contractor MICHAEL LENIN PEREZ 1745 W 37 ST 15, HIALEAH, FL 33012 Business: 3053318367 Inspection Requests: Description: ELECTRICAL WORK FOR KITCHEN NEW LOCAT49 ION Valuation: $ 3,800.00 Inspec i n Re AND OTHER ELECTRICAL PLANS E-1 Total Scl Feet: 300.00 Fees Amount Application Fee - Other $50.00 CCF $2.40 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.80 Permit Fee $83.00 Scanning Fee $15.00 Technology Fee $3.33 Total: $158.53 Building Department Copy Payments Date Paid Amt Paid Total Fees $158.53 Credit Card 01/31/2020 $158.53 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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date January 31, 2020 Page 2 of 2 BUILDING PERMIT APPLICATION ❑BUILDING 0ELECTRIC 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 ❑ ROOFING ❑ PLUMBING ❑ MECHANICAL DPLIBLICWORKS JOB ADDRESS: 10400 NE 4th avenue nNTERED JAkill 2 9 2020 BY: _CD� 'E 1 A FBC 201'-1- Master Permit No. ec— I I - I C -2 (5(0 Sub Permit No.F—L 01-2U -2 0 7 ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Citv: Miami Shores County: . Miami Dade _ Zip: Folio/Parcel#: 11-2136-013-0150 Is the Building Historically Designated: Yes NO X Occupancy Type: singlefamdy Load: Construction Type: Flood Zone: No BFE: FFE:. OWNER: Name (Fee Simple Titleholder): Edeman Lopez Address:10400 NE 4th ave Phone#: 7864618854 City: Miami Shores State: FL Zip: 33138 }Ys Tenant/Lessee Name: Phone#: ),rs Email: edelmanlopez@mac.com 11CGSt call '. Uh oSq/ CONTRACTOR: Company Name: _&7>66 e e L' -6rLc cqv/'% Phone#: 30r 33183(P 7- Address: / 7 I�LA--'G �37-S_ / .5-- City: %lcZf'/U Qualifier Name: State Certification or Registration #: 130a Ftor'r. r� ,9 ' Zip: 3 3 Phone#: SOS *_ 331 930 - 3d Certificate of Competency #: DESIGNER: Architect/Engineer: MAeLk f Ai^p fj F `L- Phone#: 305' -1 59 - Z 3) �_ Address: `1 `73 Ne 110" ST'r"r City: M (4- -)N-A i state: FL Zip: 33 13 y Value of Work for this Permit: $ 3, Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: C L lfc--tvC o"L W v Fo'\ k—t YL,,�' dr/► ao r'1.tyl i J2,P(.411rS C-- 1 Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $ Radon Fee $ Training/Education Fee $ CCF DBPR $ CO/CC $ Notary $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $. Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Chase Mortgage Mortgage Lender's Address PO BOX 78420 City Phoenix State AZ Zip Zip 85062-8420 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 deliver d-to�he person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be, ed at the job site In h absence o suth osted notice the for the first inspection which occurs seven (7) days after the building permit is issued. the abs f p , inspection will not be approved and a reinspecti n fee will be charged. 9Signature�;�, Signature�It,/l OWNER or KGENT The foregoing instrument was acknowledged before me this Q day of ) AyA't-y , 20 2-0 by C4E L,"M >A PE 7 who i ersonally known o me r who has produced L/ CONTRACTOR The foregoing instrument was acknowledged before me this S-9 day ofJAtju✓1"10 20 7-�D by M LC14Ale L 12 Gwhs personally known to as ,—me> who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: as Z-Is�:� Sign: Sign: Print: VAN +ASS Print: J04N Seal: � 0L• ��" e a �aa�:s Seal: ,*fin' ; JUAN F. ROSAS Commission # GG 90793q 8£61t1fi N x sera uo� , ';�f. . Expires November It.2023 SWON Nvnr ' • Ni, .: • Donrieri Tnru Troy bin insurana600385.1019 APPROVED BY q.-9 -J11 4�11� Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk