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EL-17-1811Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit No. EL-7-17-1811 Permit Type: Electrical - Residential Per 111' Worn Classification: Alteration Permit Status: APPROVED Parcel Number Issue Date: 8/17/2017 1 Expiration: 02113/2018 Applicant 290 NE 101 Street 1132060134590 STEVEN T DOBIE Miami Shores, FL 33138-2423 Block: Lot: Owner Information Address Phone Cell STEVEN T DOBIE 290 NE 101 Street (512)569-3370 MIAMI SHORES FL 33138- 290 NE 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone MOODY ELECTRIC INC (305)758-2000 /pe of Work: REMODELING OF BATHROOM & KITCHEN dditional Info: REMODELING OF BATHROOM & KITCHEN lassification: Residential -anninq: 1 Fees Due Amount CCF $2.40 DBPR Fee $2.25 DCA Fee $2.25 Education Surcharge $0.80 Permit Fee - Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $163.90 Valuation: $ 3,500.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-7-17-64584 07/13/2017 Credit Card $ 50.00 $ 113.90 08/17/2017 Credit Card $ 113.90 $ 0.00 WCELLL 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 an , drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility f all w rk done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAIUMBING, MEC MICA ,WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: ify that all the f rego' g information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonino.ermore. I autho ize a above -named contractor to do the work stated. August 17, 2017 Authorized Signature: Owner' / Applicant / Contractor / Agent Building Department Copy August 17, 2017 RICK SCOTT, GOVERNOR .JONATHAN ZAHEM,SECRETARY Fldda 0,, p�, r STATE OF FLORIDA DEPARTMENT OF BUSINESS:ANDPROFESSION A! REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD THE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES MOODY, JOHN J MOODY ELECTRIC, INC. 13700 ROANOKE STREET DAVIE FL 33325 LICENSE NUMBER: EC0001199 EXPIRATION DATE: AUGUST 31 2020 Always verify licenses online at MyFloridaLicense.com %1%L- Donot alter this document in any form. Rq WThis is your license. It is unlawful for anyone other than the licensee to use this document Miami Shores Village' Building Department JU20' 1 o050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Ot Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. Vc �� 3 PERMIT APPLICATION Master Permit No. LL 1 1 - taj 11 FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder):�VPI� �8 e Phone#:/dam St; g �3 � Address: � /D � � �a � 5 � G State: AM Zip. City: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: ;:2 90 AjE Ab T City: Miami Shores County: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: /�/C7d4��/ �lee-� � ih�L Phone#: 9C�S %Sc7oz©d Address: SO zoo Al t;?_ / A/ C City:6%t��c� Qualifier State Certification or Registration #: EG 4C�/ /� al Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: N�A ' Phone#: Value of Work for this Permit: 0 a Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration Description of Work: ❑New a Submittal Fee $ Q1 Permit Fee $ 14 � CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ ❑Demolition Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... 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 NOT ' E 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 inn good faith that a copy of the tice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachmen . A o, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspecti which occurs seve (7) days after the building permit is issued. In the absence of such posted notice, the inspection will ��eppproved and re" ection fee will be charged. Owner or Agent fi- The foregoing instrument was acknowledged before me this13 day of Ut , 20 (-7 , by Siff-ey1-T0d Dkblt > who is pII sona ly known to me or who has produced br;V-QV 11 C'M54 As identification and who did take an oath. NOTARY P Sign: Print: My Commissio ############# APPROVED BY Sig z-- Contractor +h The foregoing instrument was acknowledged before me thisa day of J o I U 20 12, by 1 Q h ri J - M.OQC1 -H who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC; Sign: 1 Y I \./ `_ � 1 Print: ' My Commission p S. Notary PON, to of Florida Rebeca Mu oz u�re _,• My Commission FF 916344 o. no Expires 09/08/2019 ##################################################################### Plans Examiner Structural Review Zoning Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)