EL-18-1719Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pei
mit
Permit NO. EL-6-18-1719
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 6/28/2018
Expiration: 12/25/2018
Parcel Number
Applicant
535 NE 95 Street
Miami Shores, FL 33138-
1132060140730
Block: Lot:
GARRETT & NAYLA MOFFETT
Owner Information
Address
Phone
Cell
GARRETT & NAYLA MOFFETT
535 NE 95 Street
MIAMI SHORES FL 33138-
(305)409-2770
535 NE 95 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
ELECTRIC SOLUTIONS SERVICES CC (786)339-0938
Valuation:
Total Sq Feet:
$ 1,725.00
0
Type of Work: REPAIR A BATHROOM
Additional Info: REPAIR A BATHROOM
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.25
$2.00
$0.40
$150.00
$3.00
$1.60
$160.45
Pay Date Pay Type
Invoice # EL-6-18-68021
06/22/2018 Credit Card
06/28/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 110.45
$ 110.45 $ 0.00
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 AFF T: certify tha e•foreg information is accurate and that all work will be done in compliance with all applicable laws regulating
constructio d zo 9. Fut - reauthorize the above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
June 28, 2018
Date
Building Department Copy
June 28, 2018 1
(0\9"\\•gto
cam'
BUILDING
PERMIT APPLICATION
(BUILDING
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
LECTRIC ❑ ROOFING
Master Permit
Sub Permit
❑ REVISION
RECEIVED
JUN221018
C_HM
FBC 20
No. �— J—l8 bd
No. E. \ Ig -
❑ EXTENSION
(PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS n CHANGE OF ❑ CANCELLATION
CONTRACTOR
JOB ADDRESS: J 3 J
City: Miami Shores County: Miami Dade
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone:
n RENEWAL
❑ SHOP
DRAWINGS
Zip: 3K
NO
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): KA ' ( /� H 0 �� Phone 3v
Address: S N�'`1 ,� �s S�
City: �`Ck(�\. SV V State: — Zip: S'S1-S1
Tenant/Lessee Name: Phone#:
Email:
N Att (-)A- k (° 3YYVA I 1 • COIV1
CONTRACTOR: Company Name: e/6C 74/ 5-m(0 ' ' Uk S 6 ,,4'ttl c a
Address: 3 el (o S 6 / / Z AVP
City: _ A4I 4
Qualifier Name:
State:
/4-1T-0°4, ,4 I 1 G NI /c
State Certification or Registration #: E R l 301 40 3 ( Certificate of Competency #: / 3 I_ COO'/ 6 7 1
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Phone#: 34,1C3 3 9 / 3 0
Value of Work for this Permit: $
/2 2 �00
Zip: /
Phone#: 6'6 3 3 f 4 7 3 8
Square/Linear Footage of Work:
Type of Work: n Addition ❑ Alteration ❑ New
/ Repair/Replace 1-1Demolition
,(J
Description of Work: 20 tl 4 R 3Q � In V OD (Al
I
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 450, t20 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ a • co DBPR $ a • d"� Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE$ 11C • 45
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address " w.
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 riot be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
ZZ day of V ( jAcl_ , 20 I V , by
C U\\G MD w A +` , who is personally known to
me or who has produced l 1 1 �Q 4'ThVL, as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED BY
MAHARAI K. GONZALEZ
EXPIRES: November 2, 2020
Signature
4
CONTRACTOR
The foregoing instrument was acknowledged before me this
22, day of ,JUNc , 20 bye
knnov%'n o`-� me or who has produced ¥�, �p� Ull�- (kC.k4) =-
identifica and who did take an oath:
NOTARY IC:
Sign:
Print:
Seal:
} o' Nit. Notary Public State of Florida
Sindia Alvarez
o My Commission FF 156750 ic
i.A
1n� �� Yu�
lns Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)