ELC-18-1599Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. ELC--18-1599
Permit Type: Electrical - Commercial
Wort Classification: Low Voltage
Permit Status: APPROVED
IssueDate: 6/22/2018
Expiration: 12/19/2018
Parcel Number
Applicant
9501 NE 2 Avenue
Miami Shores, FL 33138-
1132060133920
Block: Lot:
DVS LLC
Owner Information
Address
Phone
CeII
DVS LLC
201 NE 95 Street
MIAMI FL 33138-
(305)756-3711
201 NE 95 Street
MIAMI FL 33138-
Contractor(s) Phone CeII Phone
WELL ELECTRIC TECHNOLOGY (305)726-7098 (786)473-8455
Valuation:
Total Sq Feet:
$ 1,500.00
0
Type of Work: LOW VOLTAGE OUTLETS
Additional Info: LOW VOLTAGE OUTLETS
Classification: Commercial
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.25
$2.00
$0.40
$150.00
$3.00
$1.60
$160.45
Pay Date Pay Type
Invoice # ELC-6-18-67888
06/22/2018 Credit Card
06/11/2018 Credit Card
Amt Paid Amt Due
$ 110.45 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
i
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: � certithat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zo)n Eui)aermoj I authorize the above -named contractor to do the work stated.
Authorise nature: Own ' / Applicant / Contractor / Agent
June 22, 2018
Date
Building Department Copy
June 22, 2018 1
BUILDING
PERMIT APPLICATION
❑ BUILDING ELECTRIC
❑ PLUMBING ❑ MECHANICAL
JOB ADDRESS: 9541/ ge
City: Miami Shores
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type: Load: _ Construction Type: Flood Zone: BFE:
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
RECEIVED
JUN 112018
sr h
FBC20ttk
Master Permit No. ('C -/? ' Z/5
Sub Permit No. € CI C wl
❑ ROOFING ❑ REVISION
❑ PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
z �v
> OWNER: Name (Fee Simple Titleholder):
Address:
93
1City: a r 1,.
Tenant/Lessee Name: Phone#:
Email:
County: Miami Dade
VS
State:
❑ EXTENSION ❑RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
Zip: 23138
NO
FFE:
Phone#:70
Zip: L 3
CONTRACTOR: Company Name:' WLIL/ �.beefr c 7 .if Phone#: to - 9I - 32,V
Address: «.3/2 Al 4a l` c.'6
City: /,9 . / State:
Qualifier Name: 7Q4
State Certification or Registration #: LC , 3 2 ////
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $ / Soo. a 0
Zip: 3.Ji2,6
Phone#:
Certificate of Competency #:
Phone#:
City: State: Zip:
Square/Linear Footage of Work:
Type of Work: ❑ AdditiontiAlteration n New �❑ Repair/Replace ❑ Demolition
Description of Work: L' GL,r /-,�% f
"0:., ,. s ...'. e tJ.i .:r
Specifycolor of color thru tale
Asir.. _.•:s:a:, ->.e ,-c. ♦w _ _ _ . KW^1•<.C-S
Submittal Fee $ Permit Fee $ l
Scanning Fee $ Radon Fee $
Technology Fee $
Structural Reviews $
Training/Education Fee $
CCF $ .,CO/CC $
.
DBPR$.,_......�.�.. Notary$
Double Fee $
Bond $ TOTAL FEE NOW DUE$ j 1 0 I
us
(Revised02/24/2014)
Y
Bonding Company's Name (if applicable)
•
rf
Bonding Company's Address
City i 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. , 4�, t N.
\
"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 b •�:;:. ve• an. a r '� • ction fee will be charged.
Signature
OWNER or AGENT
ti•l t i\- "-
The foregoing instrument was acknowledged before me this
g day of _ ,20 / ,by
7)&V S4__ea(1(akQ &(, who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
•
y.\
Signature c/O" J + .V.' .'v '(
•
v CONTRACTOR .,,
The foregoing instrument was acknowledged before me this
, Q 44 . day of - g 6 , 20 / c , by
70/7 frjJ , who is personally known to
me or who has produced
identification and who did take"an oath.
NOTARY PUBLIC:
Sign: _-4/ /Zr e' �' _` . Sign:
Print:
Seal: 1 liv "r ELIZABETH ELORRIAGA Seal:
•' MY COMMISSION *I FF953636
„'•�• EXPIRES January 25.2020
Me:n�
iMBen ****'1'�>`i i` ,*****
Print: ��isz.se,-Li loran'
***********
APPROVED BY
/, ,rze,i-9 Plans Examiner
Structural Review
as
1T
i+.
r
MARIA DE LA FE
MY COMMISSION 6 GG 117058
EXPIRES: June 26, 2021
Banded Tlvu Notary Pubic Underwriters
Zoning
Clerk
(Revised02/24/2014)