ELC-17-479 Permit No. ELC- -17-479
`5aoaes Miami Shores Village 0 t Permit Type:Electrical -Commercial
10050 N.E.2nd Avenue NE Pen
Miami Shores,FL 3313&0000 I Work Classification:Temp for Test
-
Phone: (305)795-2204
Permit Status:APPROVED
LORtDp`
Issue Date: 2/2812017 Expiration: 08/2712017
Project Address Parcel Number Applicant
9501 NE 2 Avenue 1132060133920
Miami Shores, FL 33138- Block: Lot: DVS LLC
Owner Information Address Phone Cell
DVS LLC 9400 NE 2 Avenue (305)756-3711
MIAMI FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 100.00
DOSOLES ELECTRICAL CORP. (954)793-2414
Total Sq Feet: 0
Type of Work:30 DAY TEMP Available Inspections:
Additional Info:30 DAY TEMP Inspection Type:
Classification:Commercial
Final
Scanning: 1 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# ELC-2-17-63058
$2.00 02/28/2017 Check#:797 $58.60 $50.00
DCA Fee $2.00
Education Surcharge $0.20 02/23/2017 Credit Card $50.00 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
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
construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated.
February 28, 2017
� ignature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 28, 2017 1
�'; Miami Shores VillageTv
- � FE
Building Department B2 2017
10050 N.E.2nd Avenue, Miami Shores,Florida 33138 [BY:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC 20
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. IC I-4-q4q
❑BUILDING ® ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[--]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: '/ �rC7 / /,� Z /�ve
City: Miami Shores County: Miami Dade Zip: 33 13 0
Folio/Parcel#: / ZO Gy / 3 3 Z c7 Is the Building Historically Designated:Yes NO
Occupancy Type:�i Load: W G1 Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):_ 9,144� Phone#:
Address: 2� oo/�t `�S— t-4% �� r
City: _'P✓ //JJ State: Zip:
Tenant/Lessee Name: VD4_ i )aik, 8��,v1 Phone#: �oS 7 Sl'ZZLd
Email:
CONTRACTOR:Company Name: �SnL- FGTGZ i� Co2 Phone#: aiS4-7`S P— 4
Address:yGY/ 14C 1�T 4 A-V
City:04,1<L4"_b P,e2i` State: �FL Zip: S33 y
Qualifier Name: t` Phone#: C)20 -7c),%
State Certification or Registration#: Ec r 300 7y$ Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ /Re lace
Re air
p p ❑ Demolition
Description of Work: Q
d �1'c:h,1,y"s7Cy WI t^i i..,..i� 1!!`' � r,•.+ E
i ,: ii a►�ifk:�•.,:1 `" •':,,;.
Specify color of color thru tile: o - `
Submittal Fee$ Permit Fee ^V• �
$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(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 AN 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 andac ' )ti will be charged.
igna a Signature
or T CONTRACTOR
he foregoin nstru nt was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 , by J/ day of f4i!�Q✓/B'n / 20 / 7 by
who is personally known to �,f/Rtife `F�UQA/& who is personally known to
rrLe 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 PUBLIC: NOTARY PUBLIC:
sigh vcQ Sign: } 4� e
Print. Print: �fk?t'A �•
Seal: :�s L**!: ELIZABETH ELORRIAOA Seal: ;` F ` b
F' uA
'= MY COMMISSION*FF93353d �� Q, `�= C�;•,�>U11 S;C`l#FF233981
EXPIRES January 25.2020 =a EXPIRE& N114 25, 2019
140I�:1Hfl-0'S8 FbnO~a 3orvice txar ,;;/,OF� WWW.AARONNOTARY.COM
APPROVED BY z3/��� /} Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
`SNOR —
yt� Miami Shores Village
Building Department
umM 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
0RtDp' Fax: (305) 756.8972
AFFIDAVIT FOR 30 DAY TEMPORARY-ELECTRIC SERVICE
NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY
TERMINATION UNLESS APPLICATION IS RENEWED.
It is understood that the temporary-electrical approval by the Miami Shores Village, Building Department given
in connection with the building being constructed under:
Building Permit N: C C," 3 -t V -&,&O Electrical Permit N:
At Address: 06 Miami Shores, FL t 3
For Owners: ?,t,c,s C,�, 8,A t-.+-1 , and is being given only for
construction purpose or for testing the following equipment in said
structure:
The owner does herby agree to assume the responsibility of maintaining the installation in such manner that
there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said
structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further
inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of
Occupancy or Completion is obtained.
The undersigned also understands that the temporary electric approval is subject to rescission and
cancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of
ie building concerned is occupied before final inspections are approved and/or obtained a Certificate of
Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will result in your
begin-� unable to obtain future Temporary for Test permits.
�i PP/c�-L , being first duly sworn, depose and say that I am the owner of the
above described property, and that I agree that the structure covered in this agreement shall not be occupied
until IJ'uilding contrac has obtained /or obtained a Certificate of
C5
ompletion. of • r I�-iti�l$���eR�iReAh of this affidavit will result in your
b 'ng am fu re Tempor ~ �N#FF953$X
• E�(P'I'R.E.S.Januwy 25.
S -",4L
ign re of Own r ��" -- - nature of Notary
I, W4 LTe.R '�9 11 C , being duly sworn, depose and say that I am the Electrical Contractor for
the above-described property and that the electrical installations as now a istinwt create afety� rf �Jly-r,o
vki
if to service is connected. Kq
r
-I
co,
Signature of Electrical Contractor Signature of Nota o� ° vJ.vvJ.AARONftiOTARY-GO
being first duly sworn, depose and say that I am the Building Contractor
of the above described property and that I will not permit occupancy of this buildin 'nal inspections have
been called for by the contractors and sub-contractors concerned and final a oval by the 'nspection division
obtained and that I have the authority insofar as the owner of said prope is concerne prohibit occupancy
until such final inspections are o and/or a Certificate of Occup cy or Com �yl> issue�np�q
cona*im 660211001
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Expires:August 21,2020
na of Building Contractor 1 -0-°new Nanry
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Signature of Inspector Signature of Notaf'�ii•;,