ELC-13-1888BUILDING
Miami Shores Village
Building Department
90050 N.E.2nd Avenue, Miami Shores, Florida 33138 AU6 1 , 1
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 li
FBC 20 1
Permit No. F-
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS: 415- lV • E - /Os-
Master Permit No
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: 1%_ .2_%3/ — ® q3 — 00/0
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): &AG1000.o� 0 � iaM 1. Phone#:,56S'-%66 -� 0.39
Address: T� / y • a cc/o--6 2!ee,
City: /kind I -Sh orac State: rr_ Zip: -3313R
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: &1d 1JIM-5 G Phone #: So,V 453 -c; sa �O
Address: / f 2
City: --/� -1
Qualifier Name:
State Certification or Registration #: E013 00 / 83 ® Certificate of Competency #:
Contact Phone#: Email Address: 1&/t./
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Zip:
Type of Work: DAddress LXAlteratio ONew ORepair/Replace ODemolition
Description of Work: 0 ° V9_ •!7 G &Xgci
1'e� la cel�l��
Submittal Fee $ Permit Fee $��"a 40 CCF $ /Q � CO /CC $
Scanning Fee $ Radon Fee $73C) DBPR $ 0 ✓Z Bond $
Notary $ Training/Education Fee $ Technology Fee $ /
Double Fee $ Structural Review $
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDMONERS, 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be appony4,and a reinspection fee will be charged.
Signature `/ �✓ - _ — " ° — Signature
Owner or Agent
The foregoing instrument was acknowledged before me this,
day of *2 , 20 L., by UU /htS"CArq 4�
who is personally known to me or who has produced �J
As identification and who did take an oath.
NOTARY PUBLIC:
Contractor -d
The foregoing instrument was acknowledged before me this l
day of • 20 q by J -O SS)h k eft 4
is personally known tom r who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
.Sign: Si . "qy 4! NE mUS
MY COMfARISSION d DD 91 =*
Print ' *' I o ember? 2013 = p(PIRES: November 7. 2013
KS Banded Thru Notary Public Unde ,AF.
My Co My pares:
APPROVED
s� ,q P,? .%pa,/7
® Plans Examiner
Structural Review
(Revised 3 /12/2012)(Re -i 07 /10107)(Revised 06110/2009)(Revised 3/15/09)
Zoning
Clerk
534652 -3 ' n'J 13 NU I A 81LL - DO NOT PAY
BUSINE HELMS ELECTRIC
17850 NE 5 AVE
33162 UNIN DADE COUNTY
OWNER
EDD HELMS GROUP INC
PAYMENT FIEOEIYED
CMOLU OROCOt►NTY TAX
60060000048
000355.00
SEE OTHER SIDE
CAL CONTRACTOR
FlRST -CLA
U.S. PO$TASS QE
PAID
MIAMI, FL
PERMIT N0.231
RENEWAL
RECEIPT NO. 558398 -5
STATE# EC13001830
WORKER /S
66
DO NOT FORWARD
EDD HELMS ELECTRIC
WADE HELMS PRES
17850 NE 5 AVE
MIAMI FL 33162
55
KELLY', JOSEPH ROBERT
EDD HELMS CROUP INC DBA EDD HELMS.ELECTRIC
840 ALTAVISTA TERRACE
DAVIL FL 33325
Congratulationsl With this license you become one of the nearly one million
Floridians licensed by the Department.of Business and Professional -Regulation.
Our professionals and businesses range from architects to yacht brokers, from
boxers to barbeque restaurants, and they keep Florida's economy strong.
Every day we work to improve the way we do business in order to serve you bettei
For information about our services, please log onto www.myfloridalicense.com.
There you can find more information about our divisions and the regulations that
irnpact you, subscribe to department newsletters and learn more about the
Departments initiatives.
Our mission at the Department Is: License Efficiently, Regulate Fairly. We
constantly strive to serve you better-so that you can serve your customers.
Thank you for doing business in Florida, and congratulations on your new license!
DETACH HERE
(850) 487 -1395
Inspection Worksheet I — F-7, E
Miami Shores Village C I 10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 197604 Permit Number: ELC -8 -13 -1888
Scheduled Inspection Date: January 27, 2014 Permit Type: Electrical - Commercial
Inspector. Devaney, Michael
Owner: CHURCH, ST ROSE OF LIMA CATHOLIC
Job Address: 415 NE 105 Street
Miami Shores, FL
Project: <NONE>
Contractor: EDD HELMS ELECTRIC
comments
Inspection Type. Final
Work Classification: Addition /Alteration
Phone Number (305)758 -0539
Parcel Number 1122310430010
Phone: (305)653 -2520
400 AMP FEED & PANEL FOR AC EXACT
REPLACEMENT
Passed
Failed
Correction ❑
Needed
Re- inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
INSPECTOR COMMENTS False
Inspector Comments
January 24, 2014 For Inspections please call: (305)762 -4949 Page 3 of 20