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EL-18-1358�st'O1s L,� Miami Shores Village 10050 N.E. 2nd Avenue NE " Miami Shores, FL 33138-0000 Phone: (305)795 2204 FtORib Project Address 1201 NE 96 Street Miami Shores, FL 33138-2553 Information POL ZAZADZE Permit No. EL-5-18-135 Permit Type: Electrical - Residential Pennimt Work Classification: Temp for Test Permit Status: APPROVED Parcel Number 1132060143830 Block: Lot: Address 1201 NE 96 Street MIAMI SHORES FL 33138- 1201 NE 96 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone M F H 2O01 INC (954)347-0852 of Work: temp for test onal Info: temp for test ification: Residential ling: 1 Fees Due Amount CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee -Add itions/Alterations $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 Valuation: $ 100.00 Total Sq Feet: p Pay Date Pay Type Amt Paid Annt Due Invoice # EL-5-18-67607 05/18/2018 Credit Card $ 50.00 $ 58.60 06/01/2018 Credit Card $ 58.60 $ 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 SWIMMING POOL work. OWNERS AFFAVIT: I certify that all foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a d z ning!7uthe.Kore, I utho above -named contractor to do the work stated. Building nature: Owner / Applicant / partment Copy Contractor / Agent June 01. 2018 June 01, 2018 1 Miami Shores Village R (_1 Building Department M Y 1 2 tg 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 By: — Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No.9,Ct6' 1684 PERMIT APPLICATION Sub Permit No. EL 116 — I3 SS ❑BUILDING W ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �` o CONTRACTOR DRAWINGS JOB ADDRESS: _ _ 20 iV ! 6 A cLe City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 1112 () (-O ( 'f 3q 3 O Is the Building Historically Designated: Yes NO Occupancy Type: 2 Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 2e -30 -710 - Z16S . Address: kEo ( W E 9 6 S IY a 4+ City: M ( k w S State: f-z _ Zip: 3 ( 3 c9 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: V F k- 1,o o 1 _ Phone#: ':2 8 G cj~% 93 Address: w 6 A112,A v c City: .^-4u \ vi c t State: Zip: �302 Qualifier Name: 1y��D O'w as Phone#: State Certification or Registration #: E-r-- QCO! S 4 ~Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: o� Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: �a hn ,n✓ G S Specify color of color thru tile: Submittal Fee $ � OIC Permit Fee $ ld © CCF $ CO/CC $ Scanning Fee $ Technology Fee Structural Reviews $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding'Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 llding permit is iss�ed. In the absence of such posted notice, the inspection will not be approved and a reinspect' fee will bed ed. Sign � Sienature OWNER or AGE The foregoing instrum nt was acknowledged before me this 6 day of 20 [ 5 ' by GLo, c' 1 who is personally known to me or who has produced 0Z as identification and who did take an lath. NOTARY TLO Sign: r--J Print: em q'te (=QA AJ Seal: aeV n0 Notary Public State of Florida Dennis Lefton Pp MY Commission GG 073635 *************** APPROVED BY CONTRACTOR The foregoing instru ent was acknowledged before me this day of A 20 Ilk by ve who -is personally known to me or who has produced D / as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: � Notary Public Stets of Florida Dennis Lefton • or n Exp Commission pti15/2021 073835 ******************************** Plans Examiner Structural Review 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: a G — (a— 1 � A 6 & (f Electrical Permit N: At Address: 0 1 N 6 Miami Shores, FL Z:3 For Owners: T r,7 —z , and is being given only for construction,purpose or forrtesting the following equipment in said structure: 4 �Qc.1w c Jtz►�„'� f_ The owner does herby agree 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 ie 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 being nable to obtain future Temporary for Test permits. I, �� 9 G'Lc-Z-e _,being first duly sworn, depose and say that I am the owner of the above described property, and that I agree that the structure covered in this agreement shall not be occupied until the building contractor obtain approval of final inspections and/or obtained a Certificate of Occupancy of Completio . Note: F ' re to comply with the provision this davit wilesult in your being unable to obtain ut emporary for Test permits. y� 1 Signature of Owner ( 11 tiWature I, 00 o �v ns , being duly sworn, depose and say that I am the the a ve-de cribed property and that the electrical installations as now exi g wi if temp rary rvice iscnnected. of Efctrical Contractor Si oa,Y oy I, � i— , being first duly sworn, depose and say that I of the above described property and that I will not permit occupancy of this building been called for by the contractors and sub -contractors concerned and final approval obtained and that I have the authority insofar as the owner of said property is concerned to until such fi inspections are ob ained and/or a Certificate of Occupanc o Com etion is gnature of klildit Contractor SI ature o o -i . t. Notary Public State of Florida I =r919073635 Notary Public State of Florida iftmg ife'i=tractor 40MWAV915 hibit occupancy aed. NobW Public State of Florida Dennis Lelton MY Commission GG 07'M5 Signature of Inspector Signature of