EL-17-167 Permit NO, EL-1-17- 67
�sNO1S a,� Miami Shores Village Et—00 Type:Electrical-Residential
10050 N.E.2nd Avenue NE
Pertill
Work Classification:Addition/Alteration
Miami Shores, FL 33138-0000 Permit Status:APPROVED
h fa` Phone: (305)795-2204
��ORIDA
issue Date:2/211.2€117 Expiration: 08/20/2017
Project Address Parcel Number Applicant
1450 NE 103 Street 1132050310040
Miami Shores, FL 33138-2626 Block: Lot: VIKTORINEX, LLC
Owner Information Address Phone Cell
VIKTORINEX, LLC 1931 CORDOVA RD Road (305)647-6486
FT. LAUDERDALE FL
Contractor(s) Phone Cell Phone
Valuation: $ 18,055.00
FUSE ELECTRICAL INC (305)970-4379
... ., m �__ w, ..... .. ... _..... Total Scl Feet: 0
Type of Work:ELECTRICAL WORK AS PER PLANS INTERI Available Inspections:
Additional Info:ELECTRICAL WORK AS PER PLANS INTERI Inspection Type:
Classification:Residential Final
Scanning:3 Meter Box
i
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
W.W.
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $11.40
DBPR Fee Invoice# EL-1-17-62685
$9.48 01/23/2017 Check#:8296 $50.00 $ 1,272.22
DCA Fee $9.48
Education Surcharge $3.80 02/21/2017 Check#:407 $ 1,272.22 $0.00
Permit Fee-Additions/Alterations $631.93
Scanning Fee $9.00
Technology Fee $15.20
Work without Permit Fee $631.93
Total: $1,322.22
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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 ELECT CAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFI AV T: I certify that all the foing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an zo ing. Futhermore, I a � e the above-named contractor to do the work stated.
February 21, 2017
Authori Sig
nature:Owne Applicant / Contractor / ent Date
Buildin Department Copy
February 21, 2017 1
Miami Shores Village �
Building Department
BY
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 `
INSPECTION LINE PHONE NUMBER:(305)762-4949 j
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F//BC 2014
BUILDING Master Permit No.42� 1 (D — 161-5 j
PERMIT APPLICATION sub Permit No._6 1 l_=� 1(p -
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
f 0 1
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
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CONTRACTOR DRAWINGS
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JOB ADDRESS: Iia So Nx \O_z
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City: Miami Shores County: Miami Dade Zip: 33 I
Folio/Parcel#: 5?,0 S —O D4 O Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):\h r'0fll/�Qx LC_ Phone#:
Address: , 3 C;j r d Ove- QA :� k M
City: '' 0.0& f.x J041 State: Zip: 3)�o
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name:,Fu U S e elp-C�-y i C In C Phone#:
Address: LrC1�D 'S AG Cj
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City: kc)WA11ojoock State: li Zip: 330 —1
Qualifier Name: �;k(OA C-)v �ce,A Phone#:
State Certification or Registration#: �C� 3 00 So 10 Certificate of Competency#:
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DESIGNER:Architect/Engineer: Phone#:
Address: City: f State: Zip:
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Value of Work for this Permit:$ L, j�/ d ),(iy Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New )❑ Repair/Replace ❑ Demolition
Descriptionof Work: �� " �.U/\
-2�C�eo� 4 d.
Ali
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{ _ Specify.color of color'thru tile:
Submittal Fee$ Permit Fee$ h.��� `/� CCF$ CO/CC$
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Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ a Double Fee$
Structural Reviews$ Bond$
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TOTAL FEE NOW DUE$
(Revised02/24/2014)
! 2 42 .
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 fee will be charged.
g__�_,
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of\4 20 by 1�day of CI�U 20 Q ,by
�o t(a Yv l\\(O�Gl who is personally known to li,10A G o�IQ/t ho is personally known to
me or who has produced &944bCk as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC:
1 NOT
ARY PUBLIC:
Sign• Si n
PL, I
P r it t: ,,,,�� P �L Print: �a 1 Q
• •! ANA MAR SIERRA
I a „6�. 1 MY COMMISSION#FF 224104
My Comm.Expires Oct 16.2018 ; +-
Seal: ' ' • '- Seal:
Commission H FF 135660 = ' o EXPIRES:April 23,2019
50 BondedThruNotaryPublicUnderwriters
Bonded Through National Notary Assn:
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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