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ELC-09-1070Project Address 9101 PARK Drive Miami Shores, FL Owner Information July 15. 2009 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $0.60 $0.20 $200.00 $3.00 $50.00 ($50.00) $5.00 $208.80 Building Department Copy Address 070 gia ELC .. P . Expiration: 1 2 200 Parcel Number PARC2003 -28 Block: Lot: Phone Applicant OMAR & TANYA OSMAN & DE LA ROSA 9101 PARK DRIVE MIAMI SHORES FL 33138 Contractor(s) Phone CESAR ELECTRIC CORPORATION 305 -221 -5721 CeII Phone Authorized Signature: Owner / Applicant / Contractor / Agent Valuation: Total Sq Feet: Type of Work: ELECTRICAL Additional Info: LOW VOLTAGE Classification: Commercial Invoice # Total Amt Paid Amt Due ELC -6-09 -35200 $ 208.80 $ 158.80 ELC -6-09 -35200 $ 208.80 $ 208.80 $ 0.0 OMAR & TANYA OSMAN & DE L CeII $ 1,000.00 0 WorgENSMIMAVANIENSISIMP Date For Inspections please call: (305)7624949 Available Inspections: Inspection Type: Underground Rough Final Meter Box Alteration Relocation Fire Alarm Service Change W. W. 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. July 15, 2009 1 A\ ti\0 °Q �� Miami Shores Village .JUN 2 4 2009 Building Department g � m�meo.vm BUILDING PERMIT APPLICATION FBC 2004 >0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Master Permit No. Permit No. c:;B n Permit Type: Electrical Owner's Name (Fee Simple Titleholder) 44( 4/..f04,0 C 4 Phone # Owner's Address rr 9 /®/' "'ice City 1.:/;/".11 State Zip 3 / . � 6 Tenant/Lessee Name Phone # E- MAIL: Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name 1 4It 1 / /G-- Phone # Contractor's Address 7 6 ,� y s� // 2 4 d6 City ®v/ I ,4G� �/ State /' Zip 7 T 16r Qualifier Name 6.---5-4(- Pet r�J .6f Phone # ye ( 6 3 a/ t er State Certificate or Registration No. TC C ®t2 Z 7 6 ? Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $ r1 7 Z re 41 O Phone # d ry 97r ya ?l Square / Linear Footage Of Work: /5d© Type of Work: kddition pi Alteration ONew Repair/Replace ❑ Demolition 4 e Work �i�'c�" % � ��E '/I6 � /t f � � � e ,iii ,v/ ie4/,'-e / r = co/z, /4 .t t) J 1 ee S - - P,&A-1 ',' ›_ fie N V A . rfi .......... ..4�4ir........ *+te,...�iir.. "... t.... �4+ 4i...... ..4�4....iii�iri....irir #i�4... SUN fp %% � ���© /l Submittal ee Permit Fee $ CCF $ 0 l0, O _OM Notary $ Training/Education Fee $ V- 10 Technology Fee $ S CO /CC Scanning $ � J' l Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 16 See Reverse side —> Zoning $ Bonding Company's Name Of 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. 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 cormnencement and construction lien law brochure will be delivered to the person whose properly 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 reinspectionfee will be charged Signature Signature Owner or Agent The foregoing instrument was acknowledged before me this day of ,20 ,by who is finally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Sign: Print: Print My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) 06) Contractor The forego, instrument was acknowledged bef this ] day of /_ - _ _ by Cry }' .� y who is �"+ me or who has produced as identification and who did take an oath. NOTARY PUBLIC: My SSION # DD 579612 .1"4,•‘. ,...__. � �� °� ... P` Bonded flw BU ServIces 'ssron Expires: O F F 1 ... „ „e L� 2sU,�v CP M tDIS Plans Examiner Engineer Zoning