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EL-17-120 Permit No. EL-1-17-120 `5NO �, Miami Shores Village M t Permit Type:Electrical -Residential 10050 N.E.2nd Avenue NE > i Work Classification:Addition/Alteration Miami Shores,FL 33138-0000Pur, Permit Status:APPROVED Phone: (305)795-2204 �GORtDp` Issue Date: 1/23/2017 Expiration: 07/22/2017 Project Address Parcel Number Applicant 68 NE 91 Street 1131010200020 Miami Shores, FL 33138- Block: Lot: ROBERT IRWIN FLOYD GONZAL Owner Information Address Phone Cell ROBERT IRWIN FLOYD GONZALES 68 NE 91 Street (305)492-9763 MIAMI SHORES FL 33138-2808 68 NE 91 Street MIAMI SHORES FL 33138-2808 Contractor(s) Phone Cell Phone Valuation: $ 1,840.00 ASSOCIATE ELECTRIC, INC. (305)898-7853 Total Sq Feet: 0 Type of Work:INSTALLATION OF 8 HIGH HATS TANKLES Available Inspections: Additional Info:INSTALLATION OF 8 HIGH HATS TANKLES Inspection Type: Classification:Residential Final Scanning:3 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee Invoice# EL-1-17-62632 $3.38 01/17/2017 Check#:404 $50.00 $ 198.96 DCA Fee $3.38 Education Surcharge $0.40 01/23/2017 Check#:401 $ 198.96 $0.00 Notary Fee $5.00 Permit Fee-Additions/Alterations $225.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $248.96 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. January 23, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy January 23, 2017 1 Miami Shores Village JAN 17 2017 Building Department By.%---t --� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 ...J ' INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 �l,l BUILDING Master Permit No. 9C t la -21q40 PERMIT APP CATION Sub Permit No. �' I f=r— 1 Z-0 ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS � JOB ADDRESS: G9 1 "J& S� J) , City: Miami Shores County: Miami Dade Zip: 33 3 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFFE: OWNER: Name((Fee Simple Titleholder): LOW 4 boo Za ff 1e S Phone#: )oS- q92-q-7463 Address: 0 �% 91-5-t54'. r�p City: k�(Vti�r v'elr State: rL- Zip: 3�i �O Tenant/Lessee Name: J /APhone#: �-7 Email: Gti0/rl2a '�S �� "�� CONTRACTOR:Com pain 'NAa'me* ( q Phone#: VV Address: Q #-i City: fJlrril+ State: rL zip: Qualifier Name: G Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: �y City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition ftDescription of Work: >A Wy% Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ 0 Training/Education Fee$ C40 Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ �V (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 L6Signature OWNER or A N CONTRACTOR The foregoing instrument was acknowledged before /m,e,this The foregoing instrument was acknowledged before me this "i day offN 0\/ 20 t1J ,by day of JA!�'l/GN�� 20 by -P I &)n-U1eSwho is personally known to �C/�� who is personally kno to / me or who has produced Y�_ C 1(V C 1 S 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: i Sign: W-4ro� Print: �I--PG I1G�/n I 60rNE— I ICZ, Print: MICHELLE MOLINA Seal: r.�Yt,". MAHARAI K GONZALEZ Seal: .= Notary Pu04c-Sta<f OI FJbrldta ' MY COMMISSION#GG 044602 'My Comm.E*ra Sep 19;2#1 7 EXPIRES:November 2,2020 s COMIhissioo it FF 0557st Bonded 17vu Notary PubNc Underwriters APPROVEDBY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850)487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 MORENO, ROBERTO ASSOCIATE ELECTRIC,LLC 7220 NW 5 STREET MIAMI FL 33126 Congratulations! With this license you become one of the nary one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque , DEPARTMENTS BUSINESS AND restaurants,and they keep Florida's economy strong. i PROFESSI REGULATION Every day we work to improve the way we do business in order EC0000838 6 to serve you better. For information about our senft".please G onto www.myfloridelicense.com. There you can find more CERTIFIED Elf l C TOR in tion about our divisions and the regulations that impact - MORENO,R06. ,; r You.subscribe to department newsletters and learn more about —ASSOCIATE EEEOCR �t. the Departments initiatives. �, � Our mission at the Department is:License Efficiently,Regulate Fairly.We constantly strive to serve you better so that you can .r serve your customers. Thank you for doing business in Florida. t��La�cIFtED otidertha.provisions or Ch.180 FS. and congratulations on your new license! ^ "iwca:so,e- 0e090ao0ot6„ .r DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON.SECRETARY STATE OF FLORIDA r DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL C014MCTORS LICENSING BOARD Ong - '.`EC0000N8, The ELECTRICAL CONTRACTOR Namedxbeiow 1S CERTIFIED. - - .Urtder'thg"Ii omisiolis of.Cha 48SfS. Esipifti ion date:•AUG:31 A 2 m18 SOCIAtt fLECTRI .-�122QfN�1H5.ST EE41 ISSUED: 09M612016 DISPLAY AS REQUIRED BY LAW SEa s L1609 M01611 Scanned by CamScanner Di 289 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT BILL-DO NOT PAY 6732268 L 13 1 1 BUSINESS NAMEILOCATION RECEIPT NO. EXPIRES ASSOCIATE ELECTRIC LLC RENEWAL SEPTEMBER 30, 2017 4805 NW 79 AVE #1 7005721 Must be displayed at place of business DORAL FL 33166 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS ASSOCIATE ELECTRIC LLC 196 ELECTRICAL CONTRACTOR PAYMENT RECEIVED C/O ROBERTO MORENO MGR ECO000838 BY TAX COLLECTOR Worker(s) 1 $49.50 10/13/2016 CREDITCARD-17-001 1 02 This Local Business Tax Receipt only confirms payment of the Local Business Tax. the Receipt isnot a license. permit or a certification of the holder's qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO.above must be displayed on all commercial vehicles-Miami-Dade Code Sec 1a-276. For mon information,visit www mismidede.govAoxcoliactor Scanned by CamScanner