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ELC-18-2252Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit NO. EL.C-8-'18-2252 Permit Type: Electrical - Commercial Pe Itw Classification: Temp for Construction Permit Status: APPROVED Parcel Number Issuie Date: 8/27/2018 Expiration: 02/23/2019 Applicant 9501 NE 2 Avenue Miami Shores, FL 33138- 1132060133920 Block: Lot: DVS LLC Owner Information Address Phone Cell DVS LLC 201 NE 95 Street MIAMI FL 33138- (305)756-3711 201 NE 95 Street MIAMI FL 33138- Contractor(s) WELL ELECTRIC TECHNOLOGY Phone CeII Phone (305)726-7098 (786)473-8455 Valuation: Total Sq Feet: $ 200.00 0 Type of Work: TEMPORARY TEST FOR CONSTRUCTION. Additional Info: TEMPORARY TEST FOR CONSTRUCTION. Classification: Commercial Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Invoice # ELC-8-18-68648 08/27/2018 Credit Card 08/22/2018 Credit Card Amt Paid Amt Due $ 58.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Review Electrical 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 S ' ING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is ccurate d t or /will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-nam Authorized Signature: Owner / Applicant / .tetra .r' / .ent tated. August 27, 2018 Date Building Department Copy August 27, 2018 1 a 3 v 12 Miami Shores Village ()0A 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 REC JVED UG222018 BY- FBC 20 BUILDING Master Permit No. C-6 c la-Z/5 PERMIT APPLICATION Sub Permit No.r (�// C.S7.e//cfg PLC✓ (e - 0- 5 2_ BUILDING LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 0 RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �) / CONTRACTOR DRAWINGS JOB ADDRESS: 7 $ 1 /?/ � C� City: Miami Shores County: Miami Dade Zip: /. Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:4COWNER: Name (Fee Simple Titleholder): T/1l� revs-- - .o ` i'S2 Phone#: " %•S /'— 2,Z ,6 Address: �� / �/ C Cf55` ► iii-- City: I `f7 la It CkW ve State: Zip: 5/ S Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Wai �,�i� z. �-Qk t� Phone#: 3a � 7(�c9� Address: V3/2 4/LU //sue / City: it/M/77 State: � Zip: f3/ Qualifier Name: /i/ a/ZIZI Phone#: 10.51 79 ea-? State Certification or Registration #: e-'e/fOe,Asy Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Z 49 a ao Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration . New ❑ Repair/Replace ❑ Demolition Description of Work: PA/MY eeliC do-Ov e•eef6VC-A;1 _.. .4 1 ..* . ,.... .,y.,4.rw N...R.�a+N�✓ *too l.syyR:. Specify color of color thru tile: • Submittal Fee $ Permit Fe $;' '©mi Scanning Fee $'"""` "`'"`"'• —Raclon•fee 2 _ Technology Fee $ Training/Education Fee $ Structural Reviews $ t '^_•4 CCF$` ?. t'aeY t pCO/CC$ DBPRi$ $ Double Fee $ Bond $� TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Adflress City . .e - State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address` City ' State Zip e 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 p?operty 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 ap • ..lied -area reinspec io ' 1 be charged. Signa Signature OWNER AGENT CONTRACTOR fl he foregoing instrent was acknowledged before me this The foregoi umng instrument was acknowl dged before me this zZ day of ' �~ U 1' 1, 20 / q , by / day of �lj A & 7 , 20%_J by A.V- ' £'�� r ho is personally known to j�J�,� who is personally known trl me or Who has produced 1 as identification and who did take an oath. NOTARY PUBLIC: Sigrt: Print: Seal: p'" "1; ELIZABETH ELORRIAGA •~ MY COMIStVCCOMA. EXPIRES Janiwy 25. 2020 Hot, 308-0' 53 Flordal4o a $e,,c# i . APPROVED BY • me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Plans Examiner as Structural Review Ai I :fe MARIA OE LA FE i ' . MY COMMISSION it GG 117056 . Bonded Thru Notary Public Etc c� Zoning Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 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: C C " g- 17" a(5(0' Electrical Permit N: a At Address: Qb 0 I 1J6 a Afit Miami Shores, FL 33133 For OwnerW P rP — l "Q Cpa, and is being given only for constructiorf purpose or for testing the following equipment in said structure: T,e,c-f -rVi The owner does herby a�ree 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 cancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of le 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 unable t• • btain future Temporary for Test permits. rec-4-- amrr.G-P , being first duly sworn, depose and say that I am the owner of the above • - ribed property, and that I agree that the structure covered in this agreement shall not be occupied until e bu . • contractor has obtained approval of final inspections and/or obtained a Certificate of Oc' upa • 140 ',,letion. Note: Failure to comply with the provisions of this affidavit will result in your b in • •• • Ie to,• •kilo ture Te I • • rary for Test permits. •i:- EUZAUYH 11I.O1414 bein I, 4 the� above -described p if teipi orary se MY COMMISSION a FF95 ZIP+ attire of Notary • EXPIRES January 25. , beinc. dlu)i iworn, deactisfioat4.5.ay that I am the Electrical Contractor for perty and that the electrical installations as now existing will not a safety hazard onnected. ✓yre,af_e-- Signe of Electrical Contractor MARIA DE LA FE MY COMMISSION # GG 117058 EXPIRES: June 26, 2021 ,..:_ . . ^_<- . _ m. _.._ Publfc u nrtitws "� GZebiocci - - . and say that I am the Building Contractor I, of the above described property and that I will not•permit occupancy of this building until final inspections have been called for by the contractors and sub -contractors concerned and final approval by the inspection division obtained and that I have the authority insofar as the owner of said property is concerned to prohibit occupancy until such final inspections are obtained and/or a Certificate of Occupancy or Completion is issued. Signature of Notary n61 2`-alntlici?' NILDA LOPEZ I MY COMMISSION # GG0566: .t ".. EXPIRES December 20, 202 li nature o gnature of Building Contractor Notary Signature of Inspector Signature of Notary