DEMO-16-2570 Miami Shores Village ■ Permit Typic„Delrltlitiart
�. 10050 N.E.2nd Avenue NE
c+ t761C�i1+41.�i fflb4fib?'tl`t ric
Miami Shores,FL 33138-0000
mvm Phone: (305)795 2204 Pelm t statua.-A `PROM P ,.
�CORiD�
10/25124-16 Expiration: 04123/2017
Project Address Parcel Number Applicant
29 NE 95 Street 1132060130690
Miami Shores, FL 33138- Block: Lot: DEUTSCHE BANK NATIONAL TF '
Owner Information Address Phone Cell
DEUTSCHE BANK NATIONAL TR CO
--- - - -- - - --- - - - FL
1661 WORTHINGTON Road
WEST PALM BEACH FL 33409-
Contractor(s) Phone Cell Phone Valuation: $ 495.00
ELECTROCOM INC (954)632-1091
Total Sq Feet: 0
f
4
Type of Demo:Electric Available Inspections:
Additional Info:DEMO ELECTRICAL FIXTURES(LIGHT FI Inspection Type:
Classification:Residential Final
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# DEMO-9-16-61377
DBPR Fee $2.00
DCA Fee $2.00 09/16/2016 Check#:1184 $50.00 $58.60
Education Surcharge $0.20 10/25/2016 Check#:1208 $58.60 $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 talo the work stated.
October 25,2016
Authorized Signature:Owner / Applicant / Contractor / Aglnt Date
Building Department Copy
October 25,2016 1
• Miami Shores Village ► j
Building Department BY:
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 , 1
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit Nbj ((z>' 2�0�
PERMIT APPLICATION Sub Permit No amo (ra" Z
❑BUILDING � ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-IPLUMBING F-1 MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 29 NE 95th st
City: Miami Shores County: Miami Dade Zip: 33131
Folio/Parcel#:11-3206-013-0690 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Deutsche Bank National TR Phone#:
Address: 1661 Worthhington RD#100
City: WPB State: FL Zip: 33409
Tenant/Lessee Name: Phone#:
Email: I
CONTRACTOR:Company Name: -TIC Phone#: q5 -14(p-2-1q4
Address: 6591 WO 461 SP
City: Lnu&r W.r t_ State: F L_ Zip: 33 319
Qualifier Name: &r-kiekA LeL6 Phone#: Q54-X32-1[)�'t I
State Certification or Registration#: EC 13 bC)Cn-t?iZ Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
t'
Value of Work for this Permit:$ ` 95.c Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration 1:1New F-1 Repair/Replace ❑ Demolition
I
Description of Work: pff-)n c,—kecAr-i ccs.( ohi !6Ire Cam [1Nkilr e 1
Specify color of color thru tile:
Submittal Fee$ ® Permit Fee$ CCF$ - coo CO/CC$ 101-
Scanning Fee$ Radon Fee$ DBPR$ 2. Notary$
Technology Fee$ , 0 Training/Education Fee$ • 2 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 e'er--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: 1 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 Signature
OWNER r GENT CONTRACTOR
The foregoing instrument was acknowledged before me this The fofegoing instrument was acknowledged before me this
day of 20 t o ,by 13 day of Sep+ ,20 l( ,by
Nr;s4opher K t-tiarjs who is personally known to C ri,r-Pie(d We l.b ,who is personally known to
me or as roi►- _ as or who has ro FIA r as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
�
Seal: 8� ` conte Seal: j
« 9g OW1B11S9 s* ?F� fl$1
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APPROVED B Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
SNu I br
'amen UMV" Miami shoresVoillage
o Building Department
R10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REG IST TION
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. COPY OF QUALIFIER'S STATE LICENCES
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF LIABILITY INSURANCE*
D. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL
CONTRACTOR'S TAX RECEIPT.
D. COPY OF LIABILITY INSURACE*
E. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
*YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW:
Certificate Holder:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
Certificate must specify the description of operations or contractor license number.
mmmmmmemmmmmmvmeeememmemmmmmemmmmmvammmemmvmmmmvmevmmmememmvemmemmsammmmmmmmmvvemevmeeemem
BUSINESS NAME: 4:-'l - rr, -f nc,
BUSINESS ADDRESS:_1e59( �� �{o } CITY Lau�Qr�li�l STATE__ J___ZIP 333 I
BUSINESS PHONE: (954 ) `I }Kv-2094 FAX NUMBER( )
CELL PHONE(954 ) co32-Ioq I QUALIFIER'S NAME:
QUALIFIER'S LIC NUMBER: 1L l��taJ17,
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395
2601 BLAIR STONE ROAD
TALLAHASSEE FL 32399-0783
WEBB, GARFIELD S
ELECTROCOM, INC.
6591 NW 46TH STREET
LAUDERHILL FL 33319
Congratulations! With this license you become one of the nearly
one million or,
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 DEPARTMENT OF BUSINESS AND
restaurants,and they keep Florida's economy strong. ;, PROFESSIONAL REGULATION
Every day we work to improve the way we do business in order EC13006732 ISSUED: 07/27/2016
to serve you better. For information about our services,please
log onto www.myfforidalloonse.com. There you can find more CERTIFIED ELECTRICAL CONTRACTOR
information about our divisions and the regulations that impact WEBB, GARFIELD S
you,subscribe to department newsletters and learn more about ELECTROCOM,INC.
the Department's initiatives.
Our mission at the Department is:License Efficiently,Regulate
Fairly.We constantly strive to serve you better so that you can
serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS.
and congratulations on your new license! Expkatkm dals:AUG 31,2018 ue07270MI&%
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION �—
ELECTRICAL CONTRACTORS LICENSING BOARD g
EC13006732
The ELECTRICAL CONTRACTOR
Named below IS CERTIFIED s�
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2018
L
WEBB, GARFIELD S
0 •
ELECTROCOM, INC. .
6591 NW 46TH STREET •
LAUDERHILL FL-33319
■ • Lr
------.-- ninrn Av11mr_nnvI A%A§ nr-i... .e..�..-,n...,...rr
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm.A-100, R. Lauderdale, FL 33301-1895—954-831-4000
VALID OCTOBER 1,2016 THROUGH- SEPTEMBER 30,2017
DBA:
Business Name:ELECTROCOM INC Receipt#:181-229334 4A>zMSlcoNTRACTo�
Business Type:
Owner Name:GARFIELD WEBB Business Opened:11/19/2009
Business Location:6591 NW 46 ST StatelCoun /Cert/R
LAUDERHILL ty eg:EC13006732
Business Phone: Exemption Code:
Rooms seats Employees Machines Professionals
1
For Vending Business onty
Number of Machines: ending T
Tax Amount Transfer Fee 9 yam'
NSF Fee Penalty Prior Years Collection Cost Total Paid
27.00 0.00 0.00
o.o0 0.00 0.00 27.00
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
non-regulatory in nature.You must meet all County and/or Municipality
THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is
planning
WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location.This receipt does not indicate that the business is legal or that
it is in Compliance with State or local laws and regulations.
Mailing Address:
GARFIELD WEBB
6591 NW 46 ST Receipt #10B-15-00006269
LAUDERHILL, FL 33319 Paid 08/11/2016 27.00
2016 - 2017