EL-18-2390�suO1s °P
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
CORig
Phone: (305)795-2204
Permit No. EL-9-18-2390
Permit Type: Electrical - Residential
t er Worts Classification: Temp for Test
Permit Status: APPROVED
Issue Date: 9/10/2018 1 Expiration: 03/09/2019
Project Address Parcel Number Applicant
420 NE 91 Street 1132060190070
Miami Shores, FL 33138- Block: Lot: PROPERTY HOUNDS LLC
Owner Information _ Address Phone Cell
PROPERTY HOUNDS LLC 420 NE 91 Street (954)520-2268
MIAMI SHORES FL 33138-
7021 NW 67 Court
PARKLAND FL 33067-
Contractor(s) Phone Cell Phone
M.B. ELECTRIC SERVICE CORP (786)325-3383
Type of Work: 30 DAY TEMP TEST -AFFIDAVIT ATTACHE
Additional Info: 30 DAY TEMP TEST -AFFIDAVIT ATTACHE
Classification: Residential
Scanning: 3
Fees Due
Amount
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee - Additions/Alterations
$100.00
Scanning Fee
$9.00
Technology Fee
$0.80
Total:
$114.60
Valuation: $ 100.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-9-18-68816
09/10/2018 Credit Card $ 64.60 $ 50.00
09/07/2018 Credit Card $ 50.00 $ 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 AFFIVAY/IT: I.certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction a.y(d - u ermore, I authorize the above -named contractor to do the work stated.
September 10, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Bui�ding Department Copy
September 10, 2018
1
�•V�
BUILDING
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
RECEIVED
SEP 0 y 2018
alvi (4-44-1
FBC 2014
Master Permit No. RC-(V-(-1-16ClI
PERMIT APPLICATION Sub Permit No. EL-I•-I'�-4 Ci
❑BUILDING &;�fLECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
3"'j
[—]PLUMBING❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ HOP
CONTRACTOR
JOB ADDRESS:
DRAWINGS
City: Miami Shores r� 1 r1County: Miami Dade Zip: 13138
Folio/Parcel#:I l -32_�J (0-0I G .�V0 -1y Is the Building Historically Designated: Yes NO
4.1
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ,(TW } ids C..L.0 Phone#: c154" 52.E 2ZU$
Address:!j0- 1 hjVV C01
City: PAKr _, State: t—L Zip: n-1
Tenant/Lessee Name:
Email
CONTRACTOR: Company Name: (;M�• P1'CC.� t C_ .�;-C Vj� QCS Phone#: �9 U— 72.5
N ,3
Address: Q 55 Vy j q GJ Sri
City: m i r i c2"Ul State: IFL Zip: 31 OSS
Qualifier Name: 17f-. VM, Qj, Phone#:
State Certification or Registration #: r-R, 1 3WA-1 U Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ (r)b 00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: 3y dau, tr MD t-CS-' . —f7-"r I da\)iT- attach d .
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Permit Fee $ � O CCF $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $,
DBPR $
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $ /
TOTAL FEE NOW DUE $ �•
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bondi.rg Company's Address
'City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zi
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 20 by
Mnr ill ft`iP.i Ra ��s who ' rs ally know o
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sig
nature_ nature t/ vl/
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of SPA} - 20, by
JtAXf M% tn0--C who i to
me or who has produced!t7 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: U LbU) kyV 11v'CLJ(.^ J%-1V Sign:_
Print: Print: L
Seal: �o NAMHABOOKE Seal:
A, .. MY COMMISSION # GG 154422
• 27 2021
•:, '�: EXPIRES: Oc4ober
Thlu Public UMatwr�
************* *aft ****************
APPROVED BY Plans Examiner
lk,�
NAASHIA BOOKE
MY COMMIS" # GG 154422
EXPIRES: October 27, 2021
**********
Zoning
Structural Review
(Revised02/24/2014)
Clerk
RECEIVED Miami Shores Village
SET 0 7 2018 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: PC7U _ i ---1 _ ( 5G —7 Electrical Permit N: E L— l —1 8 —4cl
At Address: 4Z 0 N E Miami Shores, FL 33 j 3?s
For Owners: r I-( 1 ckwe I P ancs and is being given only for
construction purpose & 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
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 unable to obtain future Temporary for Test permits.
I, tAJ0h6ift 2Q(CS , 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 has obtained approval of final inspections and/or obtained a Certificate of
Occupancy of Completion. Note: Failure to comply with the provisions of this affidavit will result in
being un to o ain future Temporary for Test permits. r4"MA
_ 1
Signature of caner Si nature of Notaryf
I, Jusef h unoz , being duly sworn, depose and say that I am the Electrical Contracto fi
the above-descr' ed properly -and that the electrical installations as now existing will not create a safety
if temporary s is is co ected.
Signature of EI trical Contractor Signature of Notary
being first duly sworn, depose and say that I am the Building Cont t4+
of the above described property and that I will not permit occupancy of this building until final inspections ve
been called for by the contractors and sub -contractors concerned and final approval by the inspection di
obtained and that I have the authority insofar as the owner of said property is concerned to prohibit occupancy
until such final ' i ns are obtained and/or a Certificate of Occupancy or Completion is issued.
gnature of Building Con Signature of Notary
Signatu of Inspector Signature of Notary