EL-13-2238 spo Ke
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l Shores Village
3: 1uilding Department
JAN 0 7 1014 1 050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax: (305)756.8972
BY: Sl'ETION'S PHONE NUMBER:(305)762.4949
FBC 2.0
BUILDING Permit NoZ113 Z Z 3J Y
PERMIT APPLICATION Master Permit No.
Permit Type: Electrical -
JOB ADDRESS: 2 D P - l O 4 S!
City: Miami Shores County: Miami Dade Zip: 33139
Folio/Parcel#: 11 — 3 — b 13 " Q9 11)
Is the Building Historically Designated: Yes NO ✓ Flood Zone: N D
n
OWNER:Name(Fee Simple Titleholder): �"(I-Fmd LyD/VL� Phone#: ?e4,-34v,- S131
Address: Z.b IV E 10 T .sl
City: M1,4141 -4-h6-re-s. State: �� Zip: 3 513
Tenant/Lessee Name: Phone#:
•Email:
CONTRACTOR: Company Name: •-1e-, J YJaeA,f_ g�'!/ _ Phone#: 73 :324 326 0131 /
Address:l,•50,C) $5GJ /t9l6".e_
City: "I;�yr�j' State:?i¢ Zip:
Qualifier Name: gi,-IdWeA&6 :7.Q2 Z41 Phone#: ZA6
c,
State Certification or Registration#: D e of Competency#:
Contact Phone#: .329•Q t?3/ Ema ssl16 xUk ` 60 C m
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: OAddress' 1riAlteration O/New �epair/Replace ❑Demolition
Descriptiog of Work: 61e 7 • ,�L a ItEl
y lf.L' tVekwssw: eruew G,t �11✓��. ,his fia/lcG( S' DWA1404
Submittal Fee$ 5® • 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$ It ke
Bond pg,Com if applicable)
Bon Ing Com .ariy s Aess
N
city State Zip
O ortgage Lender's Name(inapplicable) —'qAez fQ/'Y1;
Mortgage Lender's 1A1ddress q0t�• LLI 6r .452N
't i
city VA Q&K State zip 3b 12
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 will be rged.
Signature Signature
Owner or=gen ontractor
The fore oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
a
day of ,20 L3,by day of `� ,20 ,by LJA dV)YA
who is personally known to me or who has produce S I In Mtsonally known to me or who has produced, 5 jZq
wqpae3
As identification and who did take an l "Q as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
OTARY PUBLIC-STATE OF FLORIDA
Sign: Sign:
Print: Commission#DD973815 p t•
•. ..• tate of Florwe
My Commission Expires: BONDED Tsau ATLANTIC BONDUMca,lx4 My Co xfta M Felidano
ommiselon FF 082793
w 6VW62 01/12/2018
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012XRevised 07/10/07X Revised 06/10/2009XRevised 3/15/09)