EL-17-807Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. EL -3-17-807
Permit Type: Electrical - Residential
Work Classification: Service Change
Permit Status: APPROVED
Issue Date: 4/3/2017
Expiration: 09/30/2017
Parcel Number
Applicant
162 NE 106 Street
Miami Shores, FL
1121360050030
Block: Lot:
BRANDON SIMON
Owner Information
Address
Phone
Cell
BRANDON SIMON
162 NE 106 Street
MIAMI SHORES FL 33138-
162 NE 106 Street
MIAMI SHORES FL 33138-
Contractor(s)
Phone CeII Phone
DONALD MARESE ELECTRIC INC (954)630-6910 (954)630-6910
Type of Work: REPLACE EXISTING MAIN SERVICE , REM
Additional Info: REPLACE EXISTING MAIN SERVICE , REM
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
55.40
$4.46
$4.46
$1.80
$294.50
$9.00
$7.20
$326.82
Pay Date Pay Type
Invoice # EL -3-17-63436
03/23/2017 Cash
04/03/2017 Check #: 1384
Amt Paid Amt Due
$ 50.00 $ 276.82
$ 276.82 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
1
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 AFFID VIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructi.n and•ening. /Futhrmore, I authorize the above-named contractor to do the work stated.
( J .rrnnQ
A th
ized Signature: Owner / Applicant
Building Department Copy
April 03, 2017
Agent
April 03, 2017
Date
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
❑ BUILDING Q ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL [2 PUBLIC WORKS
JOB ADDRESS: 162 North East 106 Street
9Th
FBC 20 14
Master Permit No. Y P 16 —324
Sub Permit No.tl 11 — 801
❑ REVISION ❑ EXTENSION EI RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#:11-2136-005-0030 Is the Building Historically Designated: Yes NO
Occupancy Type: Res Load: Construction Type: Exst Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Brandon S Simon / Julio Alonso Medina Barbosa phone#:916-662-5661
Address:162 North East 106 Street
City: Miami ShoresState: Florida Zip: 33138
Tenant/Lessee Name: Owner Phone#:916-662-5661
Email:
brandon_simon21@yahoo.com
CONTRACTOR: Company Name: Donald Marese Electric Inc
Address: 2722 Thomas St
Phone#: 9546306910
City: Hollywood
Qualifier Name: Donald Marese
State: Florida
Zip: 33020
Phone#: 9546306910
State Certification or Registration #: EC 13002571AA Certificatej�of Competency #:
DESIGNER: Architect/Engineer: 3 • • is A fr (Ltt i4- l vrin Vre CA2r. Phone#: `fib A-2 es •-- y3��
Address: f S S « .C1(r LA- , ]uJC., i' City: Ph t �tf State: / Zip: -3/4/s
Value of Work for this Permit: $
(.S.. Square/linear Footage of Work: ----
Type of Work: ❑ Addition ❑ Alteration 0 New El Repair/Replace ❑ Demolition
Description of work: Replace existing main service, remove overhead service lateral, pipe to FPL
across alley to allow for construction of new pool. Subcontract to cut and patch alley.
c' y
Specify color of color thru tile:
G,�J7 7 ys y�c-a
Submittal Fee $ 5 0 Permit Fee $ -q , b - CCF $ _ •( Q/ 0�, colas
Scanning Fee $ Radon Fee $ Cf • Ct W DBPR $ Cr/Cif YNotary $
Technology Fee $ .- - ZO Training/Education Fee $ 1 • 7560 Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
Zs Z
TOTAL FEE NOW DUE $ Z R- '
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 be charged.
•
Signature
.•01iP:i1111.11111041A— Signature
OWNER o
lPIPIIIP
CONTRACTOR
The foregoing instrument was acknowledged before me this Theforegoing instru 64:;e14(41
t Iw�as�Jack�nowledged before me this
2 2_ day of P h , 20 26/7 , by 26p day of 647
R141J, 21) S • S/mor✓ , who is personally known to d� tMArfAA-
me or who has produced j1—) (z_tvell. Lrt (# as
5 5'3z, O �'7 ,f', ( (-
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
,;�': 4'• EMMANUEL REGIS
IS, MY COMMISSION # EE 877007
-
jiF ,,• BondedEXPIRES: Thru NotaryApril Pub c 14 Unde2017rwriters
########################*####**###
APPROVED BY
(Revised02/24/2014)
#############
20
ersonally know
by
0
me or who has produced as
identification and who did take an oath.
NOTA :Y
PUBLIC:
Pri I�OC'•
:MA.—.........-Alirg, (Y14— �20•.18� ',446
�.
Sig �<o;#1
313
fission # F
#######################################*#################
Plans Examiner
Zoning
Structural Review Clerk