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EL-19-156Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 01/31/019 Location Address Parcel Number 102 NW 101ST ST, Miami Shores, FL 33150 1131010220210 Contacts Permit No.: EL-01-19-156 Permit Type: 8ectrical - Residential Work Classification: Service Change Permit Status: Approved Expiration: 07/22/2019 ALVINA GUEVARA Owner BENSON ELECTRIC Contractor 102 NW 101 ST, MIAMI SHORES, FL 331501214 JAMES CLARK 10475 SW 186 ST, MIAMI, FL 33177 Business: 3052356741 Description: SERVICE REPAIR - CHANGE 3 EXISITNG SMALL Valuation: $L00.00 Inssection Re uests: PANEL INTO ONE PANEL AND CHANGE OUT SERVICE RISER 305-762-4949 WIRES AND WEATHER HEAD . UPGRADE SERVICE GROUNDTotalSq Feet: 00 ALSO. Fees Amount Application Fee - Other $50.00 CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $111.90 Payments Date Paid Amt Paid Total Fees $111.90 Credit Card 01/23/2019 $50.00 Credit Card 01/31/2019 $61.90 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 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. Futhermore, I authorize the above named contractor to do the work stated. L od �1 ,4 oliLS Authorized Signature: Owner / Applicant / Contractor Date January 31, 2019 Page 2 of 2 :P \� BUILDING PERMIT APPLICATION ❑BUILDING �LECTRIC Miami Shores Village 7JAN Building Department 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�� b� Master Permit No. EL d �'� I ' I S Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS [:]CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �' N �►`+ / 0 15 I City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: ( 1 -?�/al -OZZ-" 02-10 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): V //J7Q /7 C ��iE VAf-A Phone#: Address: 102 n! G(/0 ! City: Mm m l' State: *7L,4>7e-4'PA Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: I.: � Z"")`J Z�ie-,a c� � C Phone#: C � � - 6'�! Address: ! 0� ,7-S JamW / 8 C. City: 1Vii��c / State: rfooe-i �'�4 zip: -3r� ,-Y7 Qualifier Name: )4-- (!A"-K- Phone#: State Certification or Registration M G C, Certificate of Competency #: _ DESIGNER: Architect/Engineer: /C.1/rQ Phone#: _ Address: City: State: txJ Value of Work for this Permit: $ 2 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ERepair/Replace Zip: n Demolition Specify color of color th u tile: Submittal Fee $ 5 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 $ �% I l7 (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 Zip City State 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 after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature ! ,. ttmX", OWNER or AGENT The foregoing instrument was acknowledged before me this day of 120 by Y/;M 1u-"?ZV 7LA wh is personally known to me or who has produced identification and who did take an oath. NOT --Sign Print Seal Signature o -H 74� 6"b 0, CONTRACTOR The foregoing instrument was acknowledged before me this day of u 20 r 9 by who is personally knownAq- a---- as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign Prins Seal hWeAPPROVED BY / l / Plans Examiner Structural Review r-y Zoning Clerk (Revised02/24/2014) Ron DeSan is, Governor Halsey Beshears, Secretary dbpr i STATE OF FLORIDA DEPARTMENT OF BUSINES&AN PROFESSIONAL REGULATION .,. ELECTRICAL-C r�.4t,`RS E SING BOARD THE ELECTRICpcL CO`RA t C,�TfdkiERErIV-1S CERT�IF UNDER THE PROVISION v CH'TER489-F��A ,STAB UTES K - ENS —TRIM INC 4 . � i0475 S ,18'6 .a ST .F,.3 •5-7='67,1f. a�;3y �C aka M s EXPIRATIONh®`ATE dxA GUST 31, 2020 Always verify licenses online at MyFloridaLicense.com a ir, !Aa Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. • 006679 Local Business Tax Receipt Miami —Dade County, State ofFlorida -THIS IS NOT A BILL - DO NOT PAY 6878657 BUSINESS NAME/LOCATION BENSON ELECTRIC INC 10475 SW 186TH ST MIAMI FL 33157 LBT RECEIPT NO. txr Inca RENEWAL SEPTEMBER 30, 2019 7153794 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED BENSON ELECTRIC INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR f00000025 $75.00 07/27/2018 ECHECK-18-204302 � Worker(s) 1 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles —Miami—Dade Code Sec ga-276. I. 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