EL-19-1473Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Pe It
Issue Date: 06/28/2019
Parcel Number
540 GRAND CONC, Miami Shores, FL 33138 1132060171411
Contacts
Permit NO.: EL-06-19-1473
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 12/25/2019
DARIK & MARLENIS SMART
Owner CITY ELECTRICAL CONTRACTORS Contractor
540 GRAND CONCOURSE, MIAMI SHORES, FL 33138
CORPORATION
Other:3057518127
LESLIE DIAZ
Business: 7864023845
Description: KITCHEN REMODELING Valuation: $ 1,000.00 Inspection Requests:
49
TotalSq Feet: 200.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
06/28/2019 $110.30
Amount Due:
$0.00
Building Department Copy
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 con uction a ning. Futhermore,-1 authorize the above named contractor to do the work stated.
nature: Owner / Applicant / Contractor / Agent Date
June 28, 2019 Page 2 of 2
Miami Shores Village
Building Department REcER,%IEa
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JUN 2 019
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. t&L n -14-73
❑BUILDING '�jELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
OIKS
City: I Miami Shores County: Miami Dade Zip: :5 3i 3 x
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: ,(� cFlood Zone: BFE: l FFE: c � t� C�
OWNER: Name (Fee Simple Titleholder): �t '' 1G`r t5 `ern �i2'� Phon(#:3L63 C C100- ' ' l u
Address:: Sy rC'✓1a CCvqc-0"- sC U
City: 1 1 ' kC-✓Vl k' 1 rla re—s State: --t— I Zip:
Tenant/Lessee Name: Phon
Email:
CONTRACTOR: Company Name: C `K!:� Cski` — s Phone#: �p�p �t123b�J
Address: �5�� J Sk1 (�59
City: ykkAl`jti Stater Zip �J�
L.: l�
Qualifier Name: Le-V-s �^
tkz— r Phone#: —),&G 4CS2. !S4A57
State Certification or Registration #: CC Z_9 J Certificate of Competency #:
DESIGNER: Architect/Engineer:
Add
City:
Phone#:
State: Zip:
Value of Work for this Permit: $)4 \ Z Ob Square/Linear Footage of Work:
Type of Work: ❑ Addition I❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: 'X k l4c-t"v
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $
DBPR $
❑ Demolition
CO/CC $ -
Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
6
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. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of cJ' 20 l by
ZLk—e 5M A who i onally kn to
me or who has produced as
identification and who did take an oath.
NOT
Sign
Prins
Seal
The foregoing instrument was acknowledged before me this
11 day
I I%q 20 1 , by
,�q
who is personally known to
me or w as produced
►�� V� ✓ as
i entifi tion a who
Z/
id take an oatk+����rY•pFTO ,'�i��i
25,
OTAR PUBLIC
*
Sign:
' #GG 287268
Print.Q art
� de
r
////n.AlC:S..IMAN�����
Seal:sc-
\
APPROVED By �Plans Examiner Zoning
Structural Review
(Revised02/24/2014)
Clerk