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ELC-17-1108 Permit NO. ELC-4-17-1108 `eHnREs`,` Miami Shores Village Permit Type:Electrical-Commercial 10050 N.E.2nd Avenue NE Work Classification:Temp for Construction Miami Shores, FL 33138-0000 Penni" tPermit Status:APPROVED Phone: (305)795-2204 FGORLDp' Issue Date:412412017 F Expiration: 10/21/2017 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: $ 8,000.00 DOLCHE INC (786)399-1900 . ._... _.__ Total Sq Feet: Type of Work:TEMP FOR TEST Available Inspections: Additional Info: Inspection Type: Classification:Commercial Final Scanning: 1 Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $4.80 Invoice# ELC-4-17-63769 DBPR Fee $2.00 DCA Fee $2.00 04/21/2017 Credit Card $50.00 $69.80 Education Surcharge $1.60 04/24/2017 Credit Card $69.80 $0.00 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $6.40 Total: $119.80 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 ELECT ICAL,PLU ING,MECHANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work. OWNERS AFF VIT: 1, ify at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction zonin F ther o I authorize the above-named contractor to do the work stated. April 24, 2017 A thor¢ed Sign ure:Owner / Applicant / Contractor / Agent Date Building Department Copy April 24, 2017 1 LLQ _ •_ Miami Shores Village Building Department APR 2I 2017 g p ��- 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:_ -- Tel:(305)795-2204 Fax:(305)756-8972 ]/ INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC//_20 j/L_j n(� BUILDING Master Permit No.(2 (o-��//-156 PERMIT APPLICATION Sub Permit NoE C R -11 G� F—IBUILDING M ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING F-1 MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:��,��2fAlQ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#://T�QO/339. � Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: �/ LL 5 �'�/_ L/ OWNER: Name(Fee Simple Titleholder): V� ' Phone#: 7 Zd-- 3 S Address: (�/ �� 9�5 City: i ' �ho✓es State: /�✓i C�o� Zip: /� Tenant/Lessee Name: Phone#:�7'29_`��//��?'P/� Email: kvq CONTRACTOR:Company Name: � .52 J:;! L7 Phone#:�6 Address: l-.c—/ ,'? City: '1l P State: L` Zip: r3 �dJ Qualifier Name: Phone#: State Certification or Registration#: 6�7Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$e2 oz� Square/Linear Footage of Work: f�s�� Type of Work: ❑ Addition E❑ Alteration �❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ` �trs..Q�:?�: �_�`:-'Tt.'�Q°I�'+ :�`.y w�• # f.wrf �..,.r M �1 � Spedgly pigpof colorthru,tile: �'l I ! " _ J e � T, Submittal Fee$ sb -- P• Permit-Fee$1 CCF$ r< 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 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. S' nature Signature 0 ER or ENT CONTRACTOR The f ret ng instrume t was acknowledged before me this The foregoing instrument was ac nowledged before me this day of ,eE 20 1 by day of 20 A) by LkY9l` who is personally known to v who is personally known to ,me or who has produced as _Te or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI . Sign . Sign: \n�A `n Print: r"6L G�✓!/ Print: C\ `� '-'l( , Seal: ;R ELIZABETH ELORRIAGA Seal: %r SHARON FELDMAN MY COMMISSION it FF9535% 4 MY COMMISSION#FF902928 �'•,,q •• EXPIRES January 25.2o2o EXPIRES Juy 23.2019 aon if��s APPROVED BY i7�i�Y�i�/y Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) y Miami Shores Village Building Department NOUN 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 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: _6 — _15 Electrical Permit N: At Address: ,ld Miami Shores, FL For Owners: , 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 ncellation 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 being nable to obtain future Temporary for Test permits. I, iP&C - �a�C A-r",'_a , 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 the buildin contractor has- tained approval of final inspections and/or obtained a Certificate of 4be' unabi om letion. Note: iiure to comply with the provisions of this affidavit will result in your e ob future Te porary fo ,erg ETH o i MY COMMISSION �- 4 4L — e, EXPIRES Jarwary r of Notary 140/13+ �•y,7 being duly sworn, depose and say t a am the Electrical Contractor for the above-described property and that th electrical installations as now ex i witF rtat-create a safety hazard if temporary service is connected. SHARON FELDMA MY COMMISSION#FFant Signature of Electrical Contractor EXPIRES July 23,—!—!/- 016 n ure of Notary 1 (40713gd o+53 FlorlddVpu ppm I+ , 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 building until final inspections have been called for by the contractors and sub-cctors gLorlpqrned and final approval by the inspection division obtained and that I have the authority insofar s,��;q�wner o ncerned to prohibit occupancy until s al inspections are obtained and/ fT ��YE�r or mpletion is issued. �i P C- ato of lorld� "s7 Commttslon N FF 993993, my COMM.aEX0101 J gnature f Building Cont a df Notarf Signature of Inspector Signature of Notary