BP-12-2393Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
ec<
JOB ADDRESS: / � �p
FBC 20/0
as ri I T
JUN 0 5.2013
't ; a
Permit No.
Master Permit No.
City: Miami Shores County: Miami Dade Zip:
Foho/Parcel#:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): Phone#:
Address: ��� �y F G�2 ,4R
City: �i Y'c -u �l �o� State: /11-1 Zip: -5 j x ep
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address:
City:
Qualifier Name:
aycAe,a• #76
State Certification or Registration # Certificate of Competency #: avffqU
Contact Phone#: a�hi�A Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $��O� Square/Linear Footage of Work:
Type of Work: OAddress
Description of Work:
OAlteration ONew
oa
Submittal Fee $ Permit Fee $ i CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $
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 "e 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
E%IPROVEMENTS 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 reinspection fee will be charged. _ 'A
SSignature
Owner or Agent Contractor
The fore Ring instrument was o ledged befor e The foregoing instrgment was 9 ac ledged before me thi
day of 20by day of 20 �9 by
who is erso ly known to me or who has produced ho is onallynknown to me or who bas produced
tion and who did take an oath. �� kntification and who did take an oath.
NOTARY PUBLIC: NO ARMI PUBLIC:
My Commission Expires:
?foly
APPROVED BY ,- G P IO' Plans Examiner Zoning
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Clerk
April 25, 2013
Building Department
Miami Shores Village
10050 NE 2nd Avenue
Miami Shores, FL 33138
To Whom It May Concern:
APR 29 2083
eA
Hereby I confirm that the lighting to be installed around the pool area is of low voltage
and should not violate light emission policies. If lights installed disturb our neighbors,
and they express as such, we will take action and ensure lights are installed to their
satisfaction.
If you have any questions, comments and/or concerns feel free to contact me.
Sincerely,
G
Joe
ki
99
4d' Avenue Rd
Mi
hores, FL 33138
617-
1-4475
TICS OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT WE I Z- _ TAX FOLIO NO) ® `�,� "' 12
STATE OF FLORIDA:
COUNTY OF MIAMI-DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following Information
is provided in this Notice of Commencement.
1. L gal description f pro erty an
grallao YJ
2. Description of
OR Gk 25615 Ps 22431 (fps)
RECORDED 05/07/-`i113 15:55'=11
HARVEY RUVINY CLERK OF COURT
MIAMI—DADE COUNTYP FLORIDA
LAST PAGE
above reserved for usiL of recording office
3.Owner(s) name and address 06
Interest in property:
Name and address of fee simple titleholder:
4. Contractores name, addressd phone numb Ls' ,R"
5. Surety. (Payment bond required by owner from contractor, if any)
Name, address and phone number.
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number.
F'
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided In Secti
713.13(1)(b), Florida Statutes.Va
Name, address and phone number: -
9. Expiration date of this Notice of Commencement: y.
(the expiration date is 1 year from the date of recording unless a different date is specified)
>�1
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSID
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE sl
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YO NOTICE OF COMMENCEMENT.
Signature(:) -of Ow ) or Owner(s)' Authorized Offlcer/Director/Partner/Manag
Prepared l3y Prepared By
Print Name ° Print Name
Tdle%Office Titis/Office
STATE OF FLORIDA
COUNTY OF MIAMI-DADE /
The foregoing instrument was acknowledged before me this day of /
By
I dividually, or ❑ as for ABELDARID UBINOVIC
Personally known, or ❑ produced the following type of identification: MY N
MKM Zon
Signature of Notary Public: R c�ta er ,
Print Name: 4,OFFV
(SEAL)
VERIFICATION PURSUANT TO SECTION RAN FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above:
By By
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