EL-18-3313Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:10/31/2018
Location Address Parcel Number
90 NE 105 ST, Miami Shores, FL 33138 1121360120010
Contacts
Permit No.: EL-10-18-3313
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 04/29/2019
ALBA LIGIA GUERRERO ADKINS Owner ALBA LIGIA GUERRERO ADKINS Applicant
90 NE 105 ST, MIAMI SHORES, FL 33138 90 NE 105 ST, MIAMI SHORES, FL 33138
Other:3057519523 Other:3057519523
MIAMI ELECTRIC MASTERS, LLC Contractor
KENT CROOK
8950 SW 74 CT 1612, MIAMI, FL 33156
Home: 3053784011
Description: ELECTRICAL OUTLETS AND SWITCHES FOR A Valuation: $ 1,000.00 Inspection Requests:
KITCHEN REMODEL 305-762-4949
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
10/30/2018 $50.00
Credit Card
10/31/2018 $60.30
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 construction and zoning. Futhermore, I authorize the above nrjed contractor to do the work stated.
/ Contractor / Agent Date
October 31, 2018 Page 2 of 2
BUILDING
PERMIT APPLICATION
❑BUILDING Q ELECTRIC
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 —Ty
FBC 20 1 f (b{
Master Permit No.��
Sub Permit No:-(-7L 18 `
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 90 Northeast 105 Street
City: Miami Shores County: Miami Dade zip: 33138
Folio/Parcel#: 11-2316-012-0010 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Alba Ligia Guerrero Adkins Phone#: (305) 751-9523
Address: 90 Northeast 105 Street
City: Miami Shores State: Florida zip: 33138
Tenant/Lessee Name: Phone#:
Email: Albaguerrero2000@yahoo.com
CONTRACTOR: Company Name: Miami Electric Masters, LLC Phone#: (305) 378-4011
Address: 8950 Southwest 74 Court, Unit# 1612
City: Miami State: Florida zip: 33156
Qualifier Name: Kent D Crook Phone#: (305) 378-4011
State Certification or Registration #: EC13007692 Certificate of Competency #:
DESIGNER: Architect/Engineer:
Value of Work for this Permit:
ne#:
City: State
Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: Electrical outlets and switches for a kitchen remodel
Specify color of color thru tile:
Submittal Fee $ ' Permit Fee $ ��O �Da CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
Double Fee $
Bond $
TOTAL FEE NOW DUE $ J/20 ' 3O
(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
OWNER or AGENT
Signature
CONTRACTOR
The foregoing instrument wasacknowledgedbefore me this The foregoing instrument was acknowledged before me this
day of / t��ii6%12r 20 _ le , by day of 6C_7o l�z 20 � by
XVA/C YI who is persona known to �/►f D 6�p A , who is personal) I
rr r
me or who has produced I'�_ ��.# ��'� 3-ola AP `fnn
ne or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Notary Public - State of Florida
Seal: Commission M GG 065655
ffl MY Comm. Expires Apr 3, 2021
e°FFBonded through National NotaryAssn.
identification and who did take an oath.
NOTARY PUBLIC:
11
S1-9;
Print:KOM�f L
Ofl
MPop
my Commission GG 13337E
Seal: ExomsC3110=21
************************************************************************************************************
APPROVED BY ,��lv Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)