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EL-9-16-2434, 812 NE 92nd St�� SNORES D� Y�yFNT �N BQ� FtORtDP' Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. EL-9-16-2434 Permit Type: Electrical - Residential ermit Work Classification: Pool - Private Pennit Status: APPROVED Issue Date: 12/14/2016 1 Expiration: 06/12/2017 Project Address Parcel Number Applicant 812 NE 92 Street 1132060050190 Miami Shores, FL 33138- Block: Lot: GERALD & ANABEL DE BRUIJN Owner Information Address Phone Cell GERALD & ANABEL DE BRUIJN 812 NE 92 Street (305)299-7252 MIAMI SHORES FL 33138- 812 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone METRO ELECTRIC SERVICE, INC (305)945-1991 (305)945-1991 Type of Work: POOL PUMP AND LIGHT Additional Info: Classification: Residential Scanning: 1 Fees Due Amount CCF $0.60 DBPR Fee $4.50 DCA Fee $4.50 Education Surcharge $0.20 Permit Fee - Additions/Alterations $300 00 Scanning Fee $3.00 Technology Fee $0.80 Total: $313.60 Valuation: $ 1,000.00 { Total Sq Feet: 0 Available Inspections: Inspection Type: Final Light Niche Bonding Review Electrical Alarms Pay Date Pay Type Amt Paid Amt Due Invoice # EL-9-16-61174 09/01/2016 Credit Card $ 50.00 $ 263.60 12/14/2016 Credit Card $ 263.60 $ 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 ghee ' 'ore, ize the above -named contractor to do the work stated. ��—cam- December 14, 2016 Authorized Signature: Owner' / Applicant I✓ Contractor / Agent Date Building Department Copy 6 Miami Shores Village�� Building Department artment a, 10050 N.E.2nd Avenue, h iami Shores, Florida 33138 BY: Tel: (305) 7952204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 T+ FBC 20 l�l BUIILDING PERMIT APPLICATION Permit Type: Electrical Permit No. Ll' � — 2_Y3 9 Master Permit Nolf dOB ADDRESS• ��L �� ?Z City: Miami Shores County: Miami Dade Zip: -33 138 Folio/Parcew. Is the Bmlding )historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple L City: �?E�2r'� t state: zip: Tenant/Lessee Name: ..33 r38 CONTRACTOR: Co Name: X67, =�2Jlc� _ U 17 --,_ Company � Phone#:.�?S Zf �y Address: / 50_� ,�/v-� l :F �� ----- - - City: Qualifier Name: Phones State Certification or Registration # ��- / ,?CAD -:573274 Certificate of Competency #: Contact Phone# Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ �� s SgnardLhiear Footage of Work: Type of Work: OAddress DAlteratiioonnn Description of Work•��'� ONew ORepair/Replace ODemolition sssss**sassssss*s*ss*s**************s**F�s***ssssssssssss*s*sass**s*sss*:sass**s*ssss Submittal Fee $) - � Permit Fee $®lAi ©O CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TAL FEE NOW DUE $ Z 3 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 Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 flee will be charged. - Signatur . OWNER or AGENT The foregoing instrument was acknowledged before me this day of T S 20 by u ti� Pe- � t6s personally known t me or who has produced as identification and who did take an oath. NOTARY P BU Sign: Print: =.i :A Commission # F!F903]6 Seal:Expires JanuaryBonded Thru Troy Fain In CONTRACTOR The foregoing instrument was acknowledged before me this 30 day of A U6— . 20 , (( . by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC 4 Sign: Print: Seal: r MY COMUM N]MI904s EXPIIm May 4,2018 k107)398.0733 p1orid*?40ftrySft7kNLC= sss*sssss*ssssssssssssssss**sss*ss***ssss*sssss*ss**s*ssss*ss*sssss**ssssssssss*sssss**sssssssssssssss*ss*ss APPROVED BY�p�/E Plans Examiner Zoning Structural Review Clerk (ReviseM2/24/2014)