EL-16-2756Miami 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
RECEIVED
INOV' 1 10 1p1�
.,sit
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FBC 201 -I-
BUILDING Master Permit No.3PP16 - ZGOci
PERMIT APPLICATION Sub Permit No. El j 6-23 G
BUILDING 0 ELECTRIC ❑ ROOFING [] REVISION El EXTENSION (]RENEWAL
❑PLUMBING ❑ MECHANICAL ElPUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: HSI 1\3C- l0-3 Si
City: Miami Shores County: Miami Dade Zip: 3( '38
Folio/Parcel#:1139...o 5O3 ) 0 )e0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): L®retta H G W 1 I i O`m S
Address: 11-161 J c% \ 63st
City: 1Yl Grn l Skn®Q'e,.S State: "FL zip: 33 36
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: SHINE ELECTRICAL ENGINEERING Phone#: 305-688-2000
Address:
Phone#:306 - 3 t
3876 NW 125 ST
City: OPA-LOCKA State: FL
Qualifier Name:
FRANCISCO SANTOS Phone#: 305-688-2000
Zip: 33025
State Certification or Registration #: EC0001514 Certificate of Competency #:
171
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $
1000
Phone#:
City: State: Zip:
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace 7 ❑ Demolition
Description of Work:---WSt(\ea0i�T(= L D‘&16 UJ'taG: --1
Vzp(��c
Specify colorGO, CO
thru tile:
Submittal Fee $ O r CO Permit Fee $ rr t,�" 00 4) CCF $ 0' CO/CC $
Scanning Fee $ 3 W L
' Radon Fee $ -' g0 DBPR $ Lt. g0 Notary $
Technology Fee $ O' (9 v Training/Education Fee $ 0 ' 2. Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 263 ' GO
0
(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 tiF 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.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
ri-P"' day of )\-.1e(20l , by
LQir�-T�� \1,- Y v 111 nswho is personally known to
me or who has produced
identification and who did take a
if
►i01111
NOT PUB C:
Sign:
as
APPROVED BY
(Revised02/24/2014)
The foregoing instrument was acknowledged before me this
day of I 20 ( _ , by
FRANCISCO SANTOS
me or who has produced
, who is personally known to
identification and who did taII /
NO,PUBLIC:
Si
Print:
Seal:
as
pi MY ON FF 022108
., . ri EXPIRES:member 2017
• , ; , Bonded Thru Nay Public linden/Mitts
/O>wrid/4Plans Examiner toning
Structural Review Clerk
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Parcel Number
Expiration: 05/14/2017
Applicant
1451 NE 103 Street
Miami Shores, FL
1132050310180
Block: Lot:
LORETTA MCWILLIAMS
Owner Information
Address
Phone
Cell
LORETTA MCWILLIAMS
1451 NE 103 ST
MIAMI SHORES FL 33138-2625
470.10
Contractor(s) Phone
SHINE ELECTRICAL ENGINEERING (305)688-2000
CeII Phone
Valuation:
Total Sq Feet:
$ 1,000.00
0
Type of Work: INSTALL EQUIPUTENTIAL BONDING WIRE
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$4.50
$4.50
$0.20
$300.00
$3.00
$0.80
$313.60
Pay Date Pay Type
Invoice # EL -10-16-61614
11/15/2016 Check #: 301057
11/10/2016 Credit Card
Amt Paid Amt Due
$ 263.60 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Light Niche
Bonding
Review Electrical
Alarms
In consideration of the issuance to me of this permit, I agree to perform the work covered
pertaining thereto and in strict conformity with the plans, drawings, statements or specificati
accepting this permit I assume responsibility for all work done by either myself, my a
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOW: DO ROOFI
ROOFI
OWNERS AFFIDAVIT: I certify that all the foregoing infom
construction and zoning. Futhermore, I authorize the above -
hereunder in compliance with all ordinances and regulations
ubmitted to the proper authorities of Miami Shores Village. In
rvants, or employes. I understand that separate permits are
WIMMING POOL work.
ill be done in compliance with all applicable laws regulating
d.
Authorized Signature: Owner / Applicant / ontractor
Building Department Copy
November 15, 2016
Date
November 15, 2016 1