EL-16-2812 Permit Ara. -� 1 - 3'l 2
Miami Shores Village3ftdj7E? Elet>f1 �t IsC6J0ti
10050 N.E.2nd Avenue NE 1k ClaPOI-Private
Miami Shores,FL 33138-0000
..,. .
;.,. F'er7r71f_ tate A 'l�t�"t�'1 E6,;;
hN' e Phone: (305)795-2204
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issue late: 1112016 Expiration: 04629/2017
Project Address Parcel Number Applicant
9730 NE 5 Avenue Road 1132060171470
JOHN 8,MARIE PERIKLES
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
JOHN&MARIE PERIKLES 9730 NE 5 Avenue Road �(7�86)236-�0254
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,500.00
SHINE ELECTRICAL ENGINEERING (305)688-2000 Total Sq Feet: 1062
Type of Work:ELECTRIC FOR NEW POOL SPA Available Inspections:
Additional Info:ELECTRIC FOR NEW POOL SPA 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-10-16-61678
DBPR Fee $4.50 10/17/2016 Check#:300946 $50.00 $266.80
DCA Fee $4.50
Education Surcharge $0.60 10/31/2016 Check#:301019 $266.80 $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 thatAl the f e Ing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futherm ,I i the above-named contractor to do the work stated.
October 31,2016
Authorized Signa re:Owner / Applicant / Contracto / Agent Date
Building Department Copy
October 31,2016 1
Miami Shores Village 0cp2016
Building Department
artment _
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FRC 20AQ
BUILDING Master Permit No.9-3P P LL
PERMIT APPLICATION Sub Permit No. G 11(0 LZ
❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION E] EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION [] SHOP
y� 1 p CONTRACTOR DRAWINGS
JOB ADDRESS: -7 3� E— I`
City Miami Shores County Miami Dade 01 D:
Folio/Parcel#:I J -52 OSP o 1 , 1 A- -1 P Is the Building Historically Designated:Yes NO f
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Nx�✓ te—i t - rv; �'S Phone#.3RS-Z3(-O
Address:"17 3>A � 5 '&Lc— 0"A
City:
M r®I, v, �1���5 State: f"L— Zip: , 313 0
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: SHINE ELECTRICAL ENGINEERING Phone#: 305-688-2000
Address: 3876 NW 125 ST
City: State:State: FL Zip: 33025
Qualifier Name: FRANCISCO SANTOS Phone#: 305-688-2000
State Certification or Registration#: EC0001514 Certificate of Com peten #:
N _
DESIGNER:Architect/Engineer: ��`-'�'� M�✓ ��^'� Phone#: �� o(�3
Address: 2L'S � ���c�� �-! �lt,.,ot City: ter �t Stater— Zip: 4�
Value of Work for this Permit:$ �� 50� quare/ 'near Footage of Work:
Type of Work: ❑ Addition ❑ Alteration XNew ❑ Repair/Replace ❑ Demolition
Description of Work:El c�--r-v rc �'o r r1G ov (pQ S.p
Specify color of color thru tile:
Submittal Fee$ 45 c) Permit Fee$ F®&®d'4!9 CCF$ 1. �O CO/CC$
Scanning Fee$ 15 Radon Fee$ (4 ' S� DBPR$ CA • 6 ® Notary$
Technology Fee$ Training/Education Fee$
0 Double Fee$
Structural Reviews$ Bond$ C)
TOTAL FEE NOW DUE$ zxo
(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 of be approved and a reinspection fee will be charged.
Signature n Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
I � day ofA-e� ,20 <<r by day of - 20 t'-� by
who is personally known to FRANCISCO SANTOS who is personally known to
me or who has producedTL-DA C.S l.(CCS me or who has produced � as
identification and who did take an oath.ftOZA--*Ee-(At- identification and who did take a
N Y PUBLIC: NOT PUBLIC: YORLENYM.110INA-6
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`�y111i1tliru,F;. ` -. MY COMMISSION#FF 022108
Yoh(;✓�; e EXPIRES:September 27,2017
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APPROVED BY6 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)