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ELC-17-991 Miami Shores Village Mt Permit Type:Electrical-Commercial 1ookw.E.2nd Avenue ws Po& rill Miami Shores,rLnu1m8-ouoo Phone: (305)795-2204 L Issue,oate:411112017 Expiration: 10/08/2017 ` Project Address Parcel Number Applicant 10021 NE 2 Avenue 1132060134650 MIAMI SHORES VILLAGE Miami Shores, FL Block: Lot: Owner Information Address Phone, Cell MIAMI SHORES VILLAGE Contractor(s) Phone Cell Phone Valuation: $ 1,450.00 MOODY ELECTRIC INC (305)758-2000 Total Sq Feet: � 0 Type T of Work:INSTALLATION OF 2 HAND DRYERS 2-20 Available Inspections: Additional Info:INSTALLATION OF 2 HAND DRYERS 2-20 Inspection Type: Classification:Commercial Final Scanning: 1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground UNCEM W.W. Fees Due Amount Pay Date Pay Type Amt Paid Arnt Due CCF $1.20 Invoice# ELC-4-17-6364:7 DBPR Fee $2.00 04/10/2017 Credit Card $50.00 $60.20 DCA Fee $2.00 Education Surcharge $0.40 04/11/2017 Credit Card $60.20 $0.00 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $110.20 — / ' In consideration of the issuance to mo of this permit, | agree to perform the work covered hereunder in compliance with all mdimonmm and regulations pertaining thereto and instrict conformity with the plans,drawings, statements mspecifications submitted mthe proper authorities cxMiami Shores Village. In accepting this nonnn | assume responsibility for all work done byeither myself, my agent, servants, or employes. | understand that separate permits are equ|n�dfor ELECTRICAL,PLUMBING,MECHANICAL,vv|woOW8.DOORS,ROOFING and SWIMMING POOL wmm. Gary ( 3a5 ) q15 - 6595 a3JJ33NA3 1 t C �\�\ Miami Shores Villa C\ Village APR 102017 Budding Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ---_ Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2-014 sth BUILDING Master Permit No.E� 11 q 91" PERMIT APPLICATION Sub Permit No. ❑BUILDING 4 1 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS- ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: &6,V A)25� 0��J�0_ City: Miami Shores County: Miami Dade Zip: i Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: -Flood Zone:---- BFE: - FF.E:,- - -- -.- - - �,�7 � OWNER: Name(Fee Simple Titleholder): A 67 A a#: Address: City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:: Phone#: Address: N City: State: Zip: Qualifier Name: ZZ2 Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: 44A Phone#: Address: City: State: Zip: Value of Work for this Permit: Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: , i Specify color of color thru tile: Submittal Fee$ FQ0 Permit Fee$ dr ©Q CCF$ 2O CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ a Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ ' TOTAL FEE NOW DUE$ zo (Revised02/24/2014) i , Bonding Company's Name(if applicable) Bonding Company's Address t — City State Zip 'mortgage Lender's Name(if applicable) s 'Mortgage Lender's Address 41 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 i 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 ' in i ated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of comme ement 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 (�� AIMAA jib 1,UZIn Sign OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this I Q day of d I 20 ) by _day of Ail I ) 20 1- by �Ic;hl°1 V v In who is personally kno to �r5 hn �=Mo Q who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: J Print: c4hPrint: Seal: :�*�'Pi' BARBARAAESTEP 6tOz/80 sa�ldx3 -4 r ern a 46C9t6 3d u0lsslww00,tyy a0, MY COMMISSION#FF 07397,; Notary Public State of Florid zounyy eoagaa ;y :a EXPIRES:March 2.9,2018 Rebeca Munoz PPOW 10 atetS 01Iqnti � tips2°` Bonded Thru Notary Public Underwriters c �� My Commission FF 916344 d elOry � ?0r8&a0 Expires 09/08/2019 *********************** ****** ******** * * ********************************* APPROVED BY /d lan"s Examiner Zoning r Structural Review Clerk { (Revised02/24/2014) t