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EL-18-240 Permit No, FL- -18-240 Miami Shores Village Permit Type:Electrical -Residential 10050 N.E.2nd Avenue NE Work Classirication:Temp for Test Miami Shores,FL 33138-0000 Permit'StBt(rs:APPROVED Phone: (305)795-2204 F+!ORtDA issue nate:21112018 Expiration: 07/31/2018 Project Address Parcel Number Applicant 1420 NE 103 Street 1132050310030 MARC AND ANNE LITZENBERG Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MARC AND ANNE LITZENBERG 1420 NE 103 Street MIAMI SHORES FL 33138- 1420 NE 103 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 QUINTANA ELECTRIC BROTHERS IN( (305)986-5893 (305)681-5317 Total Scl Feet: 0 Type of Work:30 DAY TEMPORARY ELECTRICAL SERVICE Available Inspections: Additional Info:30 DAY TEMPORARY ELECTRICAL SERVICE Inspection Type: Classification:Residential Final Scanning: 1 Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-1-18-66281 DBPR Fee $2.00 DCA Fee $2.00 02/01/2018 Credit Card $58.60 $50.00 Education Surcharge $0.20 01/30/2018 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 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 for4ELECT ,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS Athat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructionuthermore, I authorize the above-named contractor to do the work stated. February 01, 2018 Au orized Signature:Owner / Applicant / Contractor / Agent Date Build ng Department Copy February 01, 2018 1 Miami Shores Village - 7"2018 AN Building Department10050 N.E.2nd Avenue,Miami Shores, Florida 33138BTel:(305)795-2204 Fax:(305)756-8972 -f INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No94 --3 PERMIT APPLICATION Sub Permit No. 4f/- ❑BUILDING P-ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR D RAW I NGS JOB ADDRESS: ILIZ() 0 T 1:2 1., ST City: Miami Shores r County: Miami Dade Zip: X31 Folio/Parcel#: �/�y��3j ��J,�i� Is the Building Historically Designated:Yes i NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: OWNER:Name(Fee Simple Titleholder): .J;rZyPhone#: r Address City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: �f � /��y, �`G Phone#: Address: ,�2 ©� C J� �r City: o�L J State: T Zip: 3 y Qualifier Name: 4/�-.At (/� i�� Phone#:1�E2S`' State Certification or Registration#:�V d ��, Certificate of Competency#: DESIGNER:Architect/Engineer: - Phone#: Address: City: State: Zip: Value of Work for this Permit:$11% '02-y Square/Linearvkootage of Work: ypetgf'r`I17br f ❑ Addition ❑ Alteration New }�5,[ Rl p/ai� eplace ❑ Demolition Descriptionof ilV k r •3i' ''u � � 1! r3 i 150100f colo�`of color thru tile:00 ';# S_ubmittal,Fee$L Permit Fee$ ©� O� CCF$': ?r CO/CC$ `14";d'";y .'nf""5' Scanning Fee$ Radon Fee$ 2 ' �A DBPR$ 2 6 Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ -^ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ S�D (Revised02/24/2014) 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. p "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." r 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 Abeapprd and a reinspection fee rill be charged. 1 r Signature Signature OWNE rAGEN/gedbefore CONTRACTOR T e foregoing instrument w ackno me this The forgoing instrument was acknowledged before me this 6 day of (�VLV4y-a 20 It by'` 1(�— day of ��a`r"� 20 V by who is personally known to uCcnz who is personally known to a— me or who has produced as me or who has produced as *dentin and who did take an oath. identification and who did take an oath. BLIC: �� T ARY PUBLIC: `# T Qy�� sSign` � •'; ar- 10, Print: :*.Print: q� 6 y _ �•� *� Seal: •�•�,�°�Wdtla�� p- Seal: *GG 137M At �tv AW owl" APPROVED BY '��i��1B Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �a r `SNOR s Miami Shores Village n Building Department ■ogo 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 ORiDp' Fax: (305) 756.8972 AFFIDAVIT FOR 30 DAY TEMPORARY-ELECTRIC SERVICE NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED. It is understood that the temporary-electrical approval by the Miami Shores Village, Building Department given in connection with the building being constructed under: Building Permit N: G L� �� 2 Electrical Permit N: /-- /^� , At Address: Miami Shores, FL For Owners: , and is being given only for construction purpose or for testing the following equipment in said structure: The owner does herby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and r-ancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of ie building concerned'is occupied before final inspections are approved and/or obtained a Certificate of Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will result in your bei unabl t obtain future Temporary for Test permits. I, c etVIr being first duly sworn, depose and say that I am the owner of the abo6. described property, nd that I agree that the structure covered in this agreement shall not be occupied until the building contractor has obtained approval of final inspections and/or obtained a Certificate of oFy 1,6� Occupan f C oompletion. No allure to comply with the provisions f�this ffi vit will resu5��° P1p10 being `' bt ' ure Temporary for Test permits. Seo 1, � pueLL� VGO��\5N°J� �"S Signature of Owner Signature of Notary.'— a being duly sworn, depose and say that I am 16__Electrhe 1Contract 'x,,16` the bov de cribed roperty and that the electrical installations as now istin ill o create a sf k0: to 1 if t ry ice is c nected. o�4SS °je -Am's, seo\ N p?! M�G Q\�g Si re of Electrical Contra for Signature of Notary 1, r c orbit , being first duly sworn, depose and say that I am the Building Cori 0KOW ,O20 of the above described prop and that I will not permit occupancy of this building until final inspectio ' - .,o been called for by the contractors and sub-contractors concerned and final approval the in obtained and t a I have the authority insofar as the owner of said propefV1 con rned to pt' pc�cy until such fin pections are obtained and/or a Certificate of Occupanr Cople ' n is iss F�� 7 gnature of Ir ng Contractor Signature of ot, r Signature of Inspector Signature of Notary