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EL-05-22-1372Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 issue Date:06/24/2022 Permit NO.: EL-05-22-1372 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Expiration: 05/08/2023 -ocation Address Parcel Number 375 NE 94TH ST, Miami Shores, FL 33138 1132060136120 ua... _.. . _____ - - �.,._...x€::®r:.. _._ .,_.: .:.:,ice-_.,....:.. .: _.. •-_ Contacts James and Summer Williams Owner STRANGE & STRANGE CONSTRUCTION Applicant 375 NE 94 ST INC Home: 9044025787 schaferlO@yahoo.com At LEN STRANGE 1325 SW 87 NE, MIAMI, FL 33174 Business: 3059156581 ALLEN@STRANGECONSTRUCTIONS.CO Mobile: 3059156581 M TONY WELL 4310 NW 11 ST, MIAMI, FL 33126 Business: 3057267098 wellelectrictech@gmail.com Other: 7864738455 inspection Requests: Description: 3 HI -HATS, ONE 20 AMP GFI IN BATHROOM 41 6 Valuation: $ 3,000.00 305-762-4949 HI -HATS, 3 SCONCES, ONE 20 AMPS GFI IN BATHROOM 42, 6 SWITCHES TOTAL FOR BOTH BATHROOMS Total Sq Feet: 131.00 Fees Amount , application tee - Other $50.00 CCF $1.80 Change of Contractor $145.00 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $55.00 Scanning Fee $3.00 Technology Fee Total: $262.03 Payments Date Paid Amt Paid Total Fees $262.03 Credit Card 06/24/2022 $117.03 Credit Card 11/07/2022 $145.00 Amount Due: $0.00 :wilding Department Copy rs ,nsideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations . n"mmg thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores wage. 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 POOLwork. 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 zooming. Futhermore, I authorize the above named contractor to do the work stated. y AA/Y-m .vsn e n // /% Authorized Signature: Owner / Applicant / Contractor / Agent Datd November 07, 2022 Page 2 of 2 Miami Shores Village Building Department 10050 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 0 ELECTRIC ROOFING PLUMBINGMECHANICAL CgCHANGEOF CONTRACTOR FBC 20 Master Permit No. RC-DS-_ZZ- 13`71 Sub Permit No.EzL- - 65-" Z7-13-7Z ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS JOB ADDRESS: 3-76- N4 St City: Miami Shores County: Miami Dade Zip: 33) 3 9 Folio/Parcel#: 1 / , Sat+ -- 013 - cpl R O Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): V)(Am -CA ':SGAw\es lJ__:))Na yyiS Phone#: W-gZ)2-57 F7 Address: 3-75- 11125c? q1h St City: ' 001 State • 12• Zip: .3 3 % 3 Tenant/Lessee Name: ti111 Phone#: Email: "i' 1 d a 0 CONTRACTOR: Company Name: We-� 1 G e�'�� '+'� iL Phone#: �l0 " 3(0 4 - ?263 Address: " / 3% 2 N • VV i /'Ox 6t K q M )' 3 31 z eo Email: - Shores Qualifier Name: --7-p h PJ ei Phone#: -7q_?0-34eU - 9 Z // 3 State Certification or Registration #: j'5: C 130o 111 Certificate of Competency #: DESIGNER: Architect/Engineer: Gt_,E�� /_ P_ , � "12• 4!�' . Phone#: 30,.5-- gP-3 - 393 9 Address: —79SD AW 1 16 -14 --9 5-bq City: R- LAW-S State: _FL -Zip: '3_30)to Value of Work for this Permit: $ '�n O O • f' Square/Linear Footage of Work: 131 S :2 Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work:, kU - 9afs , ome zo a n145 co P/ , i n -g oL� re � - l (D 4 �xt5 , 3 _<,yo nce 3 a one 2-0 aa:e 5 a -# Z Specify color of color thru tile; Submittal Fee $, Scanning Fee $ 7,; Permit Fee $ DCA Fee $ Technology Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Structural Reviews $ P&Z Review $ Notary $ Double Fee $ Bond $ (Revised04/05/2022) TOTAL FEE NOW DUE $ 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 and a reinspect ion fee will be charged. Signature 4<sx6L�(�v tl-� Signature �— OWNERor AGENT C TRACTOR The foregoing instrument was acknowledged before me this day of �iOd2vr�lox r 20 ZL by e�- W lli cL s who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this aZ -1 day of 6GAQY)L,(- 20 nA ra)( by �O`IW UuG� who I per�_known to as me r who has produced identification and who did take an oath. NOTw ov m im ,e. as Sign: l ��-`— C/V W Sign: Print: Y t ✓ i-e-✓1✓r+- 0..a Print: kyRlcu Seal: ""11p"r� VivienneYao no ry �'d�uE t21p of Florida `. pr n0 p. Seal: '�L 7t: O - IiSIBP 4 bb 04IA67 Comm.:HH22241C E ,t oR 1f�i§t410.2024 = Expire • Jan.31, 2026 a , Mry.nn. �= ewe �b 5'g'�'�"�� olar�Pu ic•StateofFlodda ry OF p irYIp11PQ`t#i t# #R #tttt t##4####4ii#tiit##tt#Rt##4##4#######t#i#tt#RtR44iRi4#4Rttttt#ttttt# APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised04/05/2022) 31y,_ r e n e S. Gr ttin. S_ucl_ •: dbpr STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS' LICENSING BOARD THE ELECTRICAL CONTRACTOR I IEREIN IS CERI II`ILD UNDLR I HE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES WELL, TONY WELL ELECTRIC TECHti'OLOCY INC 4310 NW 11 STREET MIAMI FL 33126 LICENSE NUMBER: EC13001181 EXPIRATION DATE: AUGUST 31, 2024 Alwo.vs verity licenses onLre at N1yFIc ri:lt�Li�cnsc.wni Du not Biller this document in any form. �� ' fir This is your licenses It is unlay.,ful for anyone other thin the licensee to use this document. Local Business Tax Receipt Miami —Dade County, State of Florida THIS IS NOT A BILL -DO NOT PAY 5567087 RECEIPT NO. RENEWAL BUSINESS NAMEILOCATION 5807087 WELL ELECTRIC TECHNOLOGY INC 4312 NW 11TH ST , MIAMI, FL 33126-2504 OWNER SEC. TYPE OF BUSINESS WELL ELECTRIC TECHNOLOGY INC 116 ELECTRICAL CONTRACTOR Worker(s) EC13001181 L 13 Ir EXPIRES SEPTEMBER 30, 2023 Must be displayed at place of business Pursuant to County Code Chapter SA - Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR 45.00 08/05/2022 CHECK21-22-=141 Thb Lard B=1== Tea R*0dPt Q* =dff= psratnt d the Local BUhN= Ttx Tint Radpt b tot a llmm, ptn A w a antlSadw tithe folders quOudow to do hubmw liddsrwd com* wo wq limes or acsaortrneenbd rspdatQq bws and roqdromub whicb sp* to the badnm Tbt RECOP"f NIX show aiadbt dkpleped os an oomane ,I wN., -111bM Deft Code Seo ia-M ®u Far wore ia%MwdoR, tbB ACo ® CERTIFICATE OF LIABILITY INSURANCE �'�" °°` "r' 7r18=ZL-- THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IINSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the po[icy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endomemen s . PRODUCER PAULETTE BROWN IMPACT INSURANCE SERVICES LLC PFK 954 885 884 FAx 954 685.3885 180" SW 33 Court lomm. impactooryaRmsn.com Miramar, FL 33029 INS S i FORDING VERAGE NAIC f INSURED IN WRER S WELL ELECTRIC TECHNOLOGY, INC. mac; 4312 NW 11 STREET INSURER D MIAMI, FL 33126 INSURER E : 0•0n1k8=nA0%-00 f'%C0T1C#eATC UIIUQCD• i?RVIAMN NItYRFD• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRLTR TYPE OF INSURANCE POLICY NUMBERADOLSUSR POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR CL 1799478CD 3MGM= 3nG=n EACH OCCURRENCE $ 11,0001000 $ 100,000 MED EXP one $ 5.000 PERSONAL 6 ADV INJURY s 1000 000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE $ Z0001000 PRODUCTS - COMP/OP AGG S 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNE AUTOS ONLY AUTOS ONLY (E INED l R $ BODILY INJURY (Per person) S BODILY INJURY (Per accident) S DAMAGE Pcr $ S UMBRELLA LL46D EXCESSLL48 OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE Is DED I I RETENTION S S WORKERS COMPENSATION AND EPAPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE� OFFICER(MEMBER EXCLUDED? (Mandatory In NFL) If desalbe under D OF OPERATIONS below NIA PTR OTH R - E.L. EACH ACCIDENT S EL DISEASE - EA EMPLO S EL DISEASE - POLICY LIMIT S DESCRLPTION OF OPERATIONS I LOCATIONS I vEMLES MCORD In AdMonal Remarks Seh *ft may be attached If more space Is ragointo ELECTRICAL WORK w2--1ftqn0-ff0.A9ra-_ ufti e%rs eAaaf =1 1 ATIONU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORE VILLAGE BUILDING DEPARTMENT 10050 NE 2nd AVENUE ,MIAMI SHORES,FL933138 THE EXPERATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRovLswNs. TEL:(305)756-8972 AUTHORIZED REPlZEMTATIVE %R i va wwi o AuwKIJ uwKI'LiKA I nim. All r19n18 reserves. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ACOO CERTIFICATE OF LIABILITY INSURANCE IM1 nATE 70711 °°`�"'�'@/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(Ies) must have ADDITIONAL INSURED provisions or be endorsed. It SUBROGATION IS WANED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such erdorsement(s). PRODUCER Eastern Insurance Group, Inc. 9570 SW 107 Avenue Suite 104 Miami FL 33176 cc cTNAME: Amanda Nogues PHONE (305) 595-3323 FAX no): (305) 595-7135 amanda@easteminsurance.net INSURER(S) AFFORDING COVERAGE NAIL 0 INSURER A: RetallFirst Insurance Company 10700 INSURED Well Electric Technology, Inc. 4312 NW IIth St Miami FL 33126 INSURER B INSURER C : INSURER D: INSURER E : INSURER F : cevFRACPS CERTIFICATE NUMBER: Master 20-21 REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NURIBER lJlYlr UwrS COMMERCIAL GENERAL LIABILITY CLAIMS4AADE OCCUR EACH OCCURRENCE S PR S MED EXP (Any oneperson) S PERSONAL & ADV INJURY S GEN'LAGGREGATELIMIT APPLIES PER: POLICY El JECT LOC OTHER: GENERAL AGGREGATE S PRODUCTS - COMNOP AGG S $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ BODILY INJURY (Per parson) $ BODILY INJURY (Per accident) $ PROPERTYWOM (Pat aadftm S S UVORF�.LA UA0 EXCESS LIAR OCCUR CLAIMS -MADE. EACH OCCURRENCE S AGGREGATE S DED I I RETENTION S S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER(MEMBER EXCLUDED? (Mandatory In NH) 0 Yes, desaibe tmder DESCRIPTION OF OPERATIONS bebw N / A 12361 O7I211Z022 07/29/2023 STATUTE I ER E.L. EACH ACCIDENT 3 1.000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 EL DISEASE - POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEFitCM (ACORD I M, AddNtlww Remarks Scloodule, may be attached It mo a space Is roqulred) Bectdcal Work SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORE VILLAGE BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd AVENUE. MIAMI .SHORES,FLORID& 33138 ACCORDANCE WITH THE POLICY PROVISIONS. TEL•(305)756-8972 AUTHORIZED REPRESIWATNE 01985-2015 ACORD CORPORATION. All rignts reserved. ACORD 25 (2016M) The ACORD name and [ago are registered marks of ACORD PernnitNumberrL'OS' 2a-13 7Z PC-as•22-1371 Owner's Name (Fee Simple Title Holder)I LUM Phone: - 0a 5 Owner's Address: 3 7,Ts-�- city: Qrn i Jha-e State:--- r2-- Zip Code: 3 3 / .lob Address (where work is being done: 6 7!E�- N6 City: Mlaml Shores State: Florida Zip Code: 33) 3 9 Contractor's Company Name: d . s Phone: 3�s - 92. 6 sso-7 -- Lo Address: D 3• NF Ale - City: State:_ -R- Zip Code: 3 3) 90 Qualifier's Name: -2& veil�.r�r`fi` s _ Uc. Number: Architect/ Engineer of Record Name: Address: City State: Phone: Zip Code: Describe Work:Z 0a 6f-4- 'In rZ, z 3 zv' 3 ce s 1 hereby Co Scvr�ttS �"i'� that the work has been abandoned and/or the Contractor/architect Is unable or unwilling to Complete the contract, I hold the Building offidal and the Miami Shores harmless of all legal In-- v=85ent. Owner / Agent The foregoing instrument was aknowledged before me this I day of Ala Y-.20 �z, by Who Is personally known to me or who has produced as indentification. Notary Public Sign and Seal: Vt ' V-" K` Y� NContractor / Architect / Engineer The foreg g instrument was aknowledged before me this day of _ .20 , by known to me or who Notary Public Sign and Seal: Who is personally as Viv' nneYso 11062,,.-• a ofCC Page 2 of 2 ore.. �trm 4� Expires: Jan. 31, 2026 Notary Public- State of Florida ,�En�a 4,1 i -its; 1,e,; 1 **J*. tAy elli -31ViV 30� *0 .4192 - Alduil M1 To: L S Curtis Inc Lewis Curtis 20341 NE 30 Ave #108 Aventura, FI 33180 RE: Permit # EL-05-22-1372 Address: 375 NE 9401 St, Miami Shores, This is a letter of notification that as legal owner(s) of subject property, I/We have requested a change of contractor and are removing you and your business from the permit referenced above, permit issued to L S Curtis Inc. whose mailing address is 20341 NE 30 Ave #108 Aventura, FI 33180. The Permit was issued on 06/24/2022. I/We requested a change of contractor for the following reason: A new general contractor will be taking over our project/permit and prefers to use a different electrician of his choice. I/We no longer authorize the previous permit holder, LS Curtis Inc. to proceed with any further work covered by this permit. /Ja=mes Williams - ate �minec� JD.f�� a3�aa Summer Williams- Date C./1 QG� IG Qi2 RM POSTS SERVICE, MIAMI SHORES 9825 NE 2ND AVE MIAMI. FL 33153-9998 (800)275-8777 09/23/2022 12:26 PM Product Oty Unit - --Price Price First -Class Mail® 1 $0.60 Letter Miami, FL 33180 Weight: 0 lb 0.40 oz Estimated Delivery Date -,. Mon 09/26/2022 Certified Mail@ $4.00 Tracking #: .� 702127200Q0279584174 Return Receipt $3.25 Tracking #: 9590 9402 6882 1104 8912 93 Total $7.85 First -Class Mail® 1 $0.60 Letter Miami. FL 33161 Weight: 0 lb 0.50 oz Estimated Delivery Date Mon 09/26/2022 Certified Mail® $4.00 Tracking #: 70212720000279584167 Return Receipt $3.25 Tracking #: 9590 9402 6882 1104 8913 09 Total $7.85 Grand Total: $15.70 Credit Card Remit - $15,70 Card- Name AMEX Account #: XXXXXXXXXXXJ009 Approval #: 829783 Transaction #: 398 AID: AOOOOOG025010801 Contactless AL: AMERICAN EXPRESS PIN: Not Required Text yoLr tracking number to 28777 (2USPS) to get the latest status. Standard Message and Data rates may apply. You may also visit WWW.usps.COM USPS Tracking or call 1-800-222-1811. Preview your Mail Track your Packages Sign up for FRET= 9 https.//informeddelivery.usps.com All sales final on stamps and postage. Refunds for guaranteed services only. Thank you for Your business. Tell us about your experience. Go to: https://postalexperience.com/Pos or scan this code with your mobile device. or call T-1I00-410-7420. --------------------------=�_ -- Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 375 NE 94TH ST, Miami Shores, FL 33138 Contacts Permit NO.: EL-05-22-1372 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Issue Date:06/24/2022 Expiration:12/26/2022 Parcel Number 1132060136120 James and Summer Williams Owner Arco Construction Corporation Applicant 375 NE 94 ST LESTER JENSEN Home: 9044025787 schaferl0@yahoo.com 1665 NE 137 TER, MIAMI, FL 33181 Business: 3058926507 arcoconstruction@aol.com Other: 3058926507 L S Curtis Inc Contractor Lewis Curtis 20341 NE 30 AVE 108, Aventura, FL 33180 Business: 305-933-0683 steve@lscurtis.com I Ins ection Requests: Description: 3 HI -HATS, ONE 20 AMP GFI, IN BATHROOM #16 Valuation: $ 3,000.00 305 ectio 949 HI -HATS, 3 SCONCES, ONE 20 AMPS GFI IN BATHROOM #2, 6 SWITCHES TOTAL FOR BOTH BATHROOMS Total Sq Feet: 131.00 Fees Amount Application Fee - Other $50.00 CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $55.00 Scanning Fee $3.00 Technology Fee $2.63 Total: $117.03 Payments Date Paid Amt Paid Total Fees $117.03 Credit Card 06/24/2022 $217.03 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 zoning. Futhennore, I authorize the above named contractor to do the work stated. Signature: Owner / Applicant / Contractor / Agent Date June 24, 2022 Page 2 of 2 Miami Shores Village ENTERED Building Department MAY 3 r ZOZZ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BY. INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No. PC -OS -2.2-13-( PERMIT APPLICATION Sub Permit No. -EL -05 "ZZ- 13-72— ❑BUILDING FAELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS Ej CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ' l N e q4 City Miami Shores County: Miami Dade zip: Folio/Parcel#: 61- 3 LOIo - C)13 —(P 1 Zo Is the Building Historically Designated: Yes NO 1� Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 50(1(1r f .i�tH� (nit 11A.(�� Phone#: Address: '�i� �" ISIC U -117761e z: City:State: Zip: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: � r "�'j , / V �-,f) Phone#: 0 Address: _ 70 —L) 41 N'6 O AVE -* 1()Q City: kNo c of State: (__ Zip: 22Z g Qualifier Name: i r-w l S �&09 1Z1 l Phone#: /�i0� C(i� O 1 State Certification or Registration/#: E COgo �7 S Ce (rti�ficate of Competency* Architect/Engineer: YYIW/SAtCIIce ,IAA .IJ (Z Y+ 0 Phone#:r�Z2"1 Address:�� D AI rw��Ll (� T 4 ! c;toQ City: , (, .�� State: %l zip: 33�0 i � g Value of Work for this Permit: $ O D i Square/Linear Footage of Work: 22 A� Type of Work: ❑ Addition ❑ Alteration ❑ New [r� Repair/Replace ❑ Demolition Specify color of color thru We: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ Permit Fee $ CCF $ CO/CC $ Radon Fee $ DBPR $ Notary. Training/Education Fee $ Double Fee $ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City S1 Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 and a reinspection fee will be charged. Signature f, AIYYUV IA W.(� OWNER or AGENT The foregoing instrument was acknowledged before me this �q day of ' V'"'7 ,20 2 Z by W,wnt -V T W. I Ita"a3 . who is personally known to me or who has produced FL P L . as identification and who did take an oath. NOTARY PUBLIC: Print: .. it, '5 xe-Ls. Q4 �iJ, Seal = "O[er runic fiat-OfHonda Commissionffi GG 27a249 s cnmm 00- 31. 2022 *sssssssssssssssssssssssssssssss**ss*:::::ssss APPROVED B4�jEG`y`A%'1.6�L-TiJCPI%�2-. Signature CONTRACTOR The foregoing instrument was acknowledged before me this rr� day of z jiZ •/ 20 by G�c�/� •.�.TiC w is personally known to me or who has produced i identification anti who did take an oath. NOTARY PUB61C: n 1 \, Sign: .r'P U6SANDRA NEBBIA -� '�.. ^-fission R GG 974415 Print: i`• �.P., re,` Bonded[hrou § mna'!, Notary Assn. Seal: :ssss::*****::sssssssssss*s***:ssss*sss*******sss Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk