EL-05-21-1331, 10634 NE 11th CtPermit NO.: EL-05-21-1331
Miami Shores Village Permit Type: Electrical - Res! oential
10050 NE 2 Ave Aft
Miami Shores FL 33138 ,j Work Classification: Alteration
305-795-2204 r
,. ,.WANII&L,_.. 0—ifCt.,t— Annmt&nA
Expiration: 11/22/2021
Location Address Parcel Number
10634 NE 11TH CT, Miami Shores, FL 33138 1122320280440
Contacts
JENNA RASSIF Owner SUPERIOR BUILDERS LLC Applicant
10634 NE 11 CT, MIAMI, FL 33138 MARIEDY MENDOZA
Other: 3053084774 10667 NE 11, MIAMI SHORES, FL 33138
Business: 3058151513 INFO@SUPERIORBUILDERSLLC.COM
CARABALLO ELECTRICAL INDUSTRIES INC Contractor
GEORGE CANCIO
5810 SW 113 CT, MIAMI, FL 33173
Business: 7867156056
_...... ............ .... ......... ............ ...... .... ......... .............. ......... ..................
Description: installation of 4 high hats and a ceiling fan Valuation: $ 500.00 Inspection Requests:
Total Sq Feet: 450.00 y
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Technology Fee
$2.50
Total:
$107.30
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$107.30
Credit Card
05/24/2021 $107.30
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 /
Date
May 24, 2021 Page 2 of 2
Miami Shores Village FCEIVED
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 79S-2204 Fax: (30S) 756-8972 By: ---
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING FE-1 ELECTRIC ❑ ROOFING
Fz)BC 20 (C) �//��
Master Permit Nolic-*20- or,-lsO
Sub Permit No. EL Q 5-21^ 1531
❑ REVISION ❑ EXTENSION ❑ RENEWAL
[]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 10634 NE 11 CT
Cites: _ Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-2232-028-0440 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):JENNA R RASSIF &HNOUREDDINE RASSIF Phone#:
Address:10634 NE 11 CT
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Caraballo Electrical Industries Inc Phone#: 7867156056
Address: 5810 SW 113 CT
city: Miami State: FL Zip: 33173
Qualifier Name: George Cancio Phone#: 7867156056
State Certification or Registration #: EC13008168 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ `J Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑i 19ew ❑ Repair/Replace ❑Demolition
Description of Work: � 11 �('� 1 \ CA' _�_ 10 i-i iJ �- n � b -t J
Specify color of colon thru the:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Permit Fee $ _
Radon Fee $
Training/Education Fee $
CCF $_
DBPR $
CO/CC $ _
Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $
(Revised02 /2412014)
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 low 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 (J) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approve and a reinspection fee will be charged.
Signature Signature -
OWNER ct(XGENT
The foregoing instrument was acknowledged before me this
day of ISA q 20 1 by
Wig-0 &r- 5S who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sig
Print: 4A-1A Q '1
CONTRACTOR
The foregoing instrument was acknowledged before me this
11 day of May
George Cando
as me or who has produced
2021 by
who is personally known to
as
identification and who did take an oath.
NOTARY PUBLI '
Sign: ,
Print: Mir is L. artinez
Seal: Seal: ��Y.�!✓,�; k4!(eft L WNW
c01AMISSIOk ON16M
Notary Public State of Florida '¢= cXs'IRfS Dem"in , 20M
Ana Maria Perez
************ *f g#*sQrit�li6iiPA�uia4i0H0**s i
oFn Expires02/2&2022
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)