EL-19-1594Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
I�`�IPI fI;�UU�
Issue Date: 07/25/2019
Location Address Parcel Number
10816 NW 2ND AVE, Miami Shores, Fl. 33168 1121360020160
Contacts
Permit NO.: EL-07-19-1594
Permit Type: Electrical - Residential
Work Classification: Pool
Permit Status: Approved
Expiration: 01/21/2020
FLOYD MARTINEZ Owner
10816 2 AVE, MIAMI SHORES, FL 33168
Other: 2023094959
SHINE ELECTRICAL ENGINEERING Contractor
FRANCISCO SANTOS
3876 NW 125 STREET 125 Street, OPA LOCKA, FL 33054
Business: 3056882000
Inspection Requests:
Description: ELECTRICAL FOR NEW SWIMMING POOL & DECK Valuation: $ 2,500.00 Inspec 4949
Total Sq Feet: 0.00
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
Tota I :
$111.90
Payments
Date Paid Amt Paid
Total Fees
$111.90
Check # 3140
07/25/2019 $61.90
Check # 3121
07/11/2019 $50.00
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 ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating constr tion an ing. Futhermo e, I auttl
rize the above named contractor to do the work stated.
2S1
Authoriz d Sign ture: Owner / Applicant / Contractor / Agent Date
July 25,
Page 2 of 2
C IFII\VEI7
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
PERMIT APPLICATION
❑ BUILDING ELECTRIC ❑ 'ROOFING
❑PLUMBING ❑ MECHANICAL
JOB ADDRESS:
PUBLIC WORKS
W 49 .
JUL 11 2019
NRWJAO
FBC 20 Master Permit No�bPP— 0-7— 19 —li
S9 3
Sub Permit No. C, u= d-7' m — i S94-
❑ REVISION ❑ EXTENSION RENEWAL
❑ CHANGE OF [] CANCELLATION [—]ISHOP
CONTRACTOR DRAWINGS
Folio/Parcel#: �1-7 ` l7 O Vr d'V V! �_Is the Building Historically Designated: Yes NO
Occupancy Type: Load: ' 'Construction Type: Flood Zone: BFE: ^ FFFFEE:
OWNER: Name (Fee Simple Titleholclpr): \ V- ` v Phone#:gb`�
Address: V 3 Ko 1 V`W� X PN�
City: W Q 'm i � �I,W r State: . Zip: 12.Zkk4
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: SHINE ELECTRICAL ENGINEERING Phone#: 305-688-2000
Address: 3876 NW 125 ST
City:
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: $ d V Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration M Neeww ❑ i c Repair/Repe '❑ Demolition
Description of Work: �\ JJ 4V 1(Yl • , G
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 $ / nn
TOTAL FEE NOW DUE $
(Rev1sed02/24/2014)
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
Applicationiis 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__ 7�- —
OWNER or AGENT
The foregoing instrument was acknowledged before me this
9'I day of 20 to) . by
1 \
`ok \i sonally I< o n to
me or who has produced S6 ITA�� as
identification and who did take an oath.
NOTARY P(1BLIC:
Sign:
Print: / t� a Q
Seal:
;tY �� •.. KAREN RODRIGUEZ
=off
��. No
Public . State of Florida
'4 Commission # GG 304504
*** k**** k x k k* iftres
'x My:G('khEa��iiiStil+9nk
Bondedthroug
APPROVED B �l
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
c� day of 20 J by
FRANCISCO SANTOS lu
who is personally known to
me or who has produced PERSONALLY KNOWN
as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
KAREN RODRIaZoning
Notary Public •Stat
'` y �! °Fn° My Comm. Expires FPlans Examiner Bonded through National
Structural Review
(Revlsed02/24/2014)
Clerk