EL-18-1949Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. EL-7-18-1>949
Permit Type: Electrical - Residential
Work Classification: Low Voltage
Permit Status: APPROVED
sue Date: 7126/2018
Expiration: 01/22/2019
Parcel Number
Applicant
671 NE 105 Street
Miami Shores, FL 33138-2053
1122310120100
Block: Lot:
CAROL INVEST USA INC
Owner Information
Address
Phone
CeII
CAROL INVEST USA INC
671 NE 105 Street
MIAMI SHORES FL 33138-
(305)747-3098
671 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
CASSIA ELECTRICAL CONTRACTOR: (954)650-5840 (954)274-6277
Valuation:
Total Sq Feet:
$ 6,000.00
0
Type of Work: INSTALL LOW VOLTAGE LINES FOR DATA
Additional Info: INSTALL LOW VOLTAGE LINES FOR DATA
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$3.60
$3.15
$2.10
$1.20
$210.00
$3.00
$4.80
$227.85
Pay Date Pay Type
Invoice # EL-7-18-68285
07/19/2018 Credit Card
07/26/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 177.85
$ 177.85 $ 0.00
Available Inspections:
Inspection Type:
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 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. Fut. - . re, I authorize the above -named contractor to do the work stated.
July 26, 2018
Authignature: Owner / Applicant / Contractor / Agent
Date
Build • Department Copy
July 26, 2018
1
l
(5\C)
BUILDING
PERMIT APPLICATION
I IBUILDING
ELECTRIC
n PLUMBING MECHANICAL
JOB ADDRESS: 671 NE 105 St.
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
n ROOFING
RECEIVED
CV(
19 2018
�-B"( fi
FBC 20
Master Permit NOXC" J ' f ? ` / 0Zgl
Sub Permit No. r',� tg' IQJ Q
REVISION EXTENSION LI RENEWAL
PUBLIC WORKS n CHANGE OF n CANCELLATION I I SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
Folio/Parcel#: 11-2231-012-0100
Occupancy Type: Load:
County:
Construction Type:
Miami Dade Zip: 33138
Is the Building Historically Designated: Yes
Flood Zone: BFE:
OWNER: Name (Fee Simple Titleholder): Carol Invest, USA
Address: 990 Biscayne Blvd. Suite 801
City: Miami
State: FI.
NO X
FFE:
Phone#:
Zip: 33132
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Cassia Electrical Contractors
Address: 8261 NW 48 St.
Phone#: 954- 650-5840
City: Lauderhill
Qualifier Name: Glenworth Walker
State Certification or Registration #: EC 13005907
State: Florida
DESIGNER: Architect/Engineer:
Address: 370 NE 101 St.
Victor Bruce
Zip: 33351
Phone#: (954) 650-5840
Certificate of Competency #:
Phone#: (305) 310-5030
city: Miami Shores State: FI. Zip: 33138
Value of Work for this Permit: $ 6,000.00
Type of Work: Addition
X
Alteration
Square/Linear Footage of Work: •
7 New
Description of Work: Install low voltage lines for data, tv, speakers
Repair/Replace I I Demolition
And ,. ,. ,
Specify color of color thru tile:
Submittal Fee $ Permit Fee $2/ 2,040 CCF $
Scanning Fee $ Radon Fee $ 2- C�
Technology Fee $
structural Reviews $
DBPR $ i S Notary $
Training/Education Fee $ Double Fee $
Bond $
TOTAL FEE NOW DUE $ I �=? • &
(Revised02/24/20i4)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Morteage 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 instaiiations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that ail 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, SIGNS, POOLS,
RIC, PLUMBING, }GP.S;
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC
OWNER'S AFFiDAViiT: i certify that all the foregoing information is accurate and that ail work will be done in compliance with all
applicable laws regulating construction and zcning.
'WARNING TO OWNiER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER V. IF YOU INTEND
TO ()STAIN AIN FINANCING, CONSULT WITH H YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
INicnes ro Applicant: As a condition to the issuance of a building permit with an estimated value exceeding S25000, 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 ceertifiea cop; 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 i5 issued. In the obsence o; such pasted notice. the
inspection will not be approved and 0 reinspection fee will be `:haraed.
Signature �� �.� • O .1zJ _L. 9 L
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of Z/ UL- / . 20 / , by
`7 C a< epi fy/%!.. , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED 6
Notary Public - State Of Florida
Commltelon . GG 010911
-My Comm. Expires Jul 19. 2020
Bonded through National Notary Assn
a5
Signature
CONTRACTOR
The foregoing instrument was acknowledged before�me this
____L_ _ day of �; if , 20.1 O - by
Gtae.i/62YTLi ( ei,reea; who is personally known to
J.;A or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Print: V111[ TJ
Seal:
i40,7zo/ y l Plans Examine.
Structural Review
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5. N o O
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Zoniit ° °'
Clerk
(Revi_ed02y24y20=4: