DEMO-16-3469Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. DEMO -12-16-3469
Permit Type: Demolition
Work Classification: Electric
Permit Status: APPROVED
Issue Date: 11412017
Expiration: 07/03/2017
Parcel Number
Applicant
165 NE 109 Street
Miami Shores, FL 33161-7041
1121360040500
Block: Lot:
MODESTO ECHEZARRETA
Owner Information
Address
Phone
Cell
MODESTO ECHEZARRETA
165 NE 109 Street
MIAMI SHORES FL 33161-
Contractor(s)
Phone
Cell Phone
UNITED ELECTRICAL SERVICES INC (786)797-2188
Valuation:
Total Sq Feet:
$ 400.00
0
Type of Demo: Electric
Additional Info: DEMOLITION OF DRYWALL
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.00
$2.00
$0.20
$100.00
$3.00
$0.80
$108.60
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO -12-16-62469
01/04/2017 Credit Card $ 58.60 $ 50.00
12/27/2016 Cash $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Electrical
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 and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated.
January 04, 2017
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
January 04, 2017 1
BUILDING
PERMIT APPLICATION
BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION D EXTENSION El RENEWAL
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
Master Permit No.
FBC 20
Dum
Sub Permit No. I — "2j(4 (49C1
El PLUMBING ❑ MECHANICAL OPUBLIC WORKS ❑ CHANGE OF El CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /65 /v E / d 9 S/ /`,-7;:61,<-1/ �//O
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Phone#:
Address: /'1.a 6216-7 /-V`�/T�
City: o Se/ 5 5-u' ?-osite: /!/�i�i ft%G zip: 3 3 "1 / 3
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: United Electrical Services Inc
Address: 26453 SW 135 Ct
Phone#: 786-797-2188
City: HomesteadState: Florida zip: 33032
Qualifier Name: Manuel 0 Garcia
Phone#: 786-7978-2188
State Certification or Registration #: ER 13014669 Certificate of Competency #: 12E000192
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 0 ' O o 01 Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace S7 Demolition
YP
Description of Work:
Pc "to() oH 04Klak,
Specify color of color thru tile:
Submittal Fee $ � C-' ', �� //z6
Permit Fee $ f �11' '' CCF $ 6 - 2 () co,cc $
)2)
Scanning Fee $ // - W Radon Fee $ a • W DBPR $ W Notary $ igi
Technology Fee $ 60 Training/Education Fee $ 0, Double Fee $
Structural Reviews $ 7 Bond $
TOTAL FEE NOW DUE $ 5 -6.c)
(Revised02/24/2014)
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 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 be approved and a reinspection fee will be charged.
Signature k
/M.. dv r__ mak.
Signature
OWNER orA ENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of s.2 g,/2_ , 20 14, , by
400Ee44EXA-rMe, , whpirirsonally knr_LArrDio
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Fce-evtv-4 ,/A>rirrve Z
****************
APPROVED BY
(Revised02/24/2014)
„Oil Pt*, O Notary Public State of Florida
+�
Z . Roland J Martinez . ••` My Commission FF 241052
?p 0.5 Expires 07/04/2019
* ** ***********
\''\ <day of ��C(0 w. , 20 ) f„ , by
,k,c1G. O cC Irc }- ^-, who is oersQnally knowjl to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC
Sign:
Print:
Seal:
AMIL
AN
"""MY COM ISSION # GG045258
ES February
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' e-',421474Vd1Slans Examiner
Zoning
Structural Review Clerk