EL-08-1258Project Address
1170 102
Miami Shores Village, FL
Owner Information
LAURA ARMESTO
Contractor(s)
ADT SECURITY SERVICES, INC (786)331 - 3967
Phone Cell Phone
Type of Work: ELECTRICAL
Additional Info: ALARM
Classification: Residential
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$100.00
$3.00
$2.50
$106.30
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Monday, July 14, 2008
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
Address
Type: Etllt+al`- ldelr►tal
I+Itork Cl s rifca tion Alarm
' PR
14 12
Expiration: 01/10/2009
Parcel Number
1132050190150
Block: Lot:
1170 NE 102 ST
MIAMI SHORES FL 33138 -2616
Phone
Valuation:
Total Sq Feet:
Applicant
LAURA ARMESTO
Available Inspections :
July 14, 2008
Date
CeII
$ 1,000.00
0
Inspection Type:
1
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.
1
lIo511)b .
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder)
Owners Address A ) 1 10 Imo../
Cit}�/[x, a/l(_) State
Tenant/Lessee Name
E -MAIL:
E -MAIL:
Type of Work:
Describe Work:
❑Addition
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
['Alteration
❑New
W qa or
i l .'C
Bond $ Code Enforcement $ Double Fee $
Permit No.`E
Master Permit No.
Zip 3 . 51 51(
Phone #
Job Address (where the work is being done) CO r 4 102- CJ
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # I I - 32�SO 190 ) SO
Is Building Historically Designated YES NO X
Contractor's Company Name AV* Sec uy;hI, �_/I Q) � Phone # c '7 9(0 .
Contractor's Address 2W1 -----)c) l V W Y `Q
City i�a)t�.�! 0 '1 `► State .— I Zip 55(30:1
Qualifier Nam "je( t , N ...1,012, � i Phone #
State Certificate or Registratiod No. Certificate of Competency etenc No.
❑ Repair/Re31ace
Structural Review. $ Total Fee Now Due $ i% ao
See Reverse side --�
JUL 11 288
B Y: �---
l 0Y,
S AY)iQD Phone # 7
Zip
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ V•J av
Square / Linear Footage Of Wott:
❑ Demolition
xxxxx &xi: xxx xxxxxxxxxxxxxxxxxxr. xzxxxxxxx Fees ' Y' r't't'exx'c'ex'e'cx****** *'ex** xxx xx xx*x*x*
Submittal Fee $ Permit Fee $ /'e9 ' 47® CCF $ 6'600 CO /CC
Notary $ Training /Education Fee $ O.20 Technology Fee $ 2. -So
Scanning $ 8' ` Radon $ DPBR $ Zoning $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose nr nnerti it cnht,14,, ,ttoa , 9v$„_.A,Lsp._ certified copy of the recorded notice of commencement must be posted at the job site
inspection will not be approved and a reinspection fee will be charged
Signature
/ /Pv rr 5' /
Signature
Owner or Agent Contractor
The for ; . oing instrument was acknowledged before me this3 The fore mg instrument was acknowledged before me this
day of (, , 204, by day of
Y �/ 2' by
who is ! rsonally known to me or who has produced who is rsona known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign: i L i
Print: ' L .., : �d �a :i:«� 3E 3 RIDA Print:
My Commission Expires ) :^rile ~ i sion
�� : ;F•bD682830 My Commission Expir
q qqy ry( ry(��g'
fr******** lr****�irxeY+rve4r4r�D a ,^' ;.eFnkkiik*I44 +Y�INeI'hl 2f ilk*** *dreYdrdrde**** dr****vY*dr**4rirdrx***d ***
BONDED '!'i}P.B r't1'F�'OTIE E91113 co mg
xxxxxxxxxxxx*xxxxx
APPLICATION APPROVED B
(Revised 02/08/06)
NOTARY PUBLIC:
Sign:
IC- TATS OF FLORiiiA
A u11a
Cori :.;A.o K ;i1.0682830
�44�nn��??'' Expir � s JULY 26, 2011
1Ti01s usTrAN eY (�
xir&
/7�/'%`Plans Examiner
Engineer
Zoning