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EL-19-841Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 04/23/2419 Location Address Parcel Number 395 NE 96TH ST, Miami Shores, FL 33138 1132060135930 Contacts Permit NO.: EL-04-19-841 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Apprmved Expiration: 10/14/2019 GONZALO & CATHERINE AMBER PEREZ Owner JTRS 395 NE 96 ST, MIAMI SHORES, FL 33138 LONGMAN ELECTRIC INC Contractor MICHAEL LONGMAN 95 NE 166 ST, Miami, FL 33162 Business: 3057581211 longmanelectric@bellsouth.net ti Description: 2 OPENINGS FOR KITCHEN, SLIDING DOORS AND Valuation: $ 2,000.00 on Requests: Inspection 4949 OPENING FOR DINING ROOM SLIDING DOORS. 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 $12.00 Technology Fee $2.50 Total: $120.10 Payments Date Paid Amt Paid Total Fees $120.10 Credit Card 04/23/2019 $70.10 Credit Card 04/17/2019 $50.00 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 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. Futhhee/rmore, I authorize the above named contractor to do the work stated. U'4 GJ�' Authorized SignatutWOwner / Applicant / C'ontpActor / Agent Date April 23, 2019 Page 2 of 2 V�71\vl Miami Shores Village BuildingDepartment p 410 100SO N.E.2nd Avenue, Miami Shores, Florida 33138 �Q Tel: (305) 795-2204 Fax: (305) 756-8972 U INSPECTION LINE PHONE NUMBER: (305) 762-4949 � 1_ FBC 201-1 BUILDING Master Permit No.1_= r2^ia-33 M PERMIT APPLICATION Sub Permit No. `�"��l—&`11 ❑BUILDING U ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ,{'' JOB ADDRESS: S��/ Aig 17� 4-4 S_�_ CONTRACTOR DRAWINGS 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: OWNER: Name (Fee Simple Titleholder): 6; pwzw u) ( ����' Phone#: y Address:61� A(cf�, q4 S4 City: 11144 / 5A& CAS State: �— Zip: Tenant/Lessee Name: Email: 10)(4 ,10 CONTRACTOR: Company Name:©� /vlail'� /a Phone#: -` Address: :/ & OF / G City: MIA t4l `/' State: Fz_ Zip: � g l Ir 'Z__ Qualifier Name:&I� ae// onlwaw Phone#: " 75-6 ` «`I State Certification or Registration #: Z� 130o 9-1 t'S Certificate of Competency #: DESIGNER: Architect/Engineer: one#: Address: J City: State Value of Work for this Permit: $ Square/Linear Footage of Work: _ Type of Work: ❑ Aidddition El Alteration / New ❑ Repair/Replace Description of Work: _/(/( �� /!!!!�+' Zip: ❑ Demolition Specify color of color thru tile: Submittal Fee $Sz> ' L>.3 Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ 770 • 10 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 COMMENCr4V1LIN 1 ." 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 d'ay ofd. 20� by jf l�citi who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Print as Signature qajc��; CONTRACTOR The foregoing instru ent was acknowledged before me this /- V day f ►'! 20 J by e 4Mowho is personally known to me or who has prod as identification and who did take an oath. NOTARY PUBLIC: Sign:J Print: Seal: f othwwa +F+ sl Seal: � ,. w� a � (S OEAIIAII - APPROVED BY �l t� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)