EL-17-23151
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
10658 NE 11 Avenue
Miami Shores, FL 33138-2120
Owner Information
Permit
Permit No. EL -9-17-2315
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 9/28/2017
Expiration: 03/27/2018
Parcel Number
Applicant
Address
1122320280680
Block: Lot:
CYNTHIA FARISS
Phone
CeII
CYNTHIA FARISS
Contractor(s)
MOODY ELECTRIC INC
Phone
(305)758-2000
Cell Phone
Type of Work: REWIRE EXISTING HOUSE REMOVE CLOTH
Additional Info:
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$3.60
$3.38
$3.38
$1.20
$225.00
$9.00
$4.80
$250.36
Pay Date Pay Type
Invoice # EL -9-17-65169
09/28/2017 Check #: 1015 $ 200.36 $ 50.00
09/27/2017 Check #: 1014 $ 50.00 $ 0.00
Amt Paid Amt Due
Available Inspections:
Inspection Type:
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 AFFID IT: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and on n . uthermore, I authorize the above-named contractor to do the work stated.
Authorfied Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
September 28, 2017
Date
September 28, 2017 1
fi'/\C
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit No.
RECEIVED'
StP2 7 2017
t. -i .7 -ZS i S
Master Permit No.
Permit Type: Electrical / ,, / �-
OWNER: Name (Fee Simple Titleholder): Al F#412/2./6
Address: /?3658 4)L //,4t/
City:frgea-Mi61, ►i' D4 2' State: 7(,/'7/i
O'2/�
Phone#: Gj cva
Tenant/Lessee Name: Phone#:
Email:
Zip: 3'31S
�.
JOB ADDRESS: 1.65-g7 ,iiif ! �4�ve
City:
Folio/Parcel#:
Miami Shores County:
{ 32 -- OZ.S' - o(a,s�
Is the Building Historically Designated: Yes
Miami Dade
Zip:
NO Flood Zone:
CONTRACTOR: Company Name: %rlC7i2e.-<._ /'O ' Phone#: '5 75-8 010'00
Address: 580a A.1 019 11 -
City:°%6/(.(?L�''Ci State: 7� (CM - Zip: .5J�D� 0 ,
Qualifier Name: / AN -<7— /oo L%
State Certification or Registration #:
Phone#: 365 75-c 2 Cr)
Certificate of Competency #:
Contact Phone#: (✓J 7�(F:C- Email Address:
it///4".
DESIGNER: Architect/Engineer:
Value of Work for this Permit:
Type of Work: °Address
Description f Work:
e)v,4
iti
°Alteration
//
7,26,e--17
Phone#:
Square/Linear Footage of Work:
❑New epair/Replace ❑Demolition
***************************************Fees********************************************
Sd °� Permit Fee $ 2z. / ��
Submittal Fee $ ea4 D
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
/0/4
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done incompliance 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
Owner or Agent
The foregoing instrument was a4 o' ledged before me this 2',Tt1
day of SCPtYnb(773 la, by r—, *-13A0
i �i4ttisi,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission E
Notary PubNc State of Florida
Rebeca Munoz
• My Commission FF 916344
or no' Expires 09/08/2019
**************** * * ** *** ****
Sig a u _ • /�
Contractor
The foregoing instrument was acknowledged before me this '7 7
111
day of Stet.101, 20 13, by 30114 J . MOtAt.1 ,
who is personally kno me or who has produced
as identification and who did take an oath.
NOTARY PUBL :
Sign:
Print:
11111\.—_ rL—/
My Commissi
*************************************
APPROVED BY )5-2-0Z-- Z c / Plans Examiner
Structural Review
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Ni es: Notary Public State of Florida
\®: Rebeca Munoz
p o` My Commission FF 916344
1904, nap Expires 09/08/2019
***
Zoning
Clerk