EL-05-182Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 6/8/2005
Applicant: GEORGE
Owner: LOPEZ
JOB ADDRESS: 165
NW 94
Electrical Permit
Permit Number: EL2005 -182
LOPEZ
GEORGE
ST
Contractor AFFORDABLE ELECTRICAL CONTRACTORC4Ntiractor's Address: 515 NE 190 ST
Local Phone: 305 -940 -0777
Parcel # 1131010330690
Legal Description: MIAMI SHORES SEC 6 PB 10 - 39 LOT 16 & W1/2 LOT 17 BLK 132 LOT SIZE
Fees: Description Amount
FEE2005 -7599 Building Fee $150.00
FEE2005 -7607 CCF $0.60
FEE2005 -7608 Training and Education Fee $0.20
FEE2005 -7609 Technology Fee $3.75
FEE2005 -7611 Scanning Fee $3.00
FEE2005 -7618 Submittal Fee ($50.00)
Total Fees: $107.55
Total Fees: $107.55
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 11/29/2005 Construction Value: $625.00
Work: NC WIRING
Page 1 of 1
Signed: (INSPECTOR)
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Name
Address
Correction
Re- Insp'n Fee
2507
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
D 4 15 /05
Type Insp'n 1'r)c1 1 [ec r I 1
Permit No.-�- l
C ec:) e t. f
9 &Jr' NUJ 7411-11-
Company \
Phone # C 506 J C 140 - 0
Inspection Date O &' / � b / Q 4
Approved
2507 4X.41)04,
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date0 (0 / 1-5 / 05
Type Insp'n 1 g 1 .- eC 4 r LCD I
Permit No. E-L( 1 9 .
Name CZ:ICC: LLD PeZ.
Address 1 6 N UJ
Company
Phone # (SC: .) C 140 (..)
Inspection Date 0 1 E7 / o 4
—
Approved
-
1
Correction 0 ,4
— ,
°
Re-Insp'n Fee
Miami Shores Village
Build , Department
/ 0050 N.E.2 d Av is , Florida 33138
Tel: ( 05) 795 2204Fax:'( 5 .7 6 972
BUILDING
PERMIT APPLICATION
FBC 2.01
Permit Type (circle): Building p Electrical j Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 1 o u (( LC Q - 2 —Phone # 5 s t(6
Owner's Address \ (0 5 \ v,) q L s�
City ( 31no r vS State -I ( i L
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
Is BuildingHistorically Designated YES NO
Contractor's Company Name CI 9 &(Q E- (Q c1 Y l C Phone # d S c( l 0 ff 7 7
Contractor's Address S [q
City (∎(1 L V`R Stat ��-- Zip � 7 7
Qualifier Lk( L cc l n
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit Ji ( 5 Sq uare Footage Of Work:
Type of Work: DAddition
Describe Work:
ratio
Permit No. ri,L.0-
aster Permit No.
Zip 1
Phone #
\VNew ❑ epair/Replace ❑ Dem lition
**** r * * *** * ***ikt*** ** **F ** *, ter ** * *,r, *** * * *** * ***** * **
Submittal Fee $ • Permit Fee $ �✓ P 'CCF $
Notary $ Training/Education Fee $ Technology Fee $ a • `os•
Scanning $ t • a Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee. Now Due $
(Continue() on opposite side)
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
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 rejy+,'ection fee will be charged.
/
Signature
Owner or Agent 22
The foregoing ' strument was acknowledged before me this3
day of fl3 20CS, byRot,QAk ne Lo f
'
who is personally known to me or who has produced D1-14
Ll Q O(p (p ®S q 7 Q9aks identification and who did take an oath.
NOT ' ' UBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * **
• ry *Wm State of Florida
Erika Sangiovanni
� a °,�,�,� M xp l r e s atiPP/,RR�, 61,E
�xp/res /1 009
*********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 10/14/03
Signature
ontractor
The foregoing instrument was acknowledged bef e me this 8 /
day of 20 61--by ( L-a
who is
S3
e cols
may
o =' es: My Commission DD416687
** tvr °9 Peres 04/1012009
NOTARY PUBLIC
Sign:
Print:
My Comm
* * * * * * * * * * * * * * * * **
ompetency Holder)
v
fL
ally kno me or who has produced
as identification and who did take an oath.
State Certificate or Registration No. Ce rtificate of Competency No. �; t� 1
Plifns Examiner
Engineer
Zoning