EL-19-999Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
243 NE 103RD ST, Miami Shores, FL 33138
Contacts
Issue Date: 05/08/2019
Parcel Number
1121360130410
Permit NO.: EL-05-19-999
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 10/30/2019
BELLKRIS GROUP LLC Owner
243 NE 103 ST, MIAMI SHORES, FL 33138
Home: 7865396774
INDUSTRIAL ELECTRICAL SYSTEM CORP Contractor
NESTOR I CORVEA
10257 NW 9 ST 205, MIAMI, FL 33172
Description: REPLACE 4 OUTLETS & 3 GFCI ACCORD TO Valuation: $ 1,500.00 Inspection Requests:
APPROVED PLANS 305-762-4949
TotalSq Feet: 550.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Work Without Permit 1st Offense
$100.00
Work Without Permit 1st Offense
$100.00
Total:
$311.10
Payments
Date Paid Amt Paid
Total Fees
$311.10
Credit Card
05/03/2019 $50.00
Credit Card
05/08/2019 $261.10
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
regulati ruction and zonm 9. tut horize the ove named contractor to do the work stated.
Authonz _ ure:Owner /&Pplic nLJ----C—on—tractor / Agent Date
May 08, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
Miami Shores Village
C eIVED
Building Department MAY 3 019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY;
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
Master Permit No. RCO2-19-442
Sub Permit No. L. L 0 S- i I_
❑BUILDING 0 ELECTRIC ❑ ROOFING
[]PLUMBING MMECHANICAL MPUBLICWORKS
JOBADDRESS: 243 NE 103 ST
❑ REVISION ❑ EXTENSION ❑ RENEWAL
CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-2136-013-0410 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: d
OWNER: Name (Fee Simple Titleholder): BELLKRIS GROUP LLC Phone#: I �� " S J1 6 77 l
Address: �aa NC- y j i .r— a boa
City: H of +•M State: t-t— Zip: 7
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Industrial Electrical Systems Corp. Phone#: 305 388-4648
Address: 14050 SW 84 St Suite 206
City: Miami State: FL Zip: 33183
Qualifier Name: Nestor I. Corvea Phone#: 305 388-4648
State Certification or Registration #: EC 13002182 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ 1,500.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑■ Repair/Replace
Description of Work: Replace 4 OUTLETS & 3 GFCI ACCORD TO APPROVED PLANS.
Specify color of color t�ru tile:
Submittal Fee $ a �^ Permit Fee $
Scanning Fee $
Zip:
❑ Demolition
CCF $ CO/CC $
Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $� I ' f o
(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 an4 a re Ps ction fee will be charged.
Signature Signature &/��cl-"L �
OWNER or AGENT CONTRACTOR
The for�oing instrument was acknowledged beforemethis
3� day of O L 20 1 by
t W Q ' who is personally known to
me or who has produced I J r ; \141, UC�olw as
o`did take an oath ��Ht1tYPRill
r
Print:
The foregoing instrument was acknowledged before me this
3rd day of May 20 19 by
Nestor I Corvea who is personally known to
me or who has produced
identification and who did take !1
NOTARY PUBLIC:
�� 1
Sign: %�O `/ �-
Print: Francisco P. Morales
Seal: (� U �i�i� Alt, �\Seal:
`-,
FRANC!SCO P MORALES
Notary Public — State of Florida
_ =
Commissior R GG 158509
My Comm. Expires Nov 17, 2021
Bonded ;n!roagh Na..ona No:ary Assn.
APPROVED BY S h (� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)