ELC-15-1676 Miami Shores Village F.TVIVID
�� SS Building Department JUL 0 6 2015
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972 $Y;
INSPECTION'S PHONE NUMBER: (305) 762.4949
FISC 20
Permit No. 0t
BUILDING
PERMIT APPLICATION Master Permit No.4/0.5
�_ #
Permit Type: Electrical
JOB ADDRESS: 11300 NE end Ave. t C C1/�,j 1 V / iol fid ---
Count Miami Dade __Zip: 33161
City: — Miami Shores Y�
Folio/Parcel#: 11 2136 000 0050
Is the Building Historically Designated: Yes NO _ Flood Zone:
OWNER: Name (Fee Simple Titleholder): Bares College —
Address: 11300 NE 2nd Ave. -- -- ------ --_---_--
City: Miami Shores State: _l'l --- -- _--Zip: 33161 ---
Tenant/Lessee Name: Phone#:—
Email: --- --------- ---- —
CONTRACTOR: Company Name: Tirone Electric, Inc. — Phone#: 954-989-7162
Address: 6151 Pembroke Rd.
City: Hollywood State: FL — _Zip: _33023
Qualifier Name: L'-4r e."17 Phone#: _ —
State Certific-,ition or Registration#: EC0003059 Certificate of Competency #: —
Contact Phone#: 954-989-7162 Email Address: crosales@tirone-electric.com —
DESIGNER: Architect/Engineer: — Phone#: --__ _—
Value of Work for this Permit: $ 3725.00 Square/Linear Footage of Work: .____ -- —.
Type of Work: ❑Address dAlteration ❑New ❑Repair/Replace ` ❑Demolition
Description of Work:
Data Cabling
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Submittal Fee$ 4::;/ Permit Fee$ S 0-'00 CCF$ CO/CC $
Scanning Fee$ Radon Fee$ _ DBPR$ Bond $_----—
Notary$ Training/Education Fee$ Technology Fee $
Double Fee$ Structural Review $ —
TOTAL FEE NOW DUE $�� (�1
Bonding Company's Name(if 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 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 wjll be charged.
Signature Signature l ��
Owner or Agent Contra or
The foregoing instrument was acknowledged before me this�� The foregoing instrument was acknowledged before me this 25
day of 201 ,20!_�,by JWSAi/w L./ da of June , 20 15 , by Curtiss Morgan
who is personally known to me or who has produced who is personally known me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: /
Print: b Print:
Notary Public State o a
My Commission ExLOW)
2Jbso My ComMy�0 fisio�FF 168481 tia"r!hi;N DONEM&VILLEGAS
Expires 11/12/2018 ;.: ,: MY COMMISSION 1 FF 181029
EXPIRES:December 4,2018
'4 OC F
,*t Bonds hru P
APPROVED BY / 4 ,n'IYI-4 Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
�5eO1s y� Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
Phone: (305)795-2204
�COjtDp Expiration: 01106/2016
Project Address Parcel Number Applicant
11300 NE 2 Avenue Number: Wiegand & Ani 1121360010160-09
BARRY UNIVERSITY INC
Miami Shores, FL 33138-0000 Block: Lot:
Owner Information Address Phone Cell
BARRY UNIVERSITY INC 11300 NE 2 Avenue
MIAMI SHORES FL 33161-6628
11300 NE 2 Avenue
MIAMI SHORES FL 33161-6628
Contractor(s) Phone Cell Phone Valuation: $ 3,725.00
TIRONE ELECTRIC INC (954)989-7162
Total Sq Feet: 00
Type of Work:DATA CABLING 17 DATA DROPS Available Inspections:
Additional Info: Inspection Type:
Classification:Commercial
Review Electrical
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40 Invoice# ELC-7-15-56228
DBPR Fee $2.25 07/06/2015 Credit Card $50.00 $ 113.90
DCA Fee $2.25
Education Surcharge $0.80 07/10/2015 Credit Card $ 113.90 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $3.20
Total: $163.90
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 a,q that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named co o the w to
/ July 10, 2015
Authorized Signature:Owner / Applicant / Contrac or / Agent Date
Building Department Copy
July 10, 2015 1