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EL-15-2815 � �1- 5- Miami Shores Village rrnkj",)rj3�. Elegy N-Resldentld1,: 10050 N.E.2nd Avenue NE Alteration '• ""''� Miami Shores,FL 33138-0000 Pe rlit�tuss APPROVED x�R � Phone: (305)795 2204 Issue Data,1419/20,15 Expiration: /0702016 Project Address Parcel Number Applicant 10208 NE 4 Avenue 1132060135101 CORY GITTNER Miami Shores, FL Block: Lot: Owner Information Address Phone Cell CORY GITTNER 10208 NE 4 Avenue (305)757-4900 MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 MV ELECTRICAL SERVICES (305)216-0677 Total Sq Feet: 0 Type of Work:NEW GFI IN BATHROOMS AND KITCHEN CO Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-11-15-57668 DBPR Fee $3.38 11/09/2015 Check#:1928 $237.96 $0.00 DCA Fee $3.38 Education Surcharge $0.40 Permit Fee-Additions/Alterations $225.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $237.96 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 ELECTRIC ,PLUM G,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT 1 certify t a all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni g./ �ther 10 ,I a t r' he abo named contractor to do the work stated. V � November 09,2015 Authorized ' natu e:Own / Applicant / Contractor / Agent Date Building Department Copy November 09,2015 1 t ( 15 - V 2_6�1 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-261005 Permit Number: EL-11-15-2815 Scheduled Inspection Date: June 16,2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GITTNER,CORY Work Classification: Alteration Job Address: 10208 NE 4 Avenue Miami Shores, FL Phone Number (305)757-4900 Parcel Number 1132060135101 Project: <NONE> Contractor: MV ELECTRICAL SERVICES Phone: (305)216-0677 Building Department Comments NEW GFI IN BATHROOMS AND KITCHEN COUNTER. Infractio Passed Comments R&R ALL RECEPTACLES AND SWITCHES. INSPECTOR COMMENTS False INSTALLATION OF LIGHT. Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid June 15,2016 For Inspections please call: (305)762-4949 Page 11 of 20 Miami Shores Village NOV 6 2015 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 FBC 20 �I BUILDING Permit No. PQ- G r ^-2_2�- PERMIT APPLICATION Master Permit No. � 1 - Permit Type: Electrical JOB ADDRESS: City: Miami Shores / County: Miami Dade Zip: Folio/Parcel#: 3.2 ® G` 013- 5_L 01 Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): C C 7rN Phone#: Address: S57 Al O 1,0-2 S -r City: 14(4-A( S b T)&f_'5 State: ��' Zip:3�3 l,3 Tenant/Lessee Name: Phone#: Email: y bf dM.PG� J�J6 04,R� CONTRACTOR:Company Name: /S&V1C6-_r Phone#: 7406 c45_ 31-16 Address: I 'eI l /, d C City: M I Qym' State: FL Zip: 220 j J Qualifier Name: ►"(0LV- Ck Phone#: 3 05 ?� State Certification or Registration#: �r f 3 ® Certificate of Competency#: Contact Phone#: �c p 7 Email Address: MOW, �0 M V e7`eCOT Le:a �hK a c � e� DESIGNER:Architect/EiRgineer: Phone#: Value of Work for this Perinit:$ ®� Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New 4 J❑Re air/Replace ❑Demolition Description of Work: zcv � f ih/ to rom r S _� � Submittal Fee$ —' v Permit Fee$ 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 urs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not approve td a reinspection fee will be charged. Signature Signature caner or Agent Contractor The foregoing instrument was acknowledged before me this 02.- The foregoing instrument was acknowledged before me this _ day of NO_,20 LS,by C 00y fl UGN day of 0Cif 30 ,20 15,by Pel Hieb who is personally known to me or who has produced �L �\W who is pe onall kn to me or who has produced (IJAs identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTAR GENA CRUZ Notary Public-State at F;o:Ida • CWA1811oe 0 FF 204543 Sign: my Print: �( P * " o� Naticnal Notary Assn. oa.er Notary Public State of Florida My Commission Expires: > Sindia Alvarez 'My CommissioEx / y c My Commission FF 156750 p®� (U� Expires 09/0312018 APPROVED BY 7� �.�� Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)