EL-17-2705Miami Shores Village
10050 N.E. 2nd Avenue N
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. EL-11-17-2705
Permit Type: Electrical - Residential
erm it Work Classification: Low Voltage
Permit Status: APPROVED
issue Date: 11/17/2017 1 Expiration: 05/16/2018
Project Address Parcel Number Applicant
9400 N BAYSHORE Drive 1132050*100110
Miami Shores, FL 33138- Block: Lot: AMINE DOUKKALI MARIELA B F
Owner Information Address Phone Cell
AMINE DOUKKALI MARIELA B ROVITO 801 N VENETIAN Drive (305)992-6776
--- MIAMI BEACH FL 33139-
801 N VENETIAN Drive
MIAMI BEACH FL 33139-
Contractor(s) Phone Cell Phone
MV ELECTRICAL SERVICES (305)216-0677
Type of Work: LOW VOLTAGE WIRING
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
Amount
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee - Additions/Alterations
$100.00
Scanning Fee
$3.00
Technology Fee
$0.80
Total:
$108.60
Valuation: $ 700.00
Total Scl Feet: p
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-11-17-65648
11/17/2017 Credit Card $ 108.60 $ 0.00
Available Inspections:
Inspection Type:
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 info tion is
construction and zoning. Futhermore, I authorize the abo e7aamed c
Authorized Signature: Owner / App scant tr—* r /
and that all work will be done in compliance with all applicable laws regulating
to dQAho-wbrk stated.
November 17, 2017
Building Department Copy
November 17, 2017
1
t
Miami Shores Village
Building Department j 0V 14 2017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 !
Tel: (305) 795-2204 Fax: (305) 756-8972 tttv
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20'q
BUILDING Master Permit No. Z-0 l-9). 1%
PERMIT APPLICATION Sub Permit NoEL R -'ZM
❑BUILDING ® ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [-]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Folio/Parcel#: / ) - 3 a o 5 v 4 ti (7 - 0 t'1 D Is the Building Historically Designated: Yes NO
Occupancy Type: S—. _PA Aoad: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
ne#: �(b o f b l b
State: f_ C _ Zip: 3 5 ) �5
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: /"i `/ C_ I eGT/i (Ca -I phone#: °� a l� -0-77
Address: �O� r'�n 8 of
City: G2 �Q 4 Stater Zip: 03 0 /*Is —
Qualifier Name: gel O S Phone#: a a 1 r -O rO 7-7State Certification or Registration #: Ce A36 65(� 6� • Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address
City:
Value of Work for this Permit: $ -? C,>y Square/linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ! New❑`Repair/Replace
Description of Work: 1-bli\i r' ` S lz_ \_s'� 1,
Specify color of color thru tile:,
Submittal Fee $ Permit Fee $ &)d End CCF $
Scanning Fee $ Radon Fee $ 2 - Ci DBPR $ 2 '
Technology Fee $
Structural Reviews $
Training/Education Fee $
Zip:
❑ Demolition
CO/CC $
Notary $ 0
Double Fee $
Bond $
TOTAL FEE NOW DUES 109 ' �U
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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. A
the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature�./Qyz Signatu
OWNER or AGENT
The foregoing instrument was acknowledged before me this
U day of 1 D V'p- nn 1pc .0 I by
who is personally known to
&Lr
me or who has produced —as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seal: _ •.�= MY COMMISSION # GG 041376
EXPIRES: December 30, 2020
Bonded Thru Notary Public Underwriters
CONTRACTOR
The foregoing instru ,Wt Was acknowledged before me this
day of NU Pv 20 % - by
ho is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
sss**s*ss*s**ss*s**s*****�s-s+*ss**s***ss**ss*ss*sss*ssssss*s*******sssssssss***ss********s***ss*s**ss**ss*s**s
APPROVED BY ��ja �Nm�s l �' Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)