EL-16-803 Permit NO. 'EL-3-16-803
-9 02.%-T yam! Miami Shores Village Permit Type:Electrical-Residential
g� 10050 N.E.2nd Avenue NE
Per� it Work Classification:Pool -Private
Miami Shores,FL 33138-0000
Permit Status:APPROVED
Phone: (305)795-2204
FtORIDp'
Issue Date:5112/2016 Expiration: 11/08/2016
Project Address Parcel Number Applicant
1086 NE 96 Street 1132060143480
Miami Shores, FL Block: Lot: ANA ROJAS
Owner Information Address Phone Cell
ANA ROJAS 1086 NE 96 Street
MIAMI SHORES FL 33138-2552
Contractor(s) Phone Cell Phone Valuation: $ 2,500.00
SHINE ELECTRICAL ENGINEERING (305)688-2000 Total Sq Feet: p
Type of Work:ELECTRIC FOR NEW POOL AND SPA. Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Final
Scanning: 1
Light Niche
Bonding
Review Electrical
Alarms
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80
Invoice# EL-3-16-59158
DBPR Fee $4.50 05/12/2016 Check#:300578 $266.80 $50.00
DCA Fee $4.50
Education Surcharge $0.60 03/25/2016 Check#:300467 $50.00 $0.00
Permit Fee-Additions/Alterations $300.00
Scanning Fee $3.00
Technology Fee $2.40
Total: $316.80
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.
May 12, 2016
Authoriz e: pplicant / Contractor / Agent Date
Building Department Copy
May 12, 2016 1
RECEIVED 1,
Miami Shores Village Ma
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 [A
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C� 20►y �
BUILDING Master Permit No�`
PERMIT APPLICATION Sub Permit No.--- t6-�63
❑BUILDING XELECTRIC ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
F-IPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I E-- C,--
City:
PCity• Miami Shores County: Miami Dade Zip:c 1 3�
Folio/Parcel#: I I ` *-'��- O 14 5 :!12!)0. Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): Phone#:
Address: ) C-P t—J E Q-2 `�-T
City: t"-4" C:--A 11 it State: �C_ Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: SHINE ELECTRICAL ENGINEERING Phone#: 305-688-2000
Address: 3876 NW 125 ST
City: OPA-LOCKA State: FL Zip: 33025
Qualifier Name: FRANCISCO SANTOS Phone#: 305-688-2000
State Certification or Registration#: EC0001514 Certificate of Competency#:
DESIGNER:Arch itect/Engiin (q
nee (AJ a ' rC ML7 V V—h ICI YY1 �nr-)eTTPhone#: 9S�— �' ( �ISO
Address�ps S- rZ-��ro(1 44 J!2)V1.V1la� itY: r State:` —//��^ Zip:
Value of Work for this Permit:$ 2, 5� - Square/Linear Footage o Work- C/ �_
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work: -E-( _C--t-
Specify
C--'-T`Specify color of color thru We: C�
Submittal Fee Permit Fee$ CCF$ C b CO/CC$ rh
Scanning Fee$ 3 - Radon Fee$ DBPR$ Notary$
Technology Fee$_0 d Training/Education Fee$ U GO Double Fee$
Structural Reviews$ 0 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 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\, - vv( Sig nature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
C:: day of ��1� - 20 L ,by � day of �'�'G� 20 L C''P by
Ejc=�1c--5 ,who is personally known to FRANCISCO SANTOS who is personally known to
me or who has produced as me or who has produced NY M. -as
identification and who did take an oath. identification and who did take n oath y:GO�MIS�S%py°;L9
NO
TAR PUBLIC: NOTARY PUBLI
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221
Sign: M Sig ••�. mN
Print. Pri t STATE:1
Seal:
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0 •*� Seal:
22108 •
ditau ;41 Q''AGAicUndetwi�e:. �O
*******s****s***:***** *�#s��*`q.**`******************************yes*************s***************#*******•****
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)