EL-19-2133Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
101 NW 100TH TER, Miami Shores, FL 33150 1131010220220
Contacts
Permit NO.: .-09-19-2133
Permit Type: Electrical - Residential
Work Ciassifrcatforr;Alteration
Permit status: Approved
Expiration: 03/16/2020
GB&T INVESTMENTS LLC Owner E & S ELECTRICAL SOLUTIONS INC Contractor
JENNIFER TAMAYO EDEL ANTONIO RODRIGUEZ
101 NW 100 TER, MIAMI SHORES, FL 33150 16300 SW 99 AVE, MIAMI, FL 33157
Home: 3059702905 Business: 7862508836
Description: ELECTRICAL PERMIT FOR KITCHEN, BATH & Valuation: $ 2,300.00 Inspection Requests:
GARAGE REMODELING 305-76-499
Total Sq Feet: 190.00
.j
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.90
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.90
Credit Card
09/18/2019 $61.90
Credit Card
09/16/2019 $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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authoriz4d Sign atu er / Applicant / Contractor / Agent Date
i
September 18, 2019 Page 2 of 2
Miami Shores Villa
e g
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINIE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
BUILDING [)4 ELECTRIC ❑ ROOFING
c
EP16219
BY:_ '
FBC 20
Master Permit No. ��- del 1-7
Sib Permit No. /i_ 69-119I —Z 133
❑ REVISION 0 EXTENSION ❑ RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
10B ADDRESS: �0% NGy lao 74
Miami_Shores _ County: Miami Dade Zip: .33 !3—O
Folio/Parcel#: i1 -moo f —0A2 — OA9z Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: __Flood Zone: BFE: FIFE:
OWNER: Name (Fee Simple Titleholder): & Q T *Inyts4m en 4S Phone#: O6" 970 -a9 05"
Address: 15q OO,�y��ty 81 Ave,
City: _ i)A im e-l/y 6cpq State: F4 Zip: 03 /5
Tenant/Lessee Name: n 1A Phone#:
Email:
CONTRACTOR: Company Name: 4E.V&
Address: 11o3eOS"l q'711Y
City: _ ��/�iYt / State: _
Qualifier Name: 6e—el 4'
State Certification or Registration #: 64-- /30Oy234
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $,2300' 00
FL
Phone#: —7B6 — ZSo — B9jG
Phone#: _
Certificate of Competency #: _
Phone#: _
City: State:
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work:
Specify color of color hru tile:
Submittal Fee $__ i C _ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $__ _ Training/Education Fee $
Structural Reviews
(Revised02/24/2014)
p: 33 JS 7
8836
Zip:
CCF $__ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ (01 1 CID
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) _
Mortgage Lender's Address
City
State
WE
q
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 TOIVOUR 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__ b 1
T-VJ--�
OWNER or AGENT
The foregoing instrument was acknowledged before me this
_ day of 01 '0/—, 20 �G1 by
� JFN N 1 FC1Z l 4y'o who is personally known to
me or who has produced as
Signature
CONTRACTOR
The foregoing instrument wa cknowlle�dgge-dd before me this
day of � ' 20 ��, by
who i/s�pers naf lly known to
me or who has produced ed� f ' �'^rfbO as
identification and who did kth. e
, ntification and who did take
•' A0C CiArft Of tRIOfW�
NOTARY P BLIC j MYCommbrlon0033"07 OTARY PUBLIC
awl E*res awam
Sign:_ / Sign: ,/�,
Print: f7�[ _/ Print: /'/
Seal: Seal:
NoOy tAu{aIle sae. of Florae,
Ale Owls
�! j � 337797
::APPROVED B_gt Plans Examiner Zoning
Structural Review % Clerk
(Revised02/24/2014)