EL-19-711Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 05/02/21119
Parcel Number
500 NE 96TH ST, Miami Shores, FL 33138 1132060140700
Contacts
Permit NO.: L-04-19-711 i
Permit Type: Electrical - Residential
War* Classification: Pool
Permit status: Approved
Expiration: 10/29/2019
CAROLINA HENAO Owner SHINE ELECTRICAL ENGINEERING Contractor
500 NE 96 FRANCISCO SANTOS
3876 NW 125 STREET 125 Street, OPA LOCKA, FL 33054
Business: 3056882000
Description: NEW SWIMMING POOL AND HEATER Valuation: $ 2,500.00 Requests:
1305-762A949Ins ection nRe Re
Total Sq Feet: 628.00
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 # 2870
04/02/2019 $50.00
Check # 3009
05/02/2019 $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 AFFIDAV T: I certify thaj all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating ;ncttnand zo 'ng. thermore, I authorize the above named contractor to do the work stated.
5 12" 1-01
/ Applicant / Contractor / Agent
o
May 02, 2019
Page 2 of 2
BUILDING
PERMIT APPLICATION
❑BUILDING LhELECTRIC
[PLUMBING ❑ MECHANICAL
JOB ADDRESS:
RF-CEIVED
Miami Shores Village APR 02 1019
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305)1762-4949 'n
MC 201
Master Permit No.
Sub Permit No.
ROOFING ❑ REVISION ❑ EXTENSION ORENEWAL
PUBLIC WORKS ❑ CHANGE OF CANCELLATION F-1ISHOP
CONTRACTOR DRAWINGS
Folio/Parcel#: Is the Building- Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: 1 Flood Zone: BFE: FFE:]]
OWNER: Name (Fee Simple Titleholder): \ Phone#:(�P tLly lJ
Address: t; �� TIC 6)
City:
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: SHINE ELECTRICAL ENGINEERING
o,1,1ro«. 3876 NW 125 ST
City: OPA-LOCKA State: FL
hone#:
hone#: 305-688-2000
Zip: 33025
Qualifier Name: FRANCISCO SAN I S Phone#: _
State Certification or Registration #: EC0001514 Certificate, of Competency #: _
DESIGNER: Architect/Engineer: Phone#: _
Address: City: State:
Value of Work for this Permit: $ 270 C)
Type of Work: ❑ Addition ❑ \Alteration
Description of Work: �3ee
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Square/Linear Footage of Work:
ew ri) Re
Permit Fee $
Radon Fee $
Training/Education Fee $
d CCF $ CO/CC $
_ DBPR $ Notary $
Double Fee $
Bond $ /%
TOTAL FEE. NOW DUE $0 � - !q o
Zip:
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 toido the work and installations as indicated. I certify that no work or installation has
commenced prior, oto 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.....
DINNER'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 FAiLU.RE. TO. RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICEIFbR IMPROVEMENTS, TO YOUR. PROPERTY. iF YOU INTEND
TO OBTAIN FWANCING, CONSULT1 IITH YOUR LENDER OR AN ATTORNEY REFORE'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 !n good faith That a copy of the notice of commencement and construction lien law'brochure will be delivered to the person
whose.property !s 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.
ER or AGENT
The foregoing instrument was acknowledged before me this
day of - MIL,e.11 20 ) by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC: .. N" I rpo l •,
ARY • •'•.?'�
Print: `/ ^U 1
Seal: ; v •• EXPIRES
.,11101120210Q-,
..
OF VV .`•
4<�s:k q: :k thge kqa k+l:;k�gr�8 Sk ;q; eqe qe:M
APPROVED BY y'
as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
— day of lel >-f� 20 —� by
a°kk4 5045c is personally known to
me or who has produced PERSONALLY XNOWN
as
identification and who did take an oath.
NOTARY PUBLIC!n
Sign:
V' V J.,.�..��,,,�
Print: _
�.
r.c,�i Gl/�i,r-. R �F� ''•,
Seal:
:' NOTARY ' .•
• PUBLIC
= I REG # GG 1572001-
57200:MY
MYCOMMISSION ; rm
;h ry;:k*>k:ie:k q::k q:1{°q; gs;Ary::kae qe q; q::h;k:kgt:k qe q;q;q:mq:q:q«k:k EXPIRES aw'
�'i:
Plans Examiner
''• OF.�V
.•`�
• •� Zoning
Structural Review Clerk
(Rev1sed02/24/2014)