EL-18-200X ".RCS
Miami Shores Village
10050 N.E. 2nd Avenue NE
"'
Miami Shores, FL 33138-0000
Phone: (305)795-2204
F�ORLOp'
Permit No. ELA-18-200
Permit Type: Electrical - Residential
Pen ' Work Classification: Low Voltage
Permit Status: APPROVED
Issue oats:1/2612018 1 Expiration: 07/25/2018
Project Address Parcel Number Applicant
1569 NE 104 Street 1122320320160
ALAIN &CARLY GONZALEZ
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
ALAIN & CARLY GONZALEZ 1569 NE 104 Street (786)277-9756
MIAMI SHORES FL 33138-
1569 NE 104 Street
MIAMI SHORES FL 33138-
Contractors) Phone Cell Phone
A&B ELECTRICAL SERVICES OF FLO (786)302-1175
of Work: PRE WIRE FOR TV, WIFI, SOUND AND CA
onal Info:
ification: Residential
Scanning: 1
Fees Due
Amount
CCF
$2.40
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee - Additions/Alterations
$150.00
Scanning Fee
$3.00
Technology Fee
$3.20
Total:
$163.65
Valuation: $ 3,500.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-1-18-66238
01/25/2018 Credit Card $ 50.00 $ 113.65
01/26/2018 Credit Card $ 113.65 $ 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. Futher e, I autho ize the above -named contractor to do the work stated.
Wt January 26, 2018
Authorized Signatuu6: Owner / Applicant / Contractor / Agent
Building Department Copy
January 26, 2018
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
issue Date: 01/26/2018
Location Address Parcel Number
1569 NE 104 ST, Miami Shores, FL 1122320320160
R
Contacts
Permit NO.: L-1-18-200
Permit Type: Electrical - Residential
Work Classification: LOW Voltage
Permit status: Approved
Expiration: 06/04/2019
ALAIN & CARLY GONZALEZ Owner ALAIN & CARLY GONZALEZ Applicant
1569 NE 104 ST, MIAMI SHORES, FL 33138 1569 NE 104 ST, MIAMI SHORES, FL 33138
Mobile: 7862779756 Mobile: 7862779756
ADVANCED ELECTRICAL INNOVATIONS Contractor
JOSEBARROSO
8334 NW 56 ST, DORAL, 33138
Business: 7863021175
Description: PRE WIRE FOR TV, WIFI, SOUND AND CAMERA ON Valuation: $ 3,500.00 Inspection Requests:
THE 1ST FLOOR AND 2ND FLOOR OF HOUSE. 305-762-4949
Total Scl Feet: 0.00
Fees
Amount
CCF
$2.40
Change of Contractor
$110.00
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee - Additions/Alterations
$150.00
Scanning Fee
$3.00
Technology Fee
$3.20
Total:
$273.65
Building Department Copy
Payments
Date Paid
Amt Paid
Total Fees
$273.65
Credit Card
01/26/2018
$113.65
Credit Card
12/19/2018
$110.00
Credit Card
01/25/2018
$50.00
Amount Due:
$0.00
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 authonze the above med contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
December 19, 2018 Page 2 of 2
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR / ARCHITECT
Permit N. F-L' V6---2-0Z)
Owner's Name (Fee Simple Title Holder): 4.4AIfi y ONZ'q«L
Owner's Address: /5 6 i N is 1 q t1 d'
City:A. m) S-Xii-tar
State :
Phone #: 72 6 f! 7S-4
Zip Code: 33> 3 �?
Job Address (Of where work is being done): %S� 7 ' L� 1044,rr
City: Miami Shores State: —Florida Zip Code: 33>�
Contractor's Company Name: /4` /3 �,�, Phone #: % G w ����i - yl✓
Address: 3 61T0 0 4 AVE
City: State: Zip Code: 33012
Qualifier's Name: 4A,1 A fZ-11-'X r 010C &.0la) Lic. Number: r' /_rb4le-411V37b
Architect/ Engineer of Record Name:
Address:
City:
Describe Work: r�7-�—t(6 — s o -o
State:
Phone #:
Zip Code:
hereby certify that the work has been abandoned and/or the contractor/architect
is unable or unwilling to complete the contract. I hold the Building Official and the
Miami Shores harmless of all le al i olv ment.
Signature C� Signature
Owner or Agent Contractor or Architect
The foregoing instrument was aknowledged before me
this L� day of VIC— 120by IOW (0O4�U1Lk1-
Who is onally kn to me or wh\\\�OjpmoNbed
gIV efm defi%f cation.
Notary Public: �Q� �6 20�op4/9� „� M
Sign:
Seal: o*'. gFEg5A1�`44zz
.
The foregoing instrument was aknowledgedRR before me
this day oft"LC • 20 bWLtItS 3
wh ' personally known me or who has produced
as indentification.
Notary Public:
Sign: dhim
11SSy ARIoN IMORN OnOM paWo9
Seal: 3
61ff i ndossaildx }yo YY ;Ir
d68 iStl �o� _ • ,
epuol4 to aleiS • ollgnd A�eloN :�,a .,� _
Z3lVZDIQ9 NIV /q••���'!1 ;",,,,
Miami Shores Village RECEIVEV
6 'Id' D
UI Ing epartment fl .�19 29
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 S
FBC 201y
BUILDING Master Permit No. Ric I-) 15� 5
PERMIT APPLICATION Sub Permit No. F—LI �__cl;zloo
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
� l CONTRACTOR DRAWINGS
JOB ADDRESS: 1 �(S� 9
City: Miami Shores County: Miami Dade Zia: 3�13
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Al h% ly �,i1 LALC -, Phone#: I E) ` d�7 /'`
Address:/ f � A) Es' A) f
City: �/ )A h') fX bjZ� State: / -& Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: '40y'*1✓ 'T0 1/✓.f/d1m-7-1n)�1 Phone#: e r yf� �?I'4
Address: 9 33 y I" .S6 ,ram
City:
Qualifier Name:
Zip: 31/f z
Phone#: _7,56 - i719-1— J
State Certification or Registration #: 45-6 - f 3d0rP11 / Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
412r 17jV
Address: City: State: Zip:
Value of Work for this Permit: $ Jl� 4�n Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: _PAeLlm 4''i7 !/� �/ ` v2
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $
Structural Reviews $
h().oD
Training/Education Fee $
CCF $
CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ � `� 'a')
(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 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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of F,,-. , 20 by
A--44r-�i GTJn1ZI41---who is perco-n-5-57k—n—ovin to
me or who has produced as
identification and who did take an oath. B
NOTARY PUBLIC: I A
4C
EJ :pON
t0 •
�
rn X•
1/011IIlN11%Oxx
APPROVED BY
Signature %u lJ�//jiG✓�'Ld
CONTRACTOR
The foregoing instrument was acknowledged before me this
1 1� day of 1DkQE4-n 96f'� , 20 iC2�:, by
—SO-) c5 '�, --z' who is personally known to
me or who has produced' c V �i�_� as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
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
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLI ATION
❑BUILDING ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS
J N 25 01�
BY:
FBC 20 ('-
Master Permit Nol!C, (r - 17 - 1 S&5'
Sub Permit No. 'C-L I Pj - 2-00
❑ REVISION ❑ EXTENSION RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
10B ADDRESS: 1,56 f iUL /04"'fr
City: Miami Shores County: Miami Dade Zip: 33I38
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): A Z-A / N U �NZ� L �Z- Phone#: -7 96 -a77- �Ml
A Address: 5- J�iC:, �� 4 u / rb
City: /�'%/,�%%'? 1 �� Stater Zip:
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: t r �L�Gf72/GAL S�lZ1�dGLr' OF �G�lyl7/Y Phone#: ZA 30Z-1/7r
Address: T 80 60 "b4� 5
City: State: Zip:
Qualifier Name: 13~010 Phone#: 7c?6- $4yY- 19Yf6
State Certification or Registration #: �iLI�O %S�l� Certificate of Competency #:
DESIGNER: Architect/Engineer:
Add
Value of Work for this Permit: $1
Type of Work: ❑ Addition ❑ Alteration
Description of Work:
.. � --j ,vg G
Specify color of color thru tile:
ne#:
City:
Square/Linear Footage of Work:
fNew
a Tv.wlr-1,soaw
❑ Repair/Replace
Zip:
❑ Demolition
,J r'/ /rT
Submittal Fee $ 0:) Permit Fee $ / -5rC ''V%P CCF $ 2. • 4f O CO/CC $
Scanning Fee $ 3 Radon Fee $ 2 • DBPR $ 2. 25 Notary $
Technology Fee $ 3 ' ?�� Training/Education Fee $ d �`� Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ (a- GG ✓
(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 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 Signat�r
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
) day of ) ) 20 �by
IR�.C�;a& v>�KIO�I-�Z who i personal) nown to
me or who has produced
as
The foregoing instrument was acknowledged before me this
3 day of �' i� 20A' by
who is personally known to
me or who has produced .41'6W-f —'as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Tvi� e v �a�w Print: NOTAF;Y F'.r9LJC
UL
Seal: :'+; V �6 : Notary Public cFEStat Do! Florida
Seal:
Commission # GG 171862�
JENNI
My Comm. Expires Jan 2.2022
Bonded through Nation, Notary Assn.
l9?
APPROVED BY -Plans Examiner
Zoning
Structural Review
(Revised02/24/2014)
Clerk