EL-18-3355Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date:11/13/2018
Parcel Number
Permit No.: EL-11-18-3355
Permit type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 05/01/2019
1 85 NW 103 ST, Miami Shores, FL 33150-1233 1121360131080 1
Contacts
DM INVESTMENT SERVICES LLC Owner DM INVESTMENT SERVICES LLC Applicant
85 NW 103 ST, MIAMI SHORES, FL 33150 85 NW 103 ST, MIAMI SHORES, FL 33150
Other:7864735959 Other:7864735959
FREEMAN'S CONSTRUCTION & Contractor
ENGINEEERING GROUP INC
GUILLERMO A ALONSO
10610 SW 146 PL, MIAMI, FL 33186
Business: 7863370665
Description: NEW ELECTRICAL RE-CONECTION Valuation: $ 300.00 Inspection Requests:
Total Sq Feet: 2,500.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Payments
Date Paid Amt Paid
Total Fees
$110.30
Check # 534
11/13/2018 $60.30
Check # 501
11/02/2018 $50.00
Amount Due:
$0.00
Building Department Copy
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 require^r ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFFIAV : I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
g c� s u o regulatinn and zoning. Futhermore, I authorize�the 3bove named contractor to do the work stated.
Owner / Applicant / Contractor / Agent
Date
November 13, 2018 Page 2 of 2
Miami Shores Village
Building Department R C�
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 N 0 V O 2 18
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 BY:
BUILDING
PERMIT APPLICATION
❑BUILDING VELECTRIC ❑ ROOFING
FBC 20 IZ rr h
Master Permit No. q —i n— 2"z3 g"�
Sub Permit No.LLlCl.--
3
❑ REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: qS 11 1� V cJ sT
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:
OWNER: Name (Fee Simple Titleholder):
City: I %,%
State:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: V \
Address: \ A
City: \\
Qualifier Name: \V m
L
p:
Zip: `'53`� (I1
hone#: (4le 71'7- G(� (,K
State Certification or Registration #: �C 1� �� Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: City: State:
Value of Work for this Permit: $ (7) Square/Linear Footage of Work:
Type of Work: ❑ Addikon ❑ Alteration — ❑ New ❑ Repair/Replace
Description of Work:
Zip:
❑ Demolition
Specify color of color thru tile:
Submittal Fee $,5b 1 Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $ {�� -30
1
(Revised02/24/2014)
r
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 w ich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be ap�yed and a reinspection fee will be charged.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of d*144'f46re . 20 160 , by
r
o is personal y known to
me or ho has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
Sea I:
Signature —q�
CONTRACTOR
The foregoing instrument was acknowledged before me this
t�
O day of Of, 20 V� by
IA 6\)' 0, �Nwho is personally known to'
me�or who has produced as
identifi
NOTARY
Sign:_
Print:
fdY CAMMISSION # GG 2092?5 Seal:
o EXPIRES: Juiy ; 2, 2022
Bonded Thru Notary FubUc Undinw ftm
nd who did take an oath.
V
Commission # GG 1233>I�
Expires July
ew" Tt" v rater ' "
************************************************************************************************************
APPROVED BY ��'%L 8,v��-!g Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
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 k_%_-„`�3�'a Electrical Permit N:
At Address: Miami Shores, FL
For Owners: %k , and is being given only for
construction purpose or for testing the following equipment in said
structure:
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
P.ancellation 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
Occupa or Completion. Note: Failure to comply with the provisions of this affidavit will result in your
being able t m future Temporary for Test permits.
being first duly sworn, depose and say that I am the owner of the
ab e s ibed property, d that I agree that the structure covered in this agreement shall not be occupied
til the buildigconfor has obtained approval of final inspections and/or obtained Certificate of
Occupancy ofn. Note: Failure to comply with the provisions thisbeing ufuture Temporary for Test permits. �''" p MAMFERNANDEZ
MY COMMISSION # GG 209275
EXPI` 2022
SignaSignature/,iWNWw#BondW Tbm Notary Pub, rs
I, y , being duly sworn, depose and say that I am the Electrical Contrac Q i
the above -described p operty and that the electrical installations as now Jjwfilll
,a 1
if tem ora ervice is connected., ,.•••.• `.a�►r> °�':
* o�
'Expires ��
Signature of Electrical Contractor Signat e : ----
I, ��tOb�S 4 `
�.FAW� , being first duly sworn, depose and say that I am the Building Contractor
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 appthe inspection division
obtained and that I have the authority insofar as the owner of said property is c to prohibit occupafcy
unti ch final inspections are obtained and/or a Certificate of Occupancqli�
n is iWA�
� '� Commission # GG 2021
Expires Juty 11, 2021
gnatulre of Building Contractor Signatu e o otary
Signature
Signature of Notary