EL-16-3072Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Parcel Number
No, - :'I- X3072
Permit Type: Ei esidentiai
INrirk I;fassila iron p for Test
Permit St:1l` s , PROVED
Issue Date :1111412016 Expiration: 05/14/2017
Applicant
1285 NE 95 Street
Miami Shores, FL
1132060144020
Block: Lot:
ROBERT AND NANCY FREHLINI
Owner Information
Address
Phone
Cell
ROBERT AND NANCY FREHLING
421 E SAN MARINO Drive
MIAMI BEACH FL 33139-
421 E SAN MARINO Drive
MIAMI BEACH FL 33139-
Contractor(s)
ABA ELECTRIC CORP
Phone
(786)304-7377
CeII Phone
Valuation:
Total Sq Feet:
Type of Work: TEMP FOR TEST
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.00
$2.00
$0.20
$100.00
$3.00
$0.80
$108.60
Pay Date
Invoice #
11/14/2016
Pay Type Amt Paid Amt Due
EL -11-16-62012
Credit Card $ 108.60 $ 0.00
$ 500.00
0
Available Inspections:
Inspection Type:
Final
Review Electrical
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.
November 14, 2016
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
November 14, 2016 1
BUILDING
PERMIT APPLICATION
Z
❑BUILDING LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
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
RIRCVINTRD
NOV 01 2016
FBC 201N
Master Permit No. P /4 - 542y
.0g
Sub Permit No.
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION 0 SHOP
` CONTRACTOR DRAWINGS
/2e5-�"1
JOB ADDRESS: 12it) �%s
City: Miami Shores County: Miami Dade Zip: 33 ti.`3i
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): -p&� ✓ - 4 VA Lor t 2 /-I 1 t f C) Phone#: (OS� t2 - 3q B
Address: 0 Z6( 2. 0 `v,jj i S-` 1 /
City: __ 6 � /en) 5 Lc v 0 5 State: T(. Zip:
Tenant/Lessee Name: Phone#:
Email: P,, l L
CONTRACTOR: Company Name: ABA caa Li V i t.. 0_0V p Phone#: 3(1 WL) t3 f
Address: t 27,O 0 Lir 619
City: f4 I A'VVl l State: I L Zip: 3;3) -
Qualifier Name: ✓,lGC'l l/ ✓�6i,A. G ot) 7. Phone#: 'igG, 30(f T"3 fl
State Certification or Registration #: _1i 3101 4-Ao 0 Certificate of Competency #: ii ono /(?)(9
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 300®F c Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration MNew ❑ Repair/Replace n Demolition
Description of Work:
3 i 38
Specify color o, color thru tile:
Submittal Fee $ Permit Fee $ /6'64' ag.U CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ QQ cam.
TOTAL FEE NOW DUE$ 8 d
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
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 • bsence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
(?----(A—,C.,<,
OWNER or AGENT
The foregoing instrument was acknowledged before me this
9 day of O.) irito,(' V"
120/J42 Y' f L./49 , who is
me or who has produced
identification and who did t
NOTARY PUBLIC:
Sign: pp
Print: Vu,w.��reS b� d /+%,‘4
NGtary t In; State of Florida
Uantar'rs Mibar+s
d` My C;umm, a+on FF 189892
f1iiinirixiVerxxolattaiip l pf
,20 2 ,by
rsonally know to
as
Sys i Notary Public State of Florida
Damaris Mi cans
My Commission FF 189892
gpoi Expires 01/14/2019
Seal:
Signature
ONTRACTOR
The foregoing instrument was acknowledged before me this
67) day of_ i(%/ ti/ aL t ) V , 20 CO( , by
lac_/ L!/vtic' 2 , who i rsonalo knowrnto
me or who has produced
ntification and who did take an oath.
TARY PUBLIC:
•
as
Sign:
Print: �l 1.l . A v. s
Seal:
•*i•lklk4Ml************
`_ Public State of Florida
Dam
`� Damaris Milians
+ 8` My Commission FF 189892
'�µal' Expires 01/14/2019
APPROVED BY Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
AFFIDAVIT FOR 30 DAY TEMPORARY -ELECTRIC SERVICE
NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY
TERMINATION UNLESS APPLICATION IS RENEWED.
It is understood that the temporary -electrical approval by the Miami Shores Village, Building Department given
in connection with the building being constructed under:
Building Permit N: f,G 14 " 44 Electrical Permit N: -EL-9-14-2915
At Address: 1285 4E aS Miami Shores, FL 3313$
For Owners: .Ogg1t q kiNtro1 64, , and is being given only for
construction purpose or for testing the following equipment in said
structure:
The owner does herby agree to assume the responsibility of maintaining the installation in such manner that
there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said
structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further
inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of
Occupancy or Completion is obtained.
The undersigned also understands that the temporary electric approval is subject to rescission and
cancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of
le building concerned is occupied before final inspections are approved and/or obtained a Certificate of
Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will resul
being un ble to obtain future Temporary for Test permits.
, being first duly sworn, depose and say that I am the owner
above described pro , and that I agree that the structure covered in this agreement shall not be o
until the building contractor has obtained approval of final inspections and/or obtained a Certificate of
Occupancy of Completion. Note: Fail re to comply with the provisions of this affidavi resul
bei p� unable to obtainature Te nbrary for Test permits.
Signature of Owner
1, =s.,24. -j 72(A‘A.: cy.) e -
the above-described . roperty and
if tempo s- - is, nected.
Signatu 4� r t, l ct c = Co� tractor Signature Nota
t 9Notary
Signature of Not
, being duly sworn, depose and say that I am the Electri
that the electrical installations as now existing will not cre
1, LpGpzio .'-JCi , being first duly sworn, depose and say that I am the Bu
of the above described property and that I will not permit occupancy of this building until final
been called for by the contractors and sub -contractors concerned and
obtained an; �- . I have the authority insofar as the owner of said pro
until suc► 1 inspections are obtained and/or a Certificate of Occupancy
�'
i pecuon . : vet 2 0
final approval by the ins 3 a
property
is concerned to prohibit Occup.` : ° o
or Completion i is ued.
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Building Contractor
Signature of Inspector
Signature of Notary
Signature of Notary