EL-19-2056FkoY-19-9�
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Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Location Address Parcel Number
1431 NE 103RD ST, Miami Shores, FL 33138 1132050310160
Contacts
Permit NO.. EL-09-19-2056
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit status: Approved
Expiration: 04/20/2020
CHRISTINA CABALLERO Owner
CPS ELECTRIC, INC. Contractor
ANGEL ROMERO
1315 NW 30 AVE, MIAMI, FL 33125
Business: 3056078221 efcontractor@hotmail.com
Mobile: 9542492145
Description: REMOVE AND REPLACE CABINETS, APPLIANCE, Valuation: $ 10,927.80 Inspection Requests:
KITCHEN LIGHTING AND RECEPTACLES. REMOVE AND REPLACE
BATHROOM FIXTURE, WALL AND FLOOR TILE FOR 3 Total Sq Feet: 359.00
BATHROOMS
Fees
Amount
Application Fee - Other
$50.00
CCF
$6.60
DBPR Fee
$5.74
DCA Fee
$3.82
Education Surcharge
$2.20
Permit Fee
$332.47
Scanning Fee
$3.00
Technology Fee
$9.56
Work Without Permit 1st Offense
$382.47
Total:
$795.86
Payments
Date Paid Amt Paid
Total Fees
$795.86
Credit Card
10/21/2019 $745.86
Credit Card
09/04/2019 $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 construgtron and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner
/ Applicant / Contractor / Agent
Date
October 23, 2019 Page 2 of 2
Miami Shores Village
BUildIng Department
100SO 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 Q ELECTRIC ❑ ROOFING
C F,IVF,D
S E V 0 4/2019
\MUM
FBC 20
Master Permit No. RC-06-19-1435
Sub Permit No. VL. dl—I I _,?OE-�
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1431 NE 103 Street
City: Miami Shores County: Miami Dade zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):CHRISTINA CABALLEROA^v4D�- Av14tTPhone#,3®,s 4eiS- u
Address:1431 NE 103 Street
City. Miami Shores
State: FI Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: CPS ELECTRIC, INC Phone#: 3059629742
Address: 1600 NW 28 AVE
City. Miami State: FI Zip; 33125
Qualifier Name: Angel Romero
Phone#:
State Certification or Registration #: EC 13005401 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: f_ City: State:
$8-Re : /0
Value of Work for this Permit: $� /4 Z 7. Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New Q Repair/Replace ❑ Demolition
Description of work: Kitchen Lighting, Receptacles and 3 Bathrooms Upgrade According with the Plans.
Specify color of color thru tile: rr
Submittal Fee $�Q ► Permit Fee $ -3� Z �- f CCF $ CO/CC $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $
Notary
Double Fee $
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
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 ail 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
110— IV
OWNER or AGENT
The foregoing instrument was acknowledged before me this
—day of Ss, 20 fG by
I✓AQ-`� NQ-0.\ETp,_ who is personally known to
me or who has produced -0 as
identification and who did take an oath.
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
4 day of September . 20 19 by
Angel Romero . who is perso Ily known o
me or who has produced
identification and who did take an oath.
NOTARY PU
Print:
'VIHx I HA RODRIGUEZ
Seal: Seal: MY COMMISSION k GG42566
EXPIRES: October 26, 2020
as
************************************************************************************************************
APPROVED Plans Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)