EL-17-469G
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue N
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Pe
mit
Permit NO. EL -2-17-469
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 3/28/2017
Expiration: 09/24/2017
Parcel Number
Applicant
9325 N BAYSHORE Drive
Miami Shores, FL 33138-
1132050270540
Block: Lot:
OMAR CASSOLA
Owner Information
Address
Phone
Cell
OMAR CASSOLA
9325 N BAYSHORE DR
MIAMI SHORES FL 33138-2950
(305)206-2754
Contractor(s)
HOME OWNER
Phone Cell Phone
Type of Work: 8 DECK BOLLARD LIGHTS
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.00
$2.00
$0.20
$100.00
$3.00
$0.00
$0.80
$108.60
Pay Date Pay Type Amt Paid Amt Due
Invoice # REV -2-17-63045
03/28/2017 Credit Card $ 108.60 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
1
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 AFFIDAVI .
construction and ,•010
• n r
the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
, I authorize the above-named contractor to do the work stated.
March 28, 2017
Author zed Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
March 28, 2017 1
BUILDING
PERMIT APPLICATION
BUILDING IN ELECTRIC
El PLUMBING ❑ MECHANICAL
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
❑ ROOFING
❑ PUBLIC WORKS
JOB ADDRESS: 9325 34y:sdo eco- �2
City: Miami Shores
County:
LVED
FEB 2 3 2017
FBC 2014
Master Permit No. (2\1N t'-1-467
Sub Permit No. ilreit f - 4-c.9
REVISION ❑ EXTENSIONS❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Dade
Folio/Parcel#: 1/— 32d57-0 7— e.:75-540
Occupancy Type:
Load: Construction Type:
Zip: 33i3g-
NO X
Is the Building Historically Designated: Yes
Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 0144 Al2_ Ce S.S t5 / 1 Phone#:(3�)
Address: 93 ? Al. 8A ys geeD/7.
City: /0 /4)44 / S /,l -Q Q e State: re_ Zip: 3313(
Tenant/Lessee Name:
Email:
Phone#:
CONTRACTOR: Company Name:
Address:
(AYv
Phone#:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 800
Type of Work: ❑ Addition ❑ Alteration
Square/Linear Footage of Work:
❑ New
Description of Work: A _Dc aJ 1 LG 42 D C./ G rt -7
❑ Repair/Replace ❑ Demolition
Specify color of color thru tile: l
Submittal Fee $ Permit Fee $ 73-355°,
Scanning Fee $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ r 1
TOTAL FEE NOW DUE $ l0 r • (0cJ
sD1011 r KtatE • af1Eu'9 yIsIo$ =�*"
rn�aatmirm9 r
CCF $Nimpoittweeteeis
PIM JE guA tieki* .mme3 kA,NN
, Y
Radon Fee $ DBPR $ Notary $
(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
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
cfrii day of LZ b , 20 / 7 , by day of , 20 , by
i /1, &455(44! • , who is peally known to , who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUB
Sign:
Print:
Seal:
********
JOSE J. GIRM.00
r* Notary Public - State of Florida
Commission • FF 228279
My Comm. Expires Aug 31. 2019
** ***1141Witifooloilika iNotbrfkAaw
APPROVED BY
(Revised02/24/2014)
NOTARY PUBLIC:
Sign:
Print:
Seal:
**************************************4, *********************
%C--.A73>3r' Plans Examiner Zoning
Structural Review Clerk