EL-19-190Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 03/21/2019
Location Address
671 NE 105TH ST, Miami Shores, FL 33138
Contacts
Permit NO.: EL-01-19-190
Permit Type: Electrical - Residential
Work Classification. Alteration
Permit Status: Approved
Expiration: 09/17/2019
UNAM 671, INC Owner CASSIA ELECTRICAL CONTRACTORS INC Contractor
MARCO BRUZZI GLENWORTH WALKER
671
Business: 9546505840
Other:9542746277
ti
Description: CONNECT FOUNTAIN LOW VOLTAGE PUMP AND Valuation: $ 700.00 on Requests:
Inspection
4949
LIGHT TO EXISTING OUTSIDE GFI CIRCUIT
TotalSq Feet: 50.00
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
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$116.30
Credit Card
03/21/2019 $66.30
Credit Card
01/28/2019 $50.00
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 construglion and zoning. Futhermore, I authorize the above named contractor to do the work stated.
natured Owner / Applicant / Contractor / Agent
Date
March 21, 2019 Page 2 of 2
Miami Shores Village
Building Department RECEIVED
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JAN 2 8 2019
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
--]BUILDING FX-] ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 671 NE 105 St.
QFBC 201 *-
Master Permit No. %}' �') - 01
Sub Permit No. I I�
❑ REVISION ❑ EXTENSION ORENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County' Miami Dade Zip:
Folio/Parcel#: 11-2231-012-0100 is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): UNAM 671, Inc. Phone#:
Address: 671 NE 105 St.
City: Miami Shores state: Fl. zip: 33138
Tenant/Lessee Name:
Emaii
CONTRACTOR: Company Name: Cassia Electric
AAA-- 8261 NW 48 St.
Phone#:
hone#: (954) 650-5840
City: Lauderhill state: FI- Zip: 33351
Qualifier Name: Glenworth Walker Phone#: (954) 650-5840
State Certification or Registration #: EC 13005907 Certificate of Competency #:
DESIGNER: Architect/Engineer: Victor Bruce Phone#: (305) 310-5030
Address: 370 NE 101 St. City: Miami Shores State: FI. Zip: 33138
Value of Work for this Permit: $ 700.00 Square/Linear Footage of Work: 25 L/F
Type of Work: ❑ Addition ❑ Alteration ® New ❑ Repair/Replace ❑ Demolition
Description of work: Connect fountain low voltage pump & light to existing outside GFI circuit
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $ CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
CO/Cc $
Notary $_
Double Fee $ —
Bond $
TOTAL FEE NOW DUE $
30
(Revised02/24/20141
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
E
Zi
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.
Marco Bru i VP- UNAM-671, Inc.)
Signature �
OWNER or AGENT
The foregoing instrument was acknowledged before me this
_a day of 20 �� by
Marco Bruzzi w o is pe Wally know to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: LuGG e,r
Gam/' orth Walker
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
�L
day of Vk( 20 I G , by
Glenworth Walker who is personally' known to
me or who has produced 11014 A &AW U 6—tffiS as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: �C(t
Seal: on!.. LUCIAG,iSASI Seal: ••—•�_•°•°,• w. ).
SARAH INES ALVAREZ
MY COMMISSION al: GG 247475 �r A
� Notary Public, State of Florida
�
EXPIRES: December 10, 2022 ;2 � Commission# GG 129215
APPROVED BY )L 2l I I Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)