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EL-16-3012 eg 7 t t7?? � t>G�I R@ ntia ; et° i Miami Shores Villa 10050 N.E.2nd Avenue NE WorkGla��a oe� :�dd�#n�Aite�tiOn Miami Shores,FL 33138-0000APPIR _ d° Phone: (305)7952204 issue oati.1112812016" Expiration: 06/27/2017 Project Address Parcel Number Applicant 790 NE 91 Street Number: 8 1132060390080 Miami Shores, FL Block: Lot: R GREGORY CHARLES Owner Information Address Phone Cell R GREGORY CHARLES 790 NE 91 ST#8 MIAMI FL 33138-3250 Contractor(s) Phone Cell Phone Valuation: $ 400.00 BLUEHILL ELECTRIC COMPANY INC (954)410-2688 Total Sq Feet: 0 Type of Work:WIRE AND INSTALL BATH ROOM LIGHT AN Available Inspections: Additional Info:WIRE AND INSTALL BATH ROOM LIGHT AN Inspection Type: Classification:Residential Final Scanning:1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W.W. Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-11-16-61910 DBPR Fee $2.25 11/03/2016 Credit Card $50.00 $114.10 DCA Fee $2.25 Education Surcharge $0.20 11/28/2016 Check#:2605 $114.10 $0.00 Notary Fee $5.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $164.10 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. OWNER AFFIDAVIT: 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constru ti and zonin a tho Futh rize the above-named contractor to do the work stated. C M November 28, 2016 Abth&4zed Signat re: er / Applicant / Contractor / Agent Date Building Department Copy November 28,2016 1 Miami Shores Village w1V 3 Building Department LBY.�_ 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2W4 BUILDING Master Permit No.?j C ' Soo Cj PERMIT APPLICATION sub Permit No.,(-" I - -,-W1 2 --- ❑BUILDING 'ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL Ej PUBLIC WORKS [:] CHANGE OF CANCELLATION SHOP � CONTRACTOR DRAWINGS JOB ADDRESS: RG+ ` 1'® • L: • 71 •, z • � gw? City: Miami Shores County: Miami Dade Zip: , Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): Phone#: FS Address: 6 �b A" City: State: Zip: �3 Tenant/Lessee Name: X AAA Phone#: Email: �. CONTRACTOR:Company Name: &-149— ✓lLL e42217J C. �� Phone#: Address:3613 0 iv-,eV fn &4,y eel _ City:'zALaa&Le- Z."'�/des State: kr-E9k.f®A - Zip: 1' Qualifier Name: ®/ems Z�/�/P�> Phone#: SG-7/L-36 33 State Certification or Registration M �b 0 4-0 Certificate of Competency#: a,� DESIGNER:Architect/Engineer: C,/1QV'•1 dVl1� • V Phone#: �.y tag rb/? Address: R4. F5zJNy P.A." �'�a -ity: tate�_�—Zip: Value of Work for this Permit:$ *A q . Square/Linear Footage of Work: Type of Work: ❑ Addition a ❑ Alteration New Repair/Replace ❑ Demolition e Description of Work: g L� &ja �41 �d Specify color of color thru tile: Submittal Fee$ Permit Fee$ r®-1010 CCF$ ® (00 CO/CC$ Scanning Fee$ ��Radon Fee$ 2 DBPR$ Z- 2-5 2-5 Notary$ Technology Fee$ 6® Training/Education Fee$ o W Double Fee$ Structural Reviews$ 'k BB&d$ �— TOTAL FEE NOW DUE$ 1 (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 zoDi�g. "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." YOUR Notice to Applicant: As a condition to the issuance of a building permit with an estilhated valuo 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 it subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted'dt 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. r Signatu 2zaF,L--,r Slgnatur(eL &e/ t-92 OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 3 rC( day of � VJVTVn 1Q1tV 20(,by day of � 20 / by ZU IN—Y- who is perso-n_aft knpwn to who is personally known to me or who hq's produced _'J r i V`2Y� L1 C*� `. as me or who has produced �-- as identification and who d'.t an oath. identification and who did to an oath.P NOTARY PUBLIC: v, NOTARY PUBLIC: f •, �br - ((yy Jf� Sign: G cVrC� Sign: Print: — Print: ,��aya-, YANADY PRIEM Seal: s°f `a: MY CpMMISSION#FF 214031 Sea :.: .: ; Q EXPIRES:March 25,2019 CARLOS HEHRIOUEZ p 4• Bonded Th u Notary Public Underwriters Nosy Pilo,811#9 O1 Igorlda Commie W 0014881 *&W1` * ***** APPROVED BY A" NPlans Examiner Zoning Structural Review Clerk (Revised02/24/2014) P N. ,o. 3 Dorchester Walk, Petit Halley, _ Trinidad, West Indies. Contact: (868) 299-4734. 5"' August, 2011. TO WHOM IT NLAY CONCERN This letter is to confu-m that 1, Randolph Gregory Charles, of the above address, am the owner of Apartment 8, 790 North East, 91S` Street, Miami, Florida, 33138, United States of America. I hereby authorize my uncle, Reginald Charles Fuller, of No. 10750 Forth West, 22nd Avenue Load, Miami, Florida, 33167, United States of America, to be my agent for my said Apartment. I also hereby authorize the said Reginald Charles Fuller to carry out all renovations, repairs and/or alterations to my Apartment including changing cupboards; electrical installations, wa:ing and/or tile works or whatsoever is required. Reginald Charles Fuller is also authorized to sign on any behalf any iaiimCsx!°c :oC>Ciaraiai?tstt�ion regwred foo obtaining any pe,.. ts) fvn' ¢lni �uaA renovations, repairs and/or alterations to be dove to my Apartment. If any further information is required, I can be contacted at any address and/or telephone number in Trinidad. ....-�j ...... .................... Randolph Gregory Charles Signed' by the above-named Randolph Gregory Charles (Republic of Trinidad and Tobago Driver's Permit No. 153724 E) in my presence at Second Floor, No. 55 Edward Street, Port of Spain, Trinidad, Fest Indies, this —S' 'day of August, 2011. FLORIDA SHORT-FORM INDIVIDUAL ACKNOWLEDGMENT Fs 699.25 State of Florida The foregoing instrument was acknowledged before County of 41-11"1-4�e me this day of (` Day Month ear J by Name of Person Acknowledging who is personally known to me or who has produced Type of Identification p , EVOKE P.JONES as identification. (' a, Notary Public-State of Florida ` My Comm.Expires Aug 22.2014 l Commission #EE 19695 Bonded'',rnu0h National Nntgrt.ss 9 n `' }— � / _ ��'` �__- , Notary Public c "�' ------yy Signatureof No ry Public Name of Notary Typed,Printed or Stamped Commission No. ( OPTIONAL Though the information in this section is not required by law, it may prove valuable to persons relying on the • ( document and could prevent fraudulent removal and reattachment of this form to another document. Top of thu b here i� Description of Attached Document Title or Type of Document: � �� '°yd P-7 moo (' Document Date: z Number of Pages: � Signer(s) Other Than Named Above: `�� C ` ©2000 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Prod.No.5181 Reorder:Call Toll-Fre 1-800-876-6827 c ' STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 WHITE,WINSTON THOMAS BLUEHILL ELECTRIC COMPANY, INC. 3680 NW 25 STREET LAUDERDALE LAKES FL 33311-2624 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and t Professional Regulation. Our professionals and businesses range y 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 EC13005406 ISSUED: 08/16/2016 to serve you better. For information about our services,please log onto www.myfforidalicense.com. There you can find more CERTIFIED ELECTRICAL CONTRACTOR information about our divisions and the regulations that impact WHITE,WINSTON THOMAS you,subscribe to department newsletters and learn more about BLUEHILL ELECTRIC COMPkNY 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 IS CERTIFIED under the provisions of Ch.489 FS. serve your customers. Thank you for doing business in Florida, and congratulations on your new license! Expkafim daW:AUG 31.2018 LISM16000M DETACH HERE RICK SCOTT.GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, + ELECTRICAL CONTRACTORS LICENSING BOARD " EC13006406 cam : The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. � " Expiration date: AUG 31, 2018 IN 21 WHITE,WINSTON THOMAS BLUEHILL ELECTRIC COMPANY, INC. F r 3680 NW 25 STREET LAUDERDALE LAKES- -FL 33311-2624 ® 9 B ISSUED: W16/2016 DISPLAY AS REQUIRED BY LAW SEa# L1608160002821 BROWARD COUNTY LOCAL�BUSINESS 115 S. Andrews Ave., Rm.A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 il VALID OCTOBER 1,2016 THROUGH SEPTEMBER 30,2017 1 DBA: Receipt#*EL CTRIBCAL/ALARMS/CONTRA IR Business Name:BLUEHILL ELECTRIC CO INC Business Type:(MASTER ELECTI/BURG/FIRE ) Owner Name:WINSTON T WHITE Business Opened:11/01/2002 Business Location:3680 NW 25 ST State/County/Cert/Reg:EC 13005406 LAUDERDALE LAKES Exemption Code: Business Phone:954-410-2688 ! Rooms seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 I THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality 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: WINSTON T WHITE Receipt #05C-15-00005914 3680 NW 25 ST Paid 09/02/2016 27.00 LAUDERDALE LAKES, FL 33311 r �� 2016 . 2017 �l