EL-19-2654Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Tul
Issue Date:
Parcel Number
1077 NE 98TH ST, Miami Shores, FL 33138 1132050180240
:ontacts
Permit ivo.: EL -11-192654
Permit Type: Electrical - Residential
Workiossijfcation; Alteration
Permit Status: Approved
Expiration: 05/11/2020
ONE POTATO TWO POTATO LLC Owner ALL FIELDS ELECTRIC, INC Contractor
107798 KEVIN CHATFIELD
Business: 3058285158
Business: 9546806027 CHATKEV@BELLSOUTH.NET
Other: 9546586732
Description: POINT PERMIT FORT OUTSIDE SERVICE AND Valuation: $ 1,500.00 Inspection Requests:
INSTALLING 6 FIXTURES UNDER EVE OF HOUSE IN THE BACK, -j
305-762-4949
OWNER BOUGHT HOUSE AS IS AND PULLING AFTER THE FACT Total Sq Feet: 0.00
PERMIT. WORK WAS DONE BY OTHERS
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$2.50
Work Without Permit 1st Offense
$100.00
Work Without Permit 1st Offense
$100.00
Total:
$317.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$317.10
Credit Card
11/13/2019 $267.10
Credit Card
11/06/2019 $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 foregoin formatiMisacceOate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I au oriz the,Sbtractor to do the work stated.
J
Authorized Signature: Owner / Applicant / Contractor ( / / Agent Date
November 13, 2019
Page 2 of 2
BUILDING
PERMIT APPLICATION
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 g ELECTRIC ❑ ROOFING
ENTERED
NOV 0 2019
BX:
FBC 20 l} (.0t
Master Permit No.F L_ I - 9 - 2 (o 54
Sub Permit No.
❑ REVISION [D EXTENSION RENEWAL
PLUMBING n MECHANICAL nPUBLICWORKS E]CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 161-1 P 6: q �1 Z"t'
City: Miami Shores County: Miami Dade Zip 331,38
Folio/Parcel#:- 11- 3o1u� =U19 -c Qqc) Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 0uE_ PoP*nj-D � NiVAIry U.C_ Phone#: 'n j -L cl i -2 N ds
Address: I W:-;_ 103 .7r
City: -- _t'a'i � � �S Inr as State: Fi c&v>A zip: _2'3r3,9
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Ay1 ,F� As Phone#:asL)t(Doo -(�.D al
Address: "7l[�U' c
City: _�� I opsmj C.�S State: ` 1 c) &Ap-a: Zip: U 3,31
Qualifier Name: � �� Cl- A En C_hn t KW nc? PQ ("oL/M , /UOhone#:4 6 673
State Certification or Registration #: Certificate of Competency M Oi
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ 4�Z7 15bo Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New 59 Repair/Replace ❑ Demolition
Description of Work: �i1 i .6 i1,�1 r C � 6A , CV_Z t ^ L�J► C.E i4ui n G,
11^
xn ( s t 1li .�J F. Eo'P t' i' u-'� r Rte_ A-< IK Awry
Specify color of color tru tile:
Submittal Fee $ �5- C) QUI Permit Fee $
CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee _
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 0�6� ( 0
(Revised02/24/2014)
Bending Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
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.
OWNER or AGENT
The foregoin ffhstrument was acknowledged before me this
!I fO- day of k) 0u2AVA0- __,20 1.0 , by
I��Mt,e- �g .SA , who is personally known to
me or who has oroducedd tC. 'C) L Dr.2 o LN'jS 73 as
identification and who did take an oath. OO 9 "c;>
Signature
CONTOR
The foregoing instrument was knowledged before me this
4" day ofLAP- , 20 I q by
Ve-QM A) CSA-IATFGwho isd ersonaRy nope o
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:AuLk> Sign: (IA3b &-�64
n
Print: t A i 1F -id
Seal PAIRICKCHATFIELD
K MIY OOMMMS M / (BGG 109153
EWitEl3.Avgu1d 26, 2021
0WW7W""7PdktNdN as
Print: PA 1
Seal ,.m PATRICK CHATFIELD
MY COMMISSION N GG 109153
MRES: August 26, 2021
gondad T11iU N , Pu1k Undw**e i
#######
APPROVED BY L �i!® fT! Plans Examiner
Structural Review
(Revised02/24/2014)
Zoning
Clerk
Detail by Entity Name
Detail by Entity Name
Florida Limited Liability Company
ONE POTATO TWO POTATO LLC
Filing Information
Document Number
FEI/EIN Number
Date Filed
Effective Date
State
Status
Last Event
Event Date Filed
Principal Address
1173 NE 103RD ST
MIAMI SHORES, FL 33138
Mailing Address
1173 NE 103RD ST
MIAMI SHORES, FL 33138
Page 2 of 2
L17000158648
82-2302997
07/25/2017
07/25/2017
FL
ACTIVE
REINSTATEMENT
03/28/2019
Registered Agent Name & Address
DEROSA, JAMIE M
1173 NE 103RD ST
MIAMI SHORES, FL 33138
Name Changed: 03/28/2019
Authorized Person(s) Detail
Name & Address
Title AP
DEROSA, JAMIE M
1173 NE 103RD ST
MIAMI SHORES, FL 33138
Annual Reports
Report Year Filed Date
2018 03/28/2019
2019 03/28/2019
Document Images
0312812019 -- REINSTATEMENT View image in PDF format
0712512017 -- Florida Limited Liability View image in PDF format
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http://search.sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 11/8/2019
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ALLFIELDS ELECTRIC INC
STATE-EC13001213
'1 BROWARD RECEIPT -#181-1809
Ell
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PERMIT #: EL-11-P-2to5
M'ami Shires Village
APPRQVED BY
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