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EL-18-3572Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address ID I L Issue Date:12/04/2018 Parcel Number 77 NE 106TH ST, Miami Shores, FL 33138 1121360060310 Contacts Permit NO.: EL-12-18-3572 Permit Type: Electrical - Residential Work Classification: Service Change Permit Status: Approved Expiration: 06/03/2019 TANIA GALLONI GALLONI Owner TEAC ELECTRIC Contractor CARLOS MARTINEZ Mobile: 5617038657 1900 NW 16 TERR, MIAMI, FL 33125 Other: 3057261627 Home: 7864262094 Description: PERMIT FOR SERVICE REPAIR Valuation: $ 500.00 Inspection Requests: 305-762-4949 TotalSq Feet: 120.00 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 $9.00 Technology Fee $2.50 Total: $116.30 Payments Date Paid Amt Paid Total Fees $116.30 Credit Card 12/04/2018 $66.30 Credit Card 12/03/2018 $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 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. FuthermoreA�lt-horize he above named contractor to do the work stated. Authorized Signature: Owner / Aoplicant / Contractor / Agent Date December 04, 2018 Page 2 of 2 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 IELECTRIC ❑ ROOFING EC tl 9 2 18 FBC 20 Master Permit No. 1 - �2 1 Sub Permit No. 1, — JS-� 7 ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP 1, CONTRACTOR DRAWINGS JOB ADDRESS: T� N L 10 6S-F Folio/Parcel#: i (� �13� ' V5 10 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): ; V1 1 t' lit �l ` l old 1 Phone#: 1Jals' Address:_ 53 City:a vh �- (' State: Zip: ( � Tenant/Lessee Name: Ph Email: CONTRACTOR: Company Name:. c— F— \ —1 1 I1C.. Phone#: ��b �f 2 ��C%'l y Address: t 2�0 /�� ltJ l to T�'J7i / 2 City: I� State: / Zip: 331 Z-5- ,� 'J Qualifier Name: ✓V ! 2 Phone#: �6'' LlZ6 2,6 State Certification or Registration #: 4 4O-©OD/-y `30 Certificate of Competency #: DESIGNER: Architect/Engineer: ne#: Address: City: State: Zip: Value of Work for this Permit: $ �(:D Square/Linear Footage of Work: Type of Work: ❑ Addition ®' Alteration ❑ New /� �t ElRepair/Replace - ❑ Demolition Description of Work: �M� p if1 1C�\ y cx-- ��—?M & Specify collor of, color thru tile: Submittal Fee'$'`- • ik' 'Permit Fee Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ 4 0257c" "sft DBPR $ Notary $ Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ (067 • 5b (Revised02/24/2014) It? 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P H : 786-426-2094 . A Y r � l l � , To: the city of Miami Shores Village Job 77 NE 106 ST Miami shores Village. PERWIT ##: S 12 M am- Shores Vi'I,-ge APFRO�vED BY DATE ZCNING DEPT I PG DErJT SUQ, ECT i O CC h,'PI.If P.CE WI R-i ALL FEUE9AL STP.Tt AN.� l,� I,N, f rsl.L_S F`."�D ('.i G!�LAfICIS CaF��--jam/ D/B/A TEAC Electric 1,2 � M f TEAC Electric 1900 NW 16 TER Miami FL 33125 EC-0001330 """ PH:786-426-2094 """ •••••• 12/1/18 .... .... • ..... Miami Shores Village •• •• •• •• ...... 77 NE 106 :'•••• Miami FL 33125 •• • Bathroom 1-2 Garage Living Room 3-4 Den Receptacles Badroom 5-6 Kitchen West Counter A/C 7-8. Living Room Receptacles A/C 9-10 Lights in the kitchen Well Pump 11-12 South counter Small App Well Pump 13-14 North Counter Small App Water Heate 15-16 Washing Machine Water Heate 17-18 Dryer Living Room 19-20 Dryer Den Lights 21-22 Range Living room 1 23-24 Range CoM Martinez K/B/ACt c ELECTRICAL W APPROVE DATE