EL-16-1106Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
179 NE 94 Street
Miami Shores, FL 33138-
Owner Information
Ciassilleatiota
Stat€rs.APPROV
Address
Parcel Number
1132060132930
Block: Lot:
Expiration: 11/06/2016
Applicant
JON & CYNTHIA KAWACHIKA
Phone
Cell
JON & CYNTHIA KAWACHIKA
179 NE 94 Street
MIAMI SHORES FL 33138-2821
(305)758-0927
Contractor(s) Phone
INDUSTRIAL ELECTRICAL SYSTEM C 305/228-1384
Cell Phone
Valuation:
Total Sq Feet:
$ 1,400.00
0
Type of Work: ELECTRICAL WORK FOR INTERIOR RENOVA
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.25
$2.25
$0.40
$150.00
$3.00
$1.60
$160.70
Pay Date Pay Type
Invoice # EL -4-16-59523
05/10/2016 Credit Card
04/25/2016 Credit Card
Amt Paid Amt Due
$ 110.70 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
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 zp g. Futhermore, II horize the above-named contractor to do the work stated.
1
Auth ed S gF(ature`Uwnej) / Applicant / Contractor / Agent
Building Department Copy
May 10, 2016
Date
May 10, 2016 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION RI90
FBC 20
Permit No. G - J
Master Permit No. �� (-1I
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): Jon & Cynthia Kawachika Phone#:
Address: 179 NE 94 ST 33138-2821
City: Miami Shores
State: Florida zip: 33138-2821
Tenant/Lessee Name: Phone#: 305-' b3 2 - 5 (Tr
Email: JJ ,L &ct e .zed"
JOB ADDRESS: 179 NE 94 STREET
City: Miami Shores
Folio/Parcel#: 11-3206-013-2930
County:
Miami Dade Zip: 33138-2821
Is the Building Historically Designated: Yes
NO x Flood Zone:
CONTRACTOR: Company Name: Industrial Electrical Systems Corp Phone#: 305 388-4648
Address: 14050 SW 84 ST 206
City: Miami
State: FL zap:33183
Qualifier Name: Nestor I. Coma Phone#: 305 388-4648
State Certification or Registration #: EC1 3 002182 Certificate of Competency #:
Contact Phone#: 305 388-4648 Email Address: iesflorida0comcast.net
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 1,400.00 Square/Linear Footage of Work:
Type of Work: DAddress DAlteration ONew ORepair/Replace ODemolition
Description of Work: Interior renovation.
Submittal Fee $ • Permit Fee $ `5 " CCF $ ° ° CO/CC $ fQ
Scanning Fee $ 3 - ( Radon Fee $ a DBPR $ Bond $
Notary $ Training/Education Fee $ (J ° Technology Fee $ C)
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ b
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDMONERS, 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
Signature o , d ,z' CiV et%l��
r Agent Contractor
The foregoing instrument was acknowledgedbeforeme this The foregoing instrument was acknowledged before me this 18th
day of--- P' • — 20-4 , by (Jon • ✓ /?a4 45i . day of April , 20 16, by Nestor 1 Corvea
who is personally known to me or who has produced F4--44 who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: r_CA.Y'�Wetii
My Commission Expires:
APPROVED BY
Notary Public state of Florida
8 H+�Lachapel
+.� v My Commission DD FF08S114
.
@ Expires 01/22/2018
NOTARY PUBLIC:
Print: Francisco P. M. rales) • w :: Commission #FF 39767
�Ee My Comm. Exp. November'17, 2017
MyCommission Ex 1reS �1JT7/�iQrP'!�
P Thru National Assocation -Florida
FRANCISCO P. MORALES
a
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-Plans Examiner
Structural Review
(Revised 07/10/07)(Revised 05/10/2009)(Revised 3/15/09)
Zoning
Clerk