EL-18-2033Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit No. EL-7-18-2033
Permit Type: Electrical - Residential
Per
' Worn Classification: Alteration
Permit Status: APPROVED
Parcel Number
Issue Date: 8/21/2018 1 Expiration: 02/17/2019
Applicant
1450 NE 103 Street 1132050310040
Miami Shores, FL 33138-2626 Block: Lot: PETRA MIROVA
Owner Information Address Phone Cell
PETRA MIROVA 6538 COLLINS Avenue
MIAMI BEACH FL 33141-
6538 COLLINS Avenue
MIAMI BEACH FL 33141-
Contractor(s) Phone Cell Phone
SHINE ELECTRICAL ENGINEERING (305)688-2000
e of Work: HANDRAIL BONDING AND NEW LED LIGHTS
itional Info: HANDRAIL BONDING AND NEW LED LIGHTS
,sification: Residential
nning: 1
Fees Due
Amount
CCF
$0.60
DBPR Fee
$3.38
DCA Fee
$2.25
Education Surcharge
$0.20
Permit Fee - Additions/Alterations
$225.00
Scanning Fee
$3.00
Technology Fee
$0.80
Total:
$235.23
Valuation: $ 1,000.00
Total Scl Feet: 648
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-7-18-68383
08/21/2018 Check #: 2484 $ 185.23 $ 50.00
07/31/2018 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
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
construction andkdnipq. f0thelmoreAl-authorize the above -named contractor to do the work stated.
August 21, 2018
Owner / Applicant / Contractor / Agent
Building Department Copy
August 21, 2018 1
Miami Shores Village RECEIVV3
Building Department JUL 312016
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Q fl
95 2204 F (305) 756-8972 D�
Tel. (305) 7 - — INSPECTION LINE PHONE NUMBER: (305) 762-4949 &
F B C 201�'
BUILDING Master Permit No. f�pp t5— ISO
PERMIT APPLICATION Sub Permit No. (t l A- 2o33
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1 i-'( `ro Nr )03 S1�f= ET
City Miami Shores County: Miami Dade zip: 3313
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 'PF-MA M I (,OVA Phone#: b • S3�
Address: IHSO WE 10S STREET
City: M I AM I State: El Zip: 33 t 3
Tenant/Lessee Name: Phone#:
Email: 'PE (-QA 6) N1 f AVA 12 A - 0>0
CONTRACTOR: Company Name:
SHINE ELECTRICAL ENGINEERING Phone#: 305-688-2000
Address: 3876 NW 125 ST
OPA-LOCKA State: FL Zip: 33025
City:
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: $ 1 000 • C90 Square/Linear Footage of Work: %y b
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: fit-• �� .� ` \ a^ `�`
1
1
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
�s,a,�. CC $ CO/CC $
Scanning Fee $ Radon Fee $ ' - • 2 � DBPR $ Notary $
Technology Fee
Structural Reviews $
TOTAL FEE NOW DUE $ �1 S
Training/Education Fee $
Double Fee $
Bond $
(Revised02/24/2014)
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
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 Signature
OWNER or AGENT
The forgoing instrument s acknowledged before
me this
day of / . 20 1 0 by
0` (d Y who is personally known to
me or who has produced C(— Dc— as
CONTRACTOR
The foregoing instrument as acknowledged before me this
day of 20 �� by
FRANCISCO SANTOS
w o is personally known to
me or who has produced PERSONALLY KNOWN as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY
Sign: S•
110
Print: I A Print: "� e
Seal: - • ^ = Notary Put':c - Statc of Florida
My Comm. Expires Oct 16, 2018 Seal: V� Notary Public State of Florida
Commission � FF 135660 M T Estrell8 Gomez
oi,Bonded Through National Notary Asr 1. s, �i' MY Commission GG 182104
9 y Expires 11/21/2021
*************************************************************************** ** * ** * * * * **
APPROVED BY !FIJV,l �/� Plans Examiner
Zoning
Structural Review
(Revised02/24/2014)
Clerk