EL-17-2706,ye 1%
Miami Shores Village
10050 N.E. 2nd Avenue N
�-
Miami Shores, FL 33138-0000
Phone: (305)795-2204
F�ORIDQ'
Permit NO. EL-11-17-2706
Permit Type: Electrical - Residential
Per ' Work Classification: Temp for Construction
Permit Status: APPROVED
Issue Date: 11/17/2017 1 Expiration: 05/16/2018
Project Address Parcel Number Applicant
9400 N BAYSHORE Drive 1132050100110
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: TEMPORARY FOR CONSTRUCTION
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: $ 500.00
Total Sq Feet: p
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-11-17-65649
11/17/2017 Credit Card $ 108.60 $ 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 i
construction and zoning. Futhermore, I authorize the at:
Authorized Signature: Owner / Applicant /
Building Department Copy
is accurate and that all work will be done in compliance with all applicable laws regulating
c9R9jiiff9r to do thwwork stated.
9
November 17, 2017
November 17,
Miami Shores Village
BUILDING
PERMIT APPLICATION
Building Department OV 14 2011
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (30S) 762-4949 —
FBC 201 q J
Master Permit No. P-c-0, I ` 11�6
Sub Permit Noi —t a5k in
❑BUILDING 0@ ELECTRIC ❑ ROOFING
❑PLUMBING [:]MECHANICAL [:]PUBLICWORKS
JOB ADDRESS: q "I o b
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
5tfO'n�
City: Miami Shores CiCounty: Miami Dade Zip: 1 3-9
Folio/Parcel#: 3 �- os- ^ 01 6 " o l t zi Is the Building Historically Designated: Yes NO
Occupancy Type:)—At�/-goad: Construction Type: C 5 Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Address: 0 o I 'I n) • V � /
City: 1./u i A (y
Tenant/Lessee Name:
Email:
!�r.4 (- ( Phone#0Dr) 6'07 gU It)
State: i-�- Zip: 3� _
CONTRACTOR: Company Name: MV C I ec-rAi60- f Se"'y(CeS , -70C Phone#: 3 a
Address:, // 8 3 I f /V W 9 A Cr-
t'y
City: 1 a I P a A State: F-L Zip:
Qualifier Name: "alto DO- ('(es Phone#: %3 /02/ Cv - D (o-1- .
State Certification or Registration #: Ee / 3y 0 S 668 Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: City: State:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition
Description of Work:
Zip:
❑ Alteration ^ IJ rvew Repair/Replace El Demolition
Specify color of color thru tile:
Submittal Fee $��b • (,Z) Permit Fee $ f ® Q tO4z> CCF $
Scanning Fee $ Radon Fee $ Z - 03 DBPR $ 2 -
Technology Fee
Structural Reviews $
Training/Education Fee $
CO/CC $ _
Notary $,
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ I & • ��
9%
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 com encement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. I the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature.
OWNER or AGENT
The for going instrument was acknowledged before me this
day of NW t C 1f Q J9--- , 20 1by
ffiy�Lr. you ,l.l, who is personally known to
me or who has produced u as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: MY COMMISSION # GG 041376
p , EXPIRES: December 30, 2020
'•.1o. �tQ.• Bonded Thru Notary Public Underwriters
\ \� CONTRACTOR
foregoing instrument wa acknowledged before me this
day of /�0 eoi P l/ 20 by
o is ersonally know 0
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:AQv AWMA PA tsL
w cotOMSIUN il
2020
Print: E)CplltF.: Ma
Seal:
APPROVED BY od�i�)Z /DIY&1`00' 1 k Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)