EL-17-1732 it 0-
Type,* C
`s�3fls t, Miami Shores Village P@lirtt� ��" � 0
10050 N.E.2nd Avenue NE %j � ServloithaoO
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Miami Shores,FL 33138-0000 z � �� � �., ( .
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A Phone: (305)795-2204
„� � �. t7 2 t7 Expiration: 0110312018
Project Address Parcel Number Applicant
89 NE 102 Street 1132060131690 PALOMA TEPPA
Miami Shores, FL 33138-2322 Block: Lot:
Owner Information Address Phone Cell
PALOMA TEPPA 89 NE 102 Street
MIAMI SHORES FL 33138-2322
89 NE 102 Street
MIAMI SHORES FL 33138-2322
Contractor(s) Phone Cell Phone Valuation: $ 2,430.00
SHINE ELECTRICAL ENGINEERING (305)688-2000
�..... ,.... y. .� ...., ___..._.. ..__ _..,.�... ._ ._,... ..�.�.. _..u... Total Sq Feet: 0
Type of Work:SERVICE CHANGE CONVERT FPL SERVICE Available Inspections:
Additional Info:SERVICE CHANGE CONVERT FPL SERVICE Inspection Type:
Classification:Residential Review Electrical
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80 Invoice# EL-7-17-64489
DBPR Fee $2.25 07/05/2017 Credit Card $50.00 $118.30
DCA Fee $2.25
Education Surcharge $0.60 07/07/2017 Credit Card $ 118.30 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $168.30
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,PLUMBIN ,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFID VIT: I certify t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and onin Futhe e,I authorize the above-named contractor to do the work stated.
July 07,2017
A horized S' natur .Owner / 4pplicant / Contractor / Agent Date
Building ep mentopy
July 07,2017 1
Miami Shores Village RE
CEIVEp
Building Department JUL 05 7p17
10050 N.E.2nd Avenue, Miami Shores,Florida 33138 t�10 n
Tel:(305)795-2204 Fax:(305)756-8972 S
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No. ( �-9 3 Z
PERMIT APPLICATION Sub Permit No.
BUILDING Q ELECTRIC ROOFING REVISION ❑ EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL Ej PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 89 NE 102 Street
City Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3206-013-1690 Is the Building Historically Designated:Yes NO
Occupancy Type: Residential Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Paloma Teppa Phone#: IWO -268' i005
Address: 89 NE 102 Street
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: N/A Phone#:
Email: Yair@plantthefuture.com
CONTRACTOR:Company Name: Shine Electrical Engineering Phone#: 305-688-2000
Address: 3876 NW 125 Street
City: Opa Locka State: FL Zip: 33054
Qualifier Name: Francisco E. Santos Phone#: 305-688-2000
State Certification or Registration#: EC0001514 Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ZiW 3O' o 6 Square/Linear Footage of Work:
Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Service Change» Convert FPL service from overhead to underground / Install new
meter and panel on the west corner of the house.
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ /37-0e 4P0 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ (9 `
(Revised02/24/2014)
Bonding Company's Name(if applicable) NIA
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 reins will be charged.
Signature
Signature Si g
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
�-1 day of �v�� 20 ,by 0� day of � - 20 O by
�4'byn-a i e� c- ,who is personally known to `(Ail DISC® .S(11Y1 who is personally known to
6ya 4,_ Yv%veo S UL&v)S'.
me or who has produced 'TI eo-Upo 1 a-1' O as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARYSPUBL C; NOTARY PUB
Sign: l' `®® v Sign:
00 Print:
fiFFI'��uo Q
s 1 seal: .��� A: Commission#FRM54
• " s`' ° ` ="• Expires: June 24, 2020
Bonded#IN Alm NOW
APPROVED BY Sid Ig �,J. Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)