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EL-19-1946Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 09/04/2019 Location Address Parcel Number 38 NE 110TH ST, Miami Shores, FL 33161 1121360040350 Contacts Permit NO.: EL-08-19-1946 Permit type: Electrical - Residential Work Classification: Service Change Permit Status: Applied Expiration: 02/18/2020 ROCCO AND JESSICA RIGGIO Owner 38 NE 110 ST, MIAMI SHORES, FL 33161 Other: 3055345051 STATE ELECTRICAL CONTRACTOR LLC Contractor ARMANDO OJITO 1100 SW 97 AVE, MIAMI, FL 33174 Business: 7862567068 Description: OVERHEAD TO UNDERGROUND SERVICE Valuation: $ 2,000.00 Inspection Requests: CONVERTION 200 AMP 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $117.10 Payments Date Paid Amt Paid Total Fees $117.10 Credit Card 08/22/2019 $50.00 Credit Card 09/04/2019 $67.10 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 wo done byy eit er myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, ME A I WIN jriJwS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I rtify-that,d F�o oiin ' fo a ' is urate and that all work will be done in compliance with all applicable laws regulating construct iA ning:' � t r authb'abolLe n„ or to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date September 04, 2019 Page 2 of 2 BUILDING Miami Shores Village IVF Building Department AUG 2 Z019 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BY. INSPECTION LINE PHONE NUMBER: (305) 762-4949 F Bj C 20 Master Permit No.� US 1 (I�17 PERMIT APPLI TION Sub Permit No. BUILDING ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: h Folio/Parcel#: zz340 222k — )3—';O Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): /C� _� //J� �Tl1�2 Phone#: Address: - 33� City: �i/.J'/`Zl �� State: Zip: 61 Tenant/Lessee Name: Phone#: Email: - v� CONTRACTOR: Company Name: Q F__ C C ,' - Phone#. Address: City: /19 i � /''fit' State: C�, Zip:�p� J Qualifier Name: �� f� / �i�l �1'�G/ Phone#: I, (o/ State Certification or Registration #:�<2::;;?Z X)ertificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: .14, It Zip: ❑ Demolition � i Specify color of color thru tile: - 4 Submittal Fee $ C .1 Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ D� V (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 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." 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 OWNE or AGENT The foregoing instrument was acknowledged before me this 0�ay of 120, by d who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: o` ¢ r. NotaryPublic-StateofFlwida Seal: = , • • = Commission 4 GG 112857 z My Comm. ec P' Borded through Nation 9 ll Notary Asir, Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of 204P by who is personally known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: ..q� yF�..... APPROVEDlfL�Plans Examiner Structural Review MANUELA. DIANA Notary Public - State of Florida Commission N GG 112857 My Comm. Expires Dec 15, 2019 Bcrded through National Notary Assn. N11 *********** Zoning Clerk (Revised02/24/2014) 0 . ......... . ..... LL Q ..... . .... .. .. .... .... .•• • • • • .•• • • ••• • • • ••• • • C� O X i n ICJ � m D w r� ig �o 3�1, Q-) !��(Z C-) !7, akrn L r ZLC 6 � WAt,r LL(f_ c� J t 0 ,.!ypG •.,,, NUEL A. DIANA otary ublic-State of Florida 112857 yComm. Expires Dec 9 '••.'`�,'ov �, :•''' Borded tMougP Aatloral Actary AW-. vv cr%rlC/Au I► U UllvUtKUKUU IVIJ WNVtRSIUN SKETCH FORM ;mer Name: �?� C (r daytime Contact CdJ Phone: i ze Address: ,�,�% '� City: �'ZIAI`'j 1 Zip: �3 {AMPLE see .. . . ..... .. .. $000so • • 000009 -3y i INSTRUCTIONS: 1. BUILDING ADDRESS 2. POLE LOCATION 3. INDICATE METER ON YOUR HOME 4. EXISTING OVERHEAD WIRE TO PROPERTY (INDICATE WITH SOLID LINE) 5. TRENCH ROUTE FOR NEW UNDERGROUND CONDUIT (INDICATE WITH DASHED LINE, SHOW TRENCH ROUTE FOOTAGE) 6. STREET NAME 7. INDICATE HOW MANY UNDERGROUND RISERS ARE ON POLE: 0 (SEE FAQ #10 FOR DETAIL #6 STREET NAME (ex. First St.) INSTRUCTIONS: 1. BUILDING ADDRESS 2. POLE LOCATION 3. INDICATE METER ON YOUR HOME 4. EXISTING OVERHEAD WIRE TO PROPERTY (INDICATE WITH SOLID LINE) 5. TRENCH ROUTE FOR NEW UNDERGROUND CONDUIT (INDICATE WITH DASHED LINE, SHOW TRENCH ROUTE FOOTAGE) 6. STREET NAME 7. INDICATE HOW MANY UNDERGROUND RISERS ARE ON POLE: /_ (SEE FAQ #10 FOR DETAIL) 0 U . ......... D rm m m • a c - �P � lV� NUELA.01ANA • • '2°Y . � . tary ublic—SuteofNorlda • • Comm.ExpiresDec 9 • • Bcrded t. rcu5h Nat cral Actary ASfr. OVERHEAD TO UNDERGROUND CONVERSION SKETCH FORM tomer Name: I� vice Address: EXAMPLE ADDRESS (ex. 123) #3 #1 / • r 1*5 . .. « 601 • 't4: «. .... i ..... .. .... ..... . .. ...... ...... .. . .... .. 2 . i INSTRUCTIONS: Daytime Contact Phone: C� City: /t/AL 1, Zip: 331 �nl� 1. BUILDING ADDRESS 2. POLE LOCATION 3. INDICATE METER ON YOUR HOME 4. EXISTING OVERHEAD WIRE TO PROPERTY (INDICATE WITH SOLID LINE) 5. TRENCH ROUTE FOR NEW UNDERGROUND CONDUIT (INDICATE WITH DASHED LINE, SHOW TRENCH ROUTE FOOTAGE) 6. STREET NAME 7. INDICATE HOW MANY UNDERGROUND RISERS ARE ON POLE: 0 (SEE FAQ #10 FOR DETAIL) • • • • #6 STREET NAME (ex. First St.) INSTRUCTIONS: 1. BUILDING ADDRESS 2. POLE LOCATION 3. INDICATE METER ON YOUR HOME 4. EXISTING OVERHEAD WIRE TO PROPERTY (INDICATE WITH SOLID LINE) 5. TRENCH ROUTE FOR NEW UNDERGROUND CONDUIT (INDICATE WITH DASHED LINE, SHOW TRENCH ROUTE FOOTAGE) 6. STREET NAME 7. INDICATE HOW MANY UNDERGROUND RISERS ARE ON POLE:_ (SEE FAQ #10 FOR DETAIL) I AIIE /0 C� 377 1