EL-18-1539Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. cEL-6-18-1539
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 6/15/2018
Expiration: 12/12/2018
Parcel Number
Applicant
671 NE 105 Street
Miami Shores, FL 33138-2053
1122310120100
Block: Lot:
CAROL INVEST USA INC
Owner Information
Address
671 NE 105 Street
MIAMI SHORES FL 33138-
671 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
CASSIA ELECTRICAL CONTRACTOR: (954)650-5840 (954)274-6277
Phone
Cell
Valuation:
$ 2,800.00
Total Sq Feet: 565
Type of Work: LIGHTING, SWITCHES IN 2 BATHROOMS,
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$1.80
$3.38
$2.25
$0.60
$225.00
$3.00
$2.40
$238.43
Pay Date Pay Type
Invoice # EL-6-18-67809
06/05/2018 Credit Card
06/15/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 188.43
$ 188.43 $ 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: I certify that all the foregoing informatio
construction and zoning. Futhermore, I authorize the above-n
Authorized Signature: Owner
Building Departme
ccurate and that all work will be done in compliance with all applicable laws regulating
ontractor to do the ork stated.
June 15, 2018
/ Contractor / Agent
Date
June 15, 2018 1
BUILDING
PERMIT APPLICATION
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
Master Permit No.
Sub Permit No.
Fac zo 1'r���
ie 15399�
(BUILDING (X ELECTRIC n ROOFING ❑ REVISION EXTENSION El RENEWAL
❑PLUMBING (i MECHANICAL Li PUBLIC WORKS ❑ CHANGE OF n CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 671 NE 105 St.
City:
Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 11-2231-012-0100 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Carol Invest, USA Phone#:
Address: 990 Biscayne Blvd. Suite 801
city: Miami State: Fl. Zip: 33132
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: 8261 NW 48 St.
Cassia Electrical Contractors
Phone#: (954) 650-5840
City: Lauderhill state: Florida
Qualifier Name: Glenworth Walker
Zip: 33351
Phone#: (954) 650-5840
State Certification or Registration #: EC 13005907 Certificate of Competency #:
Phone#: (305) 310-5030
city: Miami Shores state: Fl. Zip: 33138
DESIGNER: Architect/Engineer:
Address: 370 NE 101 St.
Victor Bruce
Value of Work for this Permit: $ 2.800.00 Square/Linear Footage of Work: • 565 Sq. Ft.
Type of Work: D Addition n Alteration ri New ❑ Repair/Replace I Demolition
Description of Work: Lighting, switches in 2 bathrooms, kitchen as per plan
Specify color of color tiiru tile:
Ll
Submittal Fee $ r Permit'Fee $ '5 m0 71:CCF i CO/CC $
Scanning Fee $ ` Ra'don'Fee$'"
Technology Fee $ Training/Education Fee $
Structural Reviews $
DBPR Notary.$
Double Fee $
Bond $
TOTAL FEE NOW DUE $ V
(Revised02/24/2014)
Bonding Company's Narr a (if applicable)
Bonding Company's. Address
City State Zip
Mortgage Lender'sName (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. lcertify' 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. 1 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 withan estimated value exceeding $2500, the applicantmust
promise in good faith thata'copy of the notice 9f commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of thi 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 appro ed and a reinspection fee will be charged.
Mar
Signature
• OWNER .rAGENT
The foregoing instrument was acknowledged before me this
VI day of- JV� , 20 1 O
Marco Brozz,i
, who is p
me or who has produced
- identification and who did take an oath.
NOTARY PUBLIC:
, by
Seal: ,,7'
•��!.>=,,,,,.,,,,
LUCIA G ISASI
ti '• MY COMMISSION #FF182628
..***
.. . EXPIRES December 10, 2018
******** **************************>********
(407) 398-0153 FtgriclaNctaryService.com
]�
-fglans Examiner
Signature
Glenworth Walker
CONTRACTOR
The foregoinginstrument was acknowledged before me this
014 day of .. J V .. > , 20 , by
to /PrJtJen�M G✓/¢ e"L 'who is personally known to
as me or who has produced W L12(D 2‘g" (DO37c 0 as
identification and who did take an oath.
t
NOTARY PUBLIC:
APPROVED BY
t3� •
Sign:c.C.��/t
Print: Lu Gj • 1SQSt
Seal:
*
ot
off'":°`... LUCIA G ISASI
)• "MY COMMISSION #FF182628
*
** % *******RES De****b**r *0, 2018 4
(407) 398-0153 FloridallotaryService.com
Structural Review
************
Zoning
Clerk
(Revised02/24/2014)