EL-18-3535Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
130 NW 92ND ST, Miami Shores, FL 33150
Contacts
Permit NO.: Ei_-11-18-3535
Permit Type: Electrical - Residential
Ut-( Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 01/09/2019 Expiration: 05/27/2019
Parcel Number
1131010160020
BERTRAND PILLER Owner PCA ELECTRICAL SERVICES INC Contractor
WILLIAM MANUEL DOMINGUEZ
Other: 7862466239
533 ANTIOCH AVE 1, FORT LAUDERDALE, FL 33304
Business: 9549188439
Description: NEW EXTERIOR SERVICE NEW UNDERGROUND TO Valuation: $ 2,350.00
Inspection Re uests:
POLE
305-761 49
CONVERT FROM HEAD TO UNDERGROUND SERVICE TO Total Sq Feet: 0.00
REPLACE EXPIRED PERMIT EL -2-13-276
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
Returned Check Fee ($25)($1-$50) 25.00
Scanning Fee 3.00
Technology Fee 2.50
Total: 136.90
Building Department Copy
Payments Date Paid Amt Paid
Total Fees 136.90
Check # 1323 01/09/2019 $136.90
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 constr e6on and zoning. F tf ee ore, I pizethe ab - named contractor to do the work stated.
Signature: Owner / Applicant / Contractor k Agent Date
January 09, 2019 Page 2 of 2
BUILDING
Miami Shores Village
NO 2 7 Ot8
Building Department BY:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 — - ---
J Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 17`'
fih
Master Permit No. a- L «' 3,53 S
PERMIT APPLICATION
BUILDING LECTRIC ROOFING
Sub Permit No.
F] REVISION F-1 EXTENSION [] RENEWAL
PLUMBING [:] MECHANICAL FIPLIBLICWORKS [:] CHANGE OF CANCELLATION r_ -j SHOP
i n- _ 1 i
CONTRACTOR DRAWINGS
iV JOB ADDRESS: 130 `7 j t! 3LTA
City: Miami Shores County: Miami Dade Zip:3315n
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): RG('tmy t 1Ec Phone#: 7W & -,9'j(o' (va3q
Address: 13b AlW -- 92ind _Si-iPel
H; City: ; CLIM - g k6 re,5 State: FL Zip: 33 ign
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: N.8 sal V; C QS Phone#: Q,54 -4 / W
Address: 3 Ai74iodn 'At/!L * I
City: F6 f- A- LC -,LAC("& e- State: Ff Zi1P:3_V(0
Qualifier Name:
i .
4 i n Phone#: " I A (g - 8439
T
State Certification or Registration #: lid- 3 00 S ; D'-, Certificate of Competency #: i5L- 1 300 5 30
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 1'7t] Q O 0 Square/Linear Footage of Work:
Type of Work: Addition Alteration / E] New Repair/Replace
DescriptionCofWork: o Z / 1/ yd hi e'ol 7` //HC'' vr y
Specify color of color thru tile:
Demolition
L --2-I-2,_
Submittal Fee $ Permit Fee $ !/Gri m'd- CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Revised02/24/2014)
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 6
r
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. the absence of such posted notice, the
inspection will not be approved ani a reinspection fee will be charged.
Signature)C G/ ` Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The forgoing instrument was acknowledged before me this
day of / L, 20 > 0 by day of IVOv b e/ 20 /2 by
who is personally known to i j' Vis personally known to
me or who has produced
identification and whq ' m- 10* Z?2o1
PABLO COLON JR
me or who has pro& ed e-„449/'(/ as
identification and w Q$i aan OLON JR.
MY COMMISSION # GG077492NOTARYPUBL
Eff_ MY COMMISSION # GG077492
NOTARY PUBLIC: ,•.•' EXPIRES February 27, 2021
EXPIRES February 27, 2021
Sign' ,./Sign'
Print: ` f CC Print: O v 0-1
Seal: PA13LO COLON JR. Seal:
MY COMMISSION # GG077492
EXPIRES February 27. 2021
APPROVED BYs( Z 2” ;04Pok'-/ArPlans Examiner Zoning
Structural Review Clerk
Revised02/24/2014)
PCW
ELECTRICAL SERVICES
COMMERCIAL • INDUSTRIAL • RESIDENTIAL
Licensed 6 Insured 1 24 Hour Service
LIC#EC13005304
Bill To:
Bertrand Piller
130 NW 92nd Street
Miami Shores, FL 33150
533 Antioch Avenue #1
Fort Lauderdale, FL 33304
Phone: 954-918-8439 & 305-896-3402
Email: info@pcaelectricalservices.com
Job Name:
Date 1 11/12/18
Due Date I 11/12/18
Bertrand Piller
130 NW 92nd Street
Miami Shores, FL 33150
Estimate No. Terms Project
178
Item Description Qty Cost Total
Repair Make all proper connections and prepare new existing 1,700.00 1,700.00T
service to complete FPL underground and outside panel.
Includes- Transfering of power from old service to new
service.
Permit fees not included.
Sales Tax 0.00% 0.00
PABLO COLON JR.
MY COMMISSION # GG077492
EXPIRE F b ry 27.2021
Thank you for the opportunity! We look forward to being a pah of this project! Total $1,700.00
All materials specified and used are considered for improving or repairing real property. Florida State sales taxes have been paid on material at time of
purchase and is included in price. We do not collect Florida State Sales Tax. All work to be completed in a professional manner according to standard
practices and local code requirements. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders
and will become an extra charge over and above the estimate. Not responsible for contingent schedules, delays of any kind, or incidental site damage. This
proposal may be withdrawn by us if not accepted by the above due date. Legal venue agreed is Broward County, FL and Miami Dade County, FL. LIGE
EC13005304