EL-17-1009 (2) Permit No. L-4-17-1009*
Miami Shores Village Permit Type:Electrical -Residential
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10050 N.E.2nd Avenue NE
{.�. " � Miami Shores 'r�� ' WorkC/assi>cativn:Addition/Alteration
,FL 33138-0000 PermsmitStaNs:APPROVED
Phone: (305)795-2204
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Issue Date:4/17/2017 Expiration: 1011412017
Project Address Parcel Number Applicant
672 NE 98 Street 1132060171780
Miami Shores, FL 33138- Block: Lot: CAROL INVEST USA INC
Owner Information Address Phone Cell
CAROL INVEST USA INC 990 BISCAYNE Boulevard
MIAMI FL 33132-
990 BISCAYNE Boulevard
MIAMI FL 33132-
Contractor(s) Phone Cell Phone Valuation: $ 1,800.00
CASSIA ELECTRICAL CONTRACTOR: (954)650-5840 (954)274-6277
.,.,._. ........ ._ . . ..__ �.m w,..�__............. Total Sq Feet: 0
Type of Work:WIRE NEW A/C UNIT AND ADD OUTSIDE S Available Inspections:
Additional Info:WIRE NEW A/C UNIT AND ADD OUTSIDE S Inspection Type:
Classification:Residential
Final
Scanning: 1 Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
Underground
W.W.
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $120 Invoice# EL-4-17-63666
DBPR Fee $3.38 04/17/2017 Credit Card $ 187.96 $50.00
DCA Fee $3.38
Education Surcharge $0.40 04/11/2017 Credit Card $ 50.00 $0.00
Permit Fee-Additions/Alterations $225.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $237.96
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 zoning. Futhermore, I authorize the above-named contractor to do the work stated.
April 17, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department"Copy
April 17, 2017 1
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