EL-14-1501 t 1'
Permit Ty pc Electrical
Miami Shores Village
Building Department -
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 1
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20 1
Pmuft No.�1
MasW Permit No. PC 1'4 1 Lt V
JOB ADDRESS: 1�05 =
City: miamisbores CZMW. Miami Zap: 1 4152
` 7 ,�,-'N
NO v Flood Zow.
OWNER:- Name (Fee Simple
ddms: 1065 ia•
CONTRACTOR: Company Name-.MRI ELECTRICAL CONTRACTORS P> � 3
5742 SW 7 St. Suite 201
City: MIAMI State: FLA. Zip: 33138
QualifierName: RALPH A. ALVAREZ p 305 261 6000
State Certification or of:
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Value of Work for tbb Permit S -� ' �? Square�i:m+mr Footage of Work:
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i � � AM-1
41� �i� u�x•i ..1. ::. 4iEt n i
Fps
Submittal Fee S 45D Permit Fee S /4i2? ' �'G C'CF S COrCC S
DBPR S Baud S
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TOTAL FEE MOW DUE S
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Bondit Company's Name (if applicable)
t
Bonding Company's Address
City State_,_____ Tap_
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 pesfa nned to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate pert must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDMONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is agate and that all work will be dole in compliance with all
applicable laws regulating construction and zoning,
"WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
CONMENCEMENT 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 COh04ENCEN1ENTr
Notice to Applicant: As a condWon to the issuance of a buiOng permit with an eslanawd value exceeding $2500, die applicant must
promise Ira good faith that a copy of the notice of ommnoncement and construction Hera law brochure will be delivered m the person
whose property is subject to aawfipent Also, a wed copy of the recorded notice of commencement must be pasted at the job site
for the first inspection which qVws seven (7) days *er the bw7dmg Mme a issued In due absence of such posted notuae, the
inspection will not be q7tadfilnd a reasason fee will be charged
Signature Si
C8wor Aggent contractor
The fore r insuunent VM acknowledged 'this l' The g i nitmr�t wl�g before me this �T
day of r , �i`'- 20 �by G�S�` " I�! J Lam' _ day of �^- 20 � ry(Oh''j'"`-�
who is personally known to me or who has pvodu who is pamonally known to me or who has produced
NOT
Sign:
Print:
My C
As identification and
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APPROVED BY s9 , e=� Plans Examiner Zo*9
Steal Review 0c*
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Local Business Tax Receipt
Miami —Dade County, Stag of Rorida
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