EL-16-3242Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. EL -11-16-3242
Permit Type: Electrical - Residential
Work Classification: New
Permit Status: APPROVED
Issue Date: 3/31/2017
Expiration: 09/27/2017
Parcel Number
Applicant
Owner Information
BRANDON SIMON
Address
162 NE 106 Street
MIAMI SHORES FL 33138-
162 NE 106 Street
MIAMI SHORES FL 33138-
Phone
Cell
Contractor(s) Phone
SHINE ELECTRICAL ENGINEERING (305)688-2000
Cell Phone
Valuation:
$ 1,500.00
Total Sq Feet: 950
Type of Work: ELECTRIC FOR NEW POOL
Additional Info: ELECTRIC FOR NEW POOL
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
$4.50
$4.50
$0.40
$300.00
$3.00
$1.60
$315.20
Pay Date
Invoice #
11/30/2016
03/31/2017
Pay Type
EL -11-16-62205
Check #: 301071
Check #: 301416
Amt Paid Amt Due
$ 50.00 $ 265.20
$ 265.20 $ 0.00
Available Inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
Underground
W. W.
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, ROOFI G and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is acc r4 and t
construction and zoning. Futhermore, I authorize the above-named cont cjair to do
rk will be done in compliance with all applicable laws regulating
stated.
Authorized Signature: Owner / Applicant / Contrac
Building Department Copy
ent
March 31, 2017
Date
March 31, 2017
1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
0BUILDING • ELECTRIC 0 ROOFING
FBC 20 (L--1
Master Permit No. 65 PP 1(0- Z(--(
Sub Permit No. - �32LI2
REVISION ❑ EXTENSION ❑RENEWAL
[]PLUMBING ❑ MECHANICAL 0PUBLIC WORKS Ej CHANGE OF
CONTRACTOR
JOB ADDRESS: ( (' Z i4 -F (p
City:
Folio/Parcel#:
Occupancy Type:
Miami Shores County:
12 1 ?.c, CD05 c c
0 CANCELLATION 0 SHOP
DRAWINGS
Load:
Construction Type:
Q
Miami Dade Zip: 33( `
Is the Building Historically Designated: Yes NO •
OWNER: Name (Fee Simple Titleholder): �' p^
Address: 1 2 i -1 ( n Le
si
Flood Zone:
.1‘ N 1 ..Jr:7'/1
BFE: FFE:
Phone#: Le - O LP 2, 5� (
City: Ill got i S h ✓ c State:
Tenant/Lessee Name:
Email:
Zip: 33 ! 3�
Phone#:
CONTRACTOR: Company Name: SHINE ELECTRICAL ENGINEERING
Address: 3876 NW 125 ST
Phone#: 305-688-2000
City: OPA-LOCKA State: FL
Qualifier Name: FRANCISCO SANTOS
zip: 33025
Phone#: 305-688-2000
EC0001514 Certificate of Competency #:
State Certification or Registration #: P cY
Fc,i r= 1-----4 �cn' e c -y'/1 Z35Z9-j
DESIGNER: Architect/En ineer:JJ Phone#:
Q—c�1
Address: (� Cit ('State: FC --Zip: .5 13 2_
_
Value ofWorkWork four thi�r t / 5 Square/Linear Footage of Work: �'(=j
Type of Work: ❑ Addition E Alteration New ❑ Repair/Replace El Demolition
y ski Z L) Pc:, ) 1.
Description of Work. EL l
Specify color_'of
Submittal Fee $
color thru•tile:
• is
. 1
„dU;b
'L.
P Pin` Permit Fee $ 9dt''e dG
Scanning Fee $ Radon Fee $ `f •�
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
,"
CCF $,,- _j� CO/CC $
PRPR $ ` 4 - `-+ Notary $
Training/Education Fee $ V " V Double Fee $
Bond $
TOTAL FEE NOW DUE $ 2(95 !`
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) da ,iter the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspec on fe ill be charged.
Signature
OWNE
NT
The foregoing instrument was acknowledged before me this
xDI•1
day of N .DV(- 1, 20 C , by
Spersonally known to
—Signature
The foregoing instrument was acknowledged before me this2-4 y
day of l 4- '\' X20 (CP by
FRANCISCO SANTOS
me or who has produced tel- - C--;icclLme or who has produced
identification and who did take . o. h.
, who is personally known to
identification and who did take an oat
NOT NOTA . V n„
I
IA1 l .1
__
-� M. HER
ill ""�'� 11FF022108
;t EXPIRES: September 27, 2017
,R(„ • Bonded fire Notary Public Underwlters
Y PUBLIC.
Sig ' .�� /lei— Sig
Print:
Seal:
as
Print:
Seal:
Aka*';- orf ; MY COMMISSION
N • FF 0 210
EXPIRES: SSIOW � FF 022
Ez
September27, 2017
Bonded TtxUNot&YPutdic
hers
***************************************************************************************************
G/‘ Plans Examiner
APPROVED BY
(Revised02/24/2014)
Zoning
Structural Review Clerk