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EL-19-2143Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address PDGt nu�lbt� Issue Date: 09/20/2019 Parcel Number 601 GRAND CONC, Miami Shores, FL 33138 1132060172140 Contacts Permit NO.: EL-09-19-2143 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Expiration: 03/18/2020 CARLOS FELIPE LEMOS Owner Elekron Electric Inc Contractor 601 GRAND CONC, MIAMI SHORES, FL 33138 Rodrigo Moreno Business: 7864235230 rodrigo@elekronelectric.com Description: 60 AMP EV CHARGER Valuation: $ 989.00 Inspection Requests: 305-762-4949 Total Scl Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $116.30 Payments Date Paid Amt Paid Total Fees $116.30 Credit Card 09/20/2019 $116.30 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. Futhermore, I authorize the above named c9likactor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date September 20, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION 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 Master Permit No. RFcF/v Sep 1 �, F ?pig FBC 201-1 to S �L-mac _ 1G _21`i3 BUILDING Q ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING [—]MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 601 GRAND CONCOURSE City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3206-017-2140 Is the Building Historically Designated: Yes NO Occupancy TypeRESIDENTIAL Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): CARLOS LEMOS & NICOLE BROFMAN Phone#: (305) 773-2721 Address: 601 GRAND CONCOURSE City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: (305) 773-2721 Email: NIKIBROFMAN@GMAIL.COM CONTRACTOR: Company Name: ELEKRON ELECTRIC INC Phone#: (786) 423-5230 Address: 3641 SW 25 TERRACE City: MIAMI State: FL Zip: 33133 Qualifier Name: RODRIGO MORENO Phone#: (786) 423-5230 State Certification or Registration #: EC13009214 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 989.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑i■ New ❑ Repair/Replace ❑ Demolition Description of Work: 60 AMP EV CHARGER .» .. . 4 Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 3Q) (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 and a reinspection fee will be charged. Signature Signature OWNER or GENT ONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this to dayof S-WiAkl 20 iq by 1�0_day of StOkMMi 20 (q by (�l LOQ &UmGVI who is personally known to Q.C)rll G O N)U MQ whdC so lly know to me or who has produced t7. L as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY P BLIC: NOTARY PU C: Sign: Sign: Print: LL4c164 ,F S(ta Print: 1,u L U -Ei2h Seal: :�, LUCIA VgNESSA=ONSECA .�:. Notary oLD11C - State of r;orida Seal: 'jr o�',. LUCIA VA-, =ONSECA /G� r` Notary Puy is - State of Florida �Commission = GG 907469 .:. My Comm. Expires Sep 30. 2023 F ;a Commissior = GG 907469 '`''Fo My Comm. Expires Sep 30, 2023 3onaed through Nationa; NotAssn *3 r e 'hrou h vatior.a, Notary Assn. R#060*************** ******* ************************* **** APPROVED BY _ Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) PROPOSED WORK 200 Amp Existing Interior Electrical Panel 60 Amp rated Tesla Charger ............. ............. ELECTRICAL R W /tj 5 �� '' APPROVED ATE Nicole Brofman 601 Grand Concourse Miami Shores, FL 33138 3/4" EMT Conduit (2) #6 THHN Wire (1) #10 THHN Ground Wire ^�` • LUCIAVAN[SSAFONSECA :` • Notary Public - State of ciorica Commission M ExreSe3052023 Bonder; through National Notary Assc. C� Y 91 I(Pltq Elekron Electric Inc. 3641 SW 25 Terrace Miami, FL 33133 LIC# EC13009214 Qualifier: Rodrigo Moreno (786) 918-6018