ELC-19-2071Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit No.: ELC-09-19-2071
Permit Type: Electrical - Commercial
n"n U Work Cirrssi aVon-: Alteration
Permit Status: Applied
Issue Date': Expiration: 03/03/2020
Location Address Parcel Number
602 NE 96TH ST, Miami Shores, FL 33138 1132060141410
Contacts
MIAMI SHORES PRESBYTERIAN CHURCH Owner MASTEC NETWORK SOLUTIONS, LLC Contractor
CHURCH BRADLEY FRED CONN
602 NE 96 ST, MIAMI, FL 331382742 6100 BROKEN SOUND PKWY, BOCA RATON, FL 33487
Other: 3057549541 Business: 5619629807
Inspection Requests:
Description: REPLACING RADIOS Valuation: $ 1,000.00
30�762-L j 4949
TotalSq 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
Payments Date Paid
Amt Paid
Total Fees
$110.30
Check # 205252 09/05/2019
$50.00
Credit Card 10/02/2019
$60.30
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.zont6g. Futhermore, I authorize the above named contractor to do the work stated.
WOX� G�11/11 jJ /6/"P/i,15P
Authorized Signature: Owner / Applicant / 1ontractor /
October 04, 2019 Page 2 of 2
M 139 - PN
1 _ T
BUILDING
PERMIT APPLICATION
REGE�� E®
Building Department sip 8�a
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 r k
/FBc Zon N (�
Master Permit No. C` �—AG ^� '
Sub Permit No. R.(_C—Cq 61 "7,01 1
Miami Shores Village
❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 602 NE 96th St
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#:11-3206-014-1410 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Northeast Presbyterian Church Phone#:
Address: 602 NE 96th St
City: Miami State: FL Zip: 33138
Tenant/Lessee Name: AT&T Mobility
Email: dt2108@att.com
Phone#:
CONTRACTOR: Company Name: Mastec Network Solutions Phone#: 561-962-9838
Address: 6100 Broken Sound Pkwy Suite 6
City: Boca Raton State: FL Zip: 33487
Qualifier Name: Brad Conn Phone#: 561-962-9838
State Certification or Registration #: EC13006418 Certificate of Competency #:
DESIGNER: Architect/Engineer: APX Engineering Phone#:
Address: 3400 Lakeside Dr #525 City. Miramar State: FL Zip: 33027
Value of Work for this Permit: $ 1000 Square/Linear Footage of Work:
Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Replacing radios
Specify color of color thru tile:
Submittal Fee $ �� 'Q Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE
(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
Zip
City State 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.
Signature
OW or A NT
The foregoing instrument was acknowledged before me this
5 /# day of Aa6us % 20 iq by
.Tr'1W #9:5 Ti M KD who is personally known to
me or who has produced IR ( VEA5' "CCW SG: as
identification and who did take an oath.
NOTARY PUBLIC:
Z
Signc—f�
Print: :57-evaq
L . S L- ee -FAA
�,, ,. ue,�c
Seal:
S'TEVEFI CSiLVEE 1 MV
MY COMMISSION k FF 962378
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EXPIRES: August 13,2020
#M�--Q'P"Bwxiad
Thru Budpet Notary Services
Signature aG
CONTRACTOR
The foregoing instrument was acknowledged before me this
128-Oft day of --N qy " , 20 1 C by
U,ry Imo., Ca — -J who is personally known to
me or who has produced Y�IQ LWA k-Yl611V1i1 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: +►& Notary Public State of Florida
Raphaella L De Paula
M : • My Commission GG 322520
OF Expires04/11/2023
*************************************************************
APPROVED BY �f1� Plans Examiner
Structural Review
**********
Zoning
Clerk
(Revised02/24/2014)
RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY
Florida
h�
STATE OF FLORIDA
DEPARTMENT OF BUSINESS ANDA?ROFESSIONAL REGULATION
T * tv�
ELECTRICA/yL/y CONTRACTORS LICENSING BOARD
�
��
THE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE
PROVISIONS OF . HA_PTER 4�$9, FLORIDA'ST TUTES
CONN BMDLEY FRED
V MASTEC NETWORK SOLUTIONS, LL
4
i" 806 S DOUGLAS RD 11TH FLOOR,.
\-CORAL GABLE, FL 33134r
LICENSE NUMBER: EC13006418
EXPIRATION DATE: AUGUST 31, 2020
Always verify licenses online at MyFloridaLicense.com
i
Do not alter this document in any form.
This is your license. It is unlawful for anyone other than the licensee to use this document.
■
A N N E M. C A N N O N P,O, Box 3353, West Palm Beach, FL 33402-3353 -LOCATED AT**
CONSTITUTIONAL TAX COLLECTOR Www.pbctax.com Tel: (561) 355-2264
J
Sen,ing Pala Reach County 6100 BROKEN SOUND PKWY NW
Serving you. STE 6
BOCA RATON, FL 33487-2713
TYPE OF BUSINESS OWNER CERTIFICATION # RECEIPT #.!DATE PAID AMT PAID BILL M
23-0169ELECTRICALCONTRACTOR CONN BRADLEY FRED I EC13006418 B1B.502090-06/01/18 $2750 1 640166379
This document is valid only when receipted by the Tax Collector's Office
MASTEC NETWORK SOLUTIONS LLC
MASTEC NETWORK SOLUTIONS LLC
6100 BROKEN SOUND PKWY STE 6
BOCA RATON, FL 33487
STATE OF FLORIDA
PALM BEACH COUNTY
2018/2019 LOCAL BUSINESS TAX RECEIPT
LBTR Number: 2015083753
EXPIRES: SEPTEMBER 30, 2019
This receipt grants the privilege of engaging in or
managing any business profession or occupation
within its jurisdiction and MUST be conspicuously
displayed at the place of business and in such a
manner as to be open to the view of the public.