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EL-12-2165 Miami Shores Village c IVSD Building Department SEP 2 0 2013 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 BY: INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. Z,"Z ZZ-olev"r PERMIT APP L ION Master Permit No. Ak z -61r- , Permit Type: Electrical JOB ADDRESS: 'al, City: Miami Shores County: Miami Dade Zip: .3.3��•� Folio/Parcel#: //- ." 7'4y Is the Building Historically Designated:Yes NO 1/� Flood Zone: OWNER:Name(Fee Simple Titleholder): �� l Phone#: ?%li "�!v"-ZAjP Address: role A04K City: /92 / State: 009'/- Zip: fZ14rz Tenant/Lessee Name: Phone#: 7X4 '2*F4"?.,W Email: • C®�J 00�1 J7 CONTRACTOR:Company Name: Phone#: Z yly 2•ralo Address: jW 4 . G�'r Jw_ Sl. City: �001/ s State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: Contact Phone#: 7S1v X+0 -4J-40 Email Address: s.�+/ / C DESIGNER:Architect/Engineer: Phone#: -Value of Work for this Permit:$ ,e v * Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New Wkepair/Replace ❑Demolition Description of Work-'/!.iO& 0-,2 ��,v/�i�1,�/ 12ev • f Submittal Fee$ Permit Fee CF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE �GY'� 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 y Application'is`hereby nU&to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commence prior to the issuance of a permit and that all work will be performed to meet'the standards of all laws regulating construction, i 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. W`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 estimdted value exceedbig'42500, the'applicant must promise in ggpd faith that a copy of the notice of commencement•arid construction lien law brochuie. will-be delivered to the person whose property is su�ect 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.'c` - »• �k.v,�,.�. ;t ,. 01 Signature Signd6m.gyp'` .G Owner or Agent �r-� <°Cdntractor The foregoing ithAmm-ent was acknowledged before me this 710 The foregoing instrument was acknowledgedbef6re me this day of, ,20 j,by6(Ar1 el- day of ,20_,by , who is personally known to me or who has produce4pl. 1"Ci . who is personally known to me or who has produced Z� Z•r l °As identification,a a"who Atake'an bath. as idenkcafton atld who did take an oath. NOTARY PUB C: NOTARY PUBLIC: \```�� luu rill Sign: Sign: Print: i'a: ' ... 'odd% Print: — My Commission Expires: My Commission Expires: N �x7%----�g�c��,x��,u,��a��u,x,��x�x�x��u,r�u��,��,x��,��u��,�,��u�� 00 APPROVED BY Plans Examiner zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07110/07XRevised 06/10/2009XRevised 3/15/09) Miami Shores Village - -- R�E'C FT7' Building Department Nov 14 0�2 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 — a FBC 20 l BUILDING Permit No. �� PERMIT APPLICATION Master Permit No.?—C 12- [ l Permit Type: Electrical JOB ADDRESS: fO6 It/.�• �� Jam'/�RFd� City: Miami Shores County: Miami Dade Zip: Folio/Parcelk //_ 17,210(a —b _Z76.0 Is the Building Historically Designated:Yes NO Flood Zone: y OWNER:Name(Fee Simple Titleholder): At h A0,*XP .�• g4 i2W izR, *A Phone#: 794 �.ZyG•^1•j'OC Address: A2 6 M..- 91'* .SroeA!n City: A fi tw& State: Zip: Y"19 Tenant/Lessee Name: J4 Phone#: Email: x_ /✓ - dL. L loor Al /�' CONTRACTOR:Company Name: � '�� Phone#: 7,04 Address: .906 Axe. Ar74 City: /1//I9 V 964e'r State: /=L Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: Contact Phone#: 78G 'Z !K6 ^i?A0_W Email Address: lJ9 L<5 At S-0Z 0 0 DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ Af" t!— SquarelLinear Footage of Work: Type of Work: (]Address Alex ONew L�epair/Replace ODemolition Description of Work: 17"s Alex l'd8l,� o/t 1 P kel loop 01V �xx�xx�s��x��xa�x��axx��xxx��x��aFeesx��x�xx+xx�xaxx�x��ex�xxxx��e��xeea��x�x� Submittal Fee$ Permit Fee$AgN?/ZV O CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 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_pdrmit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged., t Signature � �10'e�e Signature Owner or Agent . Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of N ,20 l Jby of .20_,by , who is personally known to me or who has produced 17 f who is personally 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: ��>>tuulltthi NOTARY PUBLIC: zk Sign: _ m Q m i O Sign: Print: — ''a'= Print: My Commission Expires: G� a CM C.>W''��` My Commission Expires: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/1 12*, 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)