ELC-18-1680Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Parcel Number
Permit NO. BLC-6-18-1'680
Permit Type: Electrical - Commercial
Work Classification: Addition/Alteration
Permit Status: APPROVED
t$ a Date: t12012tt1
Expiration: 12/17/2018
Applicant
1540 NE 105 Street Number: B-12
Miami Shores, FL
1122300530240
Block: Lot:
FREIDHELM SCHOCK
Owner Information
Address
Phone
Cell
ADELE SCHOCK
1540 NE 105 ST UNIT B-12
MIAMI SHORES FL 33138-2116
Contractor(s) r
ELECTRICAL MASTERS INC
Phone
305-265-7996
Cell Phone
Valuation:
Total Sq Feet:
$ 800.00
0
•
Type of Work: REPLACE AND NEW LIGHTS FOR BATHROOM
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF -
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$3.38
$2.25
$0.20
$225.00
$3.00
$0.80
$235.23
Pay Date
Invoice #
06/20/2018
06/19/2018
Pay Type
ELC-6-18-67977
Credit Card
Cash
Amt Paid Amt Due
$ 185.23 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
W. W.
Underground
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 a
construction and zoning. Futhermore,
foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
the above -name contractor to do the work stated.
/ Applicant / Contractdr / Agent
Authorized Signature: Owner
June 20, 2018
Date
Building Department Copy
June 20, 2018
(0\\°\.(6
0G\Jk
BUILDING
PERMIT APPLICATION
BUILDING K] ELECTRIC
❑PLUMBING El MECHANICAL
JOB ADDRESS: 1 540 ;Li
City: Miami Shores
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
I I
ROOFING
PUBLIC WORKS
ECG
County:
Co
FBC 20 (
Master Permit No.GC- 1- 16 - RS G
Sub Permit No. -=-L ( 9 _1 G2
REVISION Li EXTENSION
❑ CHANGE OF ❑ CANCELLATION
CONTRACTOR
v mac- -\ Z
Miami Dade
(RENEWAL
❑ SHOP
DRAWINGS
Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type:
Load:
DESIGNER: Architect/Engineer:
Address: ,,��City: State: Zip:
ff��
Value of Work for this Permit: $ /,� 1 00 Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration n New Repair/Replace ❑ Demolition
NO
(CConstructtiion Type:
c Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): (� '`�id WC\ (,C , (�► 'lam VOl�P
r hone#:5
Address: C 6Lt0 ^' t S s- ` \
05123-z2g ?i•
City: _a`ek4lLc- " State:
Tenant/Lessee Name: F / e4/
Email: S 4v(,�/< FP e OL
CONTRACTOR: Company Name: ekfccvig:A\ (Nr c7- _
Address: q22_3
City: V.JL,-VIN`: tate: Zip:
Qualifier Name: e 41-\ 60 �� I! a Phone#: 6j 3 -7 / 329. C
C� 00 State Certification or Registration #: , mO6 ` Certificate of Competency #: q-7£00000
Phone#:
Zip:/�J.33t5a
Phone#:307 / 2 S
786 36702q G.
Phone#:
Description of Work:
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 7 d0 CCF $ 22
Scanning Fee $ Radon Fee $ 2 • ZS DBPR•J6
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
CO/CC $
Notary $
TOTAL FEE NOW DUE $
VS
(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.
"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.
Signature
OWNER or AGENT
The foregoing instrument wa cknowledged before me this
l U day of 20 6 , by
Fried n�1n(I C eeg , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
Sign:
Print:
Seal:
l�P
(
xra"r"1"1e,, RODRIGUEZ
;s Notary Public - State of Florida
•'', ° Commission # FF 956580
lily
%'r�r.►F-d,,FLsa;Q My Comm. Expires May 12, 2020
'''°, , Bonded . '4 XYAs.i/fi
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me his
1 ` day of -q(MZ , 20 , by
✓a1do r tje1,,who is personally known to
me or who has producet' as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
�`RY
""A,; D ,RIS ROc EDRIGUEZ
a ,`c ; Notary Public - State of Florida
7.
a M = Commission # FF 956580
"� My Comm. Expires May 12, 2020
'''' , .0.0 Bonded through National Notary Assn.
*************************************************************
APPROVED BY /`� %lr�i�L«J / ' Plans Examiner
Zoning
Structural Review Clerk
oaffj aez-
(Revised02/24/2014)