EL-17-1 Permit No. EL-1-17-1
y Miami Shores Village Permit Type: Electrical-Residential
10050 N.E.2nd Avenue NE Pen m i work Classification:Alteration
Miami Shores,FL 33138-0000 Permit Status:APPROVED
Phone: (305)795-2204
F'GOInt IOp'
Issue Date: 1/26/2017 Expiration: 07/25/2017
Project Address Parcel Number Applicant
1095 NE 95 Street 1132060143630
Miami Shores, FL Block: Lot: JOEL PEREZ PEREZ
Owner Information Address Phone Cell
JOEL PEREZ PEREZ 1095 NE 95 Street
MIAMI SHORES FL 33138-
1095 NE 95 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 570.00
MOODY ELECTRIC INC (305)758-2000
Total Sq Feet: 0
Type of Work:INSTALL CONDUCT&WIRING ON DOORS L Available Inspections:
Additional Info:INSTALL CONDUCT&WIRING ON DOORS L Inspection Type:
Classification:Residential
Final
Scanning: 1 Meter Box
Alteration
_ Relocation
Fire Alarm
Service Change
Review Electrical
W.W.
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# EL-1-17-62505
DBPR Fee $2.25 01/26/2017 Credit Card $ 109.10 $50.00
DCA Fee $2.25
Education Surcharge $0.20 01/03/2017 Check#:9062 $50.00 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
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.
,,—I 0_�- January 26, 2017
Authorized ignat e: wner / A plicant / Contractor / Agent Date
Building Department
January 26,2017 1
P
� �,, - Miami Shores VillagecF
T
��G DEC 0 3 2017
Building Department
10050 N.E.2nd Avenue, Miami Shores,Florida 33138 BY:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2014 �
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. CL 1— II
❑BUILDING XELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
) G� CONTRACTOR DRAWINGS
JOBADDRESS: /UGI5' No 1-d 4' �)
City: Miami Shores County: Miami Dade Zip: 33�3 75
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): -Jala PeIIP,9,� Phone#: 30 5- -1 cs-1 13
Address: F a Ct 1� NE '35-0., 6*4 `
City: ,liar, State: ( Zip: '3311-3 1
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Q ,1 � /9 ' Phone#:
Address: 4969 A/� -/oa'
City: AIIG Alo'Ql State: Jcz Zip:
Qualifier Name: 011A) -v-r /1,00 a04.1 Phone#: 7.5&02004
State Certification or Registration#: Af C4 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 1D, a d Square/Linear Footage of Work:
Type of Work: ❑, Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work:
o clo
Specify color'`of color" tliru tihe{ `
Submittal Fee$ Permit Fee$ CCF$' - `CO/CC$ "
Scanning Fee$ Radon Fee$ DBPR$ 2- 2 Notary$
Technology Fee$ ` Training/Education Fee$ " e� C) Double Fee$ ----�
Structural Reviews$ Bond$ �----
1 d
TOTAL FEE NOW DUE$
(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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signat
-� NER or AENT CONTRACTOR
The foregoing instrument was ackn ged before me this The foregoing instrument was acknowledged before me this
I& day of necC'1'.be It, 20 1�0 by '2—(r h day of Of rnV)P r ,20 ISD by
X06 FUM who is personally known to j6hn a. M t l who is personally known
me or who has produced as Igor who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print: C
Seal: fid' Notary Public State of Florida ip•►► Notary State d Fbtlda
Seal: � Rebeca MMuunoz
Rebeca Munoz
+fir My Commission FF 916344 ?�- ` E.Commission FF 916344
OF p Expires 09!08/2019 mor w Expires 09/08r2019
n
************** ****** ** * ** ******************************************************************************
APPROVED BY � �/�ie 3 .7��/)" Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)