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EL-19-1351 (2)
Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 06/20/2019 Location Address Parcel Number 79 NE 91ST ST, Miami Shores, FL 33138 1132060130130 Contacts Permit NO.: EL-06-19-1351 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Expiration: 12/17/2019 ROBBIE & KARLA SINGER Owner CONTRACTORS ELECTRICAL SERVICES Contractor 79 NE 91 ST, MIAMI SHORES, FL 33138 LEONARDO RODRIGUEZ Business: 7862521284 Description: INTERIOR RENOVATION. REPLACE ANL TE Valuation: $ 12,000.00 Inspection Requests: GFCI RECEPTACLES, APPLIANCE RECEPTACLES IN KITD305-762-4949 LAUNDRY ROOM. INSTALL RECESSED LIGHTING IN Total Sq Feet: 370.00 LAUNDRY ROOM AND LIVING ROOM Fees Amount Application Fee - Other $50.00 CCF $7.20 DBPR Fee $6.30 DCA Fee $4.20 Education Surcharge $2.40 Permit Fee $370.00 Scanning Fee $3.00 Technology Fee $10.50 Total: $453.60 Payments Date Paid Amt Paid Total Fees $453.60 Check # 1065 06/20/2019 $453.60 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 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 authorizeAe above named contractor to do the work stated. (�/2,n / l Authorized Signature: Owner / Applicant / Kontractor/" Agent June 20, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION ❑BUILDING ® ELECTRIC Miami Shores Village RFcr,-... � Building Department jLl'�x:; 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BC 20�� ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 79 NE 91 st Master Permit No. `ZC - 03 -1 � ` S I L Sub Permit No.L ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade zip: 33138 Folio/Parcel#: 11-3206-013-0130 Is the Building Historically Designated: Yes NO Occupancy Type: RES Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): ROBBIE S SINGER, KARLA E SINGER Phone#:786-564-5925 Address: 79 NE 91 st city: Miami Shores State: FL zip: 33138 Tenant/Lessee Name: Phone#: 786-564-5925 Email: Robbie rsinger(aD-nearlynatural.com, Karla singer.karla(a)_yahoo.com CONTRACTOR: Company Name: ay ,1 11 �'�'ncl�.{ -4 b'�VI -�CT Pyq 1ckS �� Phone#: t 233— �,Z� Z Address:` '�Ay � "L� fwE L City: M t 0.1)r\ State: Zip: � :� q Qualifier Name: Uoy\ , o tCDC��10i1�12 - Phone#: iph - IS 2_-1210� State Certification or Registration #: DESIGNER: Architect/Engineer: Address: 0 Ct515q Certificate of Competency #: Phone#: City: State: Zip: Value of Work for this Permit: $ l t2, QU U Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: INTERIOR RENOVATION. REPLACE AND RELOCATE, GFCI RECEPTACLES, APPLIANCE RECEPTACLES INSTALL RECESSED LIGHTING IN KITCHEN LAUNDRY ROOM AND LIVING,ROOM Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews 5 (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ S� ICU 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 absent of such sted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNE or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this t ►, day of J UN 20 5 by AYZ L#4 S rN CrEr who is personally known to me or who has produced as The foregoing instrument was acknowledged before me this ,t)b day of 20 11 by if who is personally known to me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: 0 Sign: g g C->+ t S �nj Print: P�1�e Print: i 1 r►��ck �pm�`� gMay34. 5«, ,o::F�•, ADRIANA S. GARCIA Seal: o * se mar! Seal: ° ' : MY COMMIS.,ION # GG 126487 • o �'dF EXPIRES: July 20, 2021 : c °��� of �° "%;g;,;; ; •'' ©endad Thru Notary Public Underwriters ******************* ************************************************************************************** APPROVED BY 13 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)