EL-17-969 ��;F rtir . t�` 47-969
Miami Shores Village Permit it Type:Electrical-Residential
arc 10050 N.E.2nd Avenue NE Wwk,cfa f/cation.Addition/Alteration
Miami Shores,FL 3313&0000
. 'Permit Status.,APPROIl46::
Phone: (305)795-2204
�'Cfl1ttDA '�-
s �; ,:4)2, 612011, Expiration: 10/23/2017
Project Address Parcel Number Applicant
157 NE 101 Street 1132060131951
Miami Shores, FL Block: Lot: RACHEL&COLIN RILEY
Owner Information Address Phone Cell
RACHEL&COLIN RILEY 157 NE 101 Street (716)807-1312
MIAMI SHORES FL 33138-
157 NE 101 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone $ 600.00
Valuation:
JULIO ELECTRIC CORP 786/346-7597
Total Sq Feet: 0
I!
Type of Work:INSTALLATION OF LIGHTS AND REPLACEM Available Inspections:
Additional Info:INSTALLATION OF LIGHTS AND REPLACEM 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-4-17-63614
DBPR Fee $2.25 04/06/2017 Credit Card $50.00 $ 109.10
DCA Fee $2.25
Education Surcharge $0.20 04/26/2017 Credit Card $ 109.10 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
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 as a responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for AzFuthenmore,
PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS Aertthat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction I authorize the above-named contractor to do the work stated.
April 26, 2017
orized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
April 26,2017 1
Miami Shores Village RECEIVE
Building Department APR 06 2011
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION UNE PHONE NUMBER:(305)762-4949 S
FBC 201U
BUILDING Master Permit No. (2.
PERMIT APPLICATION Sub Permit No.eA
❑BUILDING ELECTRIC ❑ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL
❑PLUMBING ❑MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 10167- s/��z�
City: Miami Shores County: Miami Dade Zoo:
Folio/Parcel#: 11- 3?-04-013-1q61 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: / FloodZone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):&IW �Xe � S L/�vky 122/eq Phone#: V6-807-1317-
Address: 15? /to/ T LOX
City:16, yi S ha/2� State: o(- Zip: �-
Tenant/Lessee Name: Phone#.
Email:
CONTRACTOR:Company Name: ` v\``� C'Z:)C� Phone#: E.K>�
Address: � 3l c
City: we& VON-V , -State: EL Zip: 2'�3,
Qualifier Name: ��` �'® V10 1/0 Phone#:
State Certification or Registration#: 00 01
Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ _ __ Square/Linear Footage of Work: %5
Type of Work: ❑ Addition ® Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work: y � �T e� /� 21d j?,00/ ,oseGCjj &E
specify color of color thm We:
Submittal Fee$ Permit Fee$ �'��v�°� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
(09 ° 10
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 V'w Signature
OWNER or AGEIU ONTRACTOR
The JJforegoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
y —dayof A 1p- CZ 1 � 20 �_ by �t day of A i��, � 20 l- by
FA- AJ-1-2, who is personally known toJy1� � i'J�SC� who is personally known to
me or who has produced �Ri��IC ;cam �' as me or who has produced �-as Y�
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: c�U�
r �g
Print �� , , ��i Cci iC Print u ✓ `C> "KC�� 1�
- ANTULIO S MONTIEL
Seal: ANTULIO S MONTIEL Seal. = MY COMMISSION#GG014780
'Jz MY COMMISSION#GG014780 " . EXPIRES July 24,2020
EXPIRES July 24,2020
ssssssssssssssi4ssssssssssssassssssssssssss sssssssssssssssss ass:ssssssssssssssssssssss
APPROVED BY /r4&� kke& Plans Examiner Zoning
_. .._ ...... .. _.._.. - . -----
RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY
-STATE_OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRYLICENSING BOARD,. °
+ C.FC1426383 -
The'PLUMBING_C0NTRACT0R- .b,
Named below LS CERTIFIED _.a
Under the pr&isionS Of Chapter 489 FS,. R�
Expiration date:- AUG 31.f 2018
AL-ASA;ROBERTO,
MALUIPLUIIIIBINGA(C
11155 1XORA GT#20s�
"NORTH MIAMI '� F181
1�'t�' SL�•, i `�4 `� �r .k R+»"�2.Ffi� 1 ■
r "
I
ti
ISSUED: 07/11/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1607110000626
004223
Local ,Busine s Receipt-.-
Mlami.=Dade County;State of Florida
-THIS IS NOT°A'BILL-Do NOT PAY
r
5443619
.RECEIPT.NO. EXPIRES.,:
SUsI NEsti'NAME,LocAT1oN= RENEWAI,
MAI,u PLUMaING INC SEPTEMBER 30 2017
13155 IXORA CT 206 5683355 "Must bee-displayed at plica of business'
d -Pursuant to County Coda
NQRTH MIAMI FL 331$1 f Chapter 8A,=Art.9 8i 70
SEC.TYPE.OF BUSINESS PAYMENT RECEIVED
OWNER 196 PLUMBING CONTRACTOR !-
MALU PLUMBING INC BY TAX COLLECTOR
CFC7426383 $45.00 08/09/2016
Worker(s) 1 CHECK21-16-110690
This local Business Tax Receipt only confirms payme�it of the Local Business Tex The Receipt is not a license,
permit,or a.certification of the holder's qualifications,to do business.`,'Holder must comply with any governmental
or aongovemmeMal regulatory laws and requirements which apply to the busiRoss,
"The RECEIPT N0.above must be displayed on all commercial vehicles-Miami Dade Code,Sao 8a-276,
For more information,visit miemidade aov/taxcollectar
JEFF ATWATER
CHIEF FINANCIAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS'COMPENSATION
•`CERTIFICATE OF ELEC71ON TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW••
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law.
EFFECTIVE DATE: 1/3/2017 EXPIRATION DATE: 1/3/2019
PERSON: ALASA ROBERTO
FEIN: 300065332
BUSINESS NAME AND ADDRESS:
MALU PLUMBING,INC.
13155 IXORA CTAPT 206
NORTH MIAMI FL 33181
SCOPES OF BUSINESS OR TRADE:
LICENSED PLUMBING
CONTRACTOR
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