EL-19-2Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 01/16/2019
Location Address Parcel Number
70 NE 99TH ST, Miami Shores, FL 33138 1132060131050
Contacts
Pern* NO.: EL -01 19-2
Permit Type: Electrical - Residential
Mork clossfflcotion: Pool
Permitstatus: Approved
Expiration: 07/ 15/2019
JAY YAGODA Owner SHINE ELECTRICAL ENGINEERING Contractor
70 NE 99 ST, MIAMI SHORES, FL 33138 FRANCISCO SANTOS
Other: 3056577859 3876 NW 125 STREET 125 Street, OPA LOCKA, FL 33054
Business: 3056882000
Description: ELECTRICAL FOR POOL AND HEATER Valuation: $ 2,500.00 Inspection Requests:
3-762-40
Total Sq Feet: 342.00
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
Check # 2732
01/02/2019 $50.00
Check # 2806
01/16/2019 $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 ce fy that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating coAstructionAnd zcNing. Futhermore, I authorize the above named contractor to do the work stated.
0
Owner / Applicani / Contractor / Agent Date
January 16, 2019 Page 2 of 2
RECEIVED
Miami Shores Village JAN 02 2019
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305)J62-4949
C 201 -
BUILDING Master Permit No.b9p 1q
PERMIT A=ON Sub Permit No.� 1 — 2 '
BUILDING LECTRIC ❑ 'ROOFING ❑ REVISION EXTENSION RENEWAL
I
[PLUMBING. ❑ MECHANICAL PUBLIC WORKS F-1 CHANGE OF CANCELLATION ;SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 110I.rC �� 5
City: Miami Shores County: Miami Dade Zip: 3313
Folio/Parcel#: 1 (" '7 2•x(0 - 613 - 12Sy Is the Building- Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
_7c,�.3337
)WNER: Name (Fee Simple Titleholder): - �•
n��ncrr.� v
kddress: -41 D lei E !�!f ST
5)10 t'9 S State: ��
Zip: 37139-
7138'-enant/Lessee
- enant/LesseeName:
Phone#:
:mail:
:ONTRACTOR: Company Name: SHINE ELECTRICAL ENGINEERING Phone#: 305-688-2000
address: 3876 NW 125 ST
-ity: OPA-LOCKA State: FL
Zip: 33025
qualifier Name: FRANCISCO SANTOS
Phone#:
State Certification or Registration #: EC0001514
Certificate; of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address:
City: State: Zip:
Value of Work for this Permit: $ -S-0 6 Square/Linear
Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New
❑ Repair/Replace ❑ Demolition
Description of Work: �C(.�f G-cl i'v �Oo ` `(✓
T
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
CCF $ CO/CC $
Scanning Fee $ Radon Fee $
DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Double Fee $
Structural Reviews $
Bond $
.. /11-1
�v �r��. � r•. ��v yr vim... y -
(Rev1sed02/24/2014)
Bonding Company's Name (if applicable)_
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage L'ender'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
Signature _Z?
N R rAGENT
The foregoing instrument was acknowledged before me this
day of 241le0A L" 20 by
who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
SignatUr
CONTRACTOR
The foregoing instru�\ment was acknowledged before me this
2� day of Ylc<, 20 by
FRANCISCO SANTOS
who is personally known to
me or who has produced PERSONALLY KNOWN
as
identification and who did take an oath.
NOTARY PUBLIC:
i
Sign:
r/ -� ,� ` '•• Sign: �.�'� MICyq ���'•.
Print: /i n S 1�A r 4,
�p _�, ' Print: _ Q y' , y
Seal: = PUBLIC%7'
• 'fl
REG It GG 157200:�n %seal: = :REG # GG 157200.'
U : MY COMMISSION rd a
U : MY COMMISSION:
EXPIRES EXPIRES r
:k***=k :k:k:k**:k*=k :k****:k :k do*8: =k:k=k***W.* ' Q' w : ��•'•, 11/01/2021 ,: �,CG ;.
'lt�e"
APPROVED BY OF •F�-®'ae•s 1-1 OF F'�-'•i m�"
��o �epl�ans Examiner ��''•�»••"°`�
Zoning
Structural Review
(Revised02/24/2014)
Clerk