EL-18-1213`yµortes °? Miami Shores Village
10050 N.E. 2nd Avenue NE
I Miami Shores, FL 33138-0000
Phone: (305)795-2204
f10R'IDp'
Permit No. EL-5-18-1213
Permit Type: Electrical - Residential
erm Work Classification: Pool - Private
Permit Status: APPROVED
Issue Date: 5/22/2018 1 Expiration: 11/18/2018
Project Address Parcel Plumper Applicant
671 NE 105 Street 1122310120100 CAROL INVEST USA INC
Miami Shores, FL 33138-2053 Block: Lot:
Owner Information Address Phone ueh
CAROL INVEST USA INC 671 NE 105 Street (305)747-3098
MIAMI SHORES FL 33138-
671 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
SHINE ELECTRICAL ENGINEERING (305)688-2000
e of Work: NEW SWIMMING POOL AND HEATER
itional Info: NEW SWIMMING POOL AND HEATER
,sification: Residential
nning: 1
Fees Due
Amount
CCF
$1.80
DBPR Fee
$4.50
DCA Fee
$3.00
Education Surcharge
$0.60
Permit Fee - Additions/Alterations
$300.00
Scanning Fee
$3.00
Technology Fee
$2.40
Total:
$315.30
Valuation: $ 2,500.00
Total Sq Feet: 1224
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-5-18-67458
05/07/2018 Check #: 2271 $ 50.00 $ 265.30
05/22/2018 Check #: 2304 $ 265.30 $ 0.00
AvauaDie inspections:
Inspection Type:
Final
Light Niche
Bonding
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 and zoning. Futhermore, I authorize the above -named contractor to do the work stated.
May 22, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
May 22, 2018 1
Miami Shores Village REGEIvau
Building Department MAY 07 2018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 � t--1
Tel' (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 U h
FBC 20a
BUILDING Master Permit No.,6eP 2d
PERMIT APPLICATION Sub Permit No.
❑BUILDING ELECTRIC ❑'ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: G:7 t D`) C:� 97 16
City:Miami Shores County Miami Dade Zip: 33 �3 v
Folio/Parcel#: 73� ` 2'- I go Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): CAP=o� �UUL%V ' "S� �fJC Phone#:
Add ress:�g9'10 &scpy [\)e s uyu N6 (-4
City: I Rµi State: —� LOB k01% Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: 3876 NW 125 ST
City: OPA-LOCKA State: FL
Qualifier Name: FRANCISCO SANTOS
State Certification or Registration #: EC0001514
SHINE ELECTRICAL ENGINEERING
ne#: 305-688-2000
_Zip: 33025
ne#:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#: _
Address: City: State:
Value of Work for this Permit: $
2'T" ' d 0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace
Zip:
❑ Demolition
Description of Work: N e U l SU) k RM I ) �d L AND �C E-P ,
« i
+ e
r � r
• 4
1
Specify color of color thru tile: ,. r
Submittal Fee
Scanning Fee $
Permit Fee $ �T00i 00 CCF $ CO/CC $ _
Radon Fee $ 2� - C� DBPR $ Notary $,
Technology Fee $ Training/Education Fee $
Structural Reviews $
TOTAL FEE NOW DUE $ Oros .---an
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature lm.
OWNER rAGENT CONTRACTOR
The foregoing instrument was acknowledged beforemethis
03 day of 20 by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC: /I
Seal: ipf "'N Notary Public State ev of t��
Estrella Gomez
MY COmml!$lon GG 162104
an Expires 11/211202,
nay
The foregoing instrument was acknowledged before me this
03 day of 9aQ 1 20 �g by
FRANCISCO SANTOS who is personally known to
me or who has produced PERSONALLY KNOWN as
identification and who did take an oath.
NOTARY PU
Seal: Or Notary Public State o/ Florida
Estrella Gomez
My Commission GG 162104
��aeo Expires 11/21/2021
APPROVED � ! >60t / i8 Plans Examiner
Structural Review
(Revised02/24/2014)
***************
Zoning
Clerk