EL-15-1495 e ° Miami Shores Villages
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
a
Phone: (305)795-2204
x a Expiration: 12119/2015
;.
Project Address Parcel Number Applicant
9105 NE 5 Avenue 1132060141210
ALEJANDRO PINO
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
ALEJANDRO PINO 9105 NE 5 Avenue (305)302-5770
MIAMI SHORES FL 33138-
9105 NE 5 Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone $ 200.00
Valuation:
ELECTRICORP INC (305)525-6299 Total Sq Feet: 0
Type of Work:TEMP FOR CONSTRUCTION Available inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning:1 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# EL-6-16.56014
DBPR Fee $2.00 06/22/2015 Credit Card $58.60 $50.00
DCA Fee $2.00
Education Surcharge $0.20 06/18/2015 Credit Card $50.00 $0.00
Permit Fee-Additions/Aiterations $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
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
requir d for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
O NE 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
nstru ion nd zoning. u ermore, uthorize the above-named contractor to do the work stated.
A June 22,2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 22,2015 1
W 7
Miami
Shores Village
LBYY. JUN 17 2 15
b t� Building Department
�� v 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 — -
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20P
BUILDING Master Permit No. 4/(h 6
PERMIT APPLICATION Sub Permit No. ��15 -� `t9:5
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP
G I `r CONTRACTOR DRAWINGS
4S t
JOB ADDRESS: { 1 K[! f— i V E
City Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 3 a d 4 - 6C/ —/ Z/611s the Building Historically Designated:Yes NO
Occupancy Type: Load: (� Construction Type: t Flood Zone: BFE: ' FFE:
OWNER:Name(Fee Simple Titleholder): t Le 6P,�Qez P (40 Phone#:2J z Y 6)3
Address: !!�z j, ''S� (sem IF__V S I—
City: A--� /4'44' .1 State: Zip:
Tenant/Lessee Name: Phone#:
Email: (;
CONTRACTOR:Company Name: ' / f'o ! ��� �.�.e Phone#: —e G�sy�i
Address: Y -?-C/
City: c-�A St ate: I" L Zip:QualifierName: /�•v �2 Phone#: �f2
State Certification or Registration#: A 1-3,013171 Certificate of competency#: C/e, 6)
DESIGNER:Architect/Engineer: &_'�"/ 1 '; (• Phone#:
Address: / Z Z S /!/ y / 2 2 City: State:,�,Zip: 3�/
Value of Work for this Permit:$ Square/Linear Footage of Work:
Jok
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Repl*e Deroo.tio
Description of Work: v'
0;1 -
Specify color of color thru tile: eft I
Submittal Fee$ Permit Fee$ /00,10 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Bonding Company's Name(if applicable) � —
Bonding Company's Address
City State C Zip
Mortgage Lender's Name(if applicable)Mortgage
--
Mortgage Lender's Address 2�
City C- G? 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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,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 bep roved and a reinspection fee will be charged.
Signature Signature
OW ER or AGENTIQATRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 I 'C .by day of 20 y �� ,by
^LC y� wU /.✓d/ who is personally known to_ /�/G�' �C'�'Z--�irho is personally known to
me or who has produced as me or who has produced as
identification and who did take a!i oath. identification and who did take an oath.
NO NOTARY PUBLIC:
•y9 TOLONGO
tete of Florida
�a� ���'"'W"� IUflI TOLONGO
22,2018 " ''
Sign Can fl Sign•
�, ommiss41590 ,
Print: Print: C E Ao022.2010
'�i tt •`'ti• CqMMISS
Seal: Seal:
************************************************************************************************************
APPROVED BY S'/�- /��~u�''fa Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)