EL-18-2356 (2)sNO1s y, Miami Shores Village
yn 10050 N.E. 2nd Avenue NE
4 I.• ....'" Miami Shores, FL 33138-0000
Phone: (305)795-2204
LtlRIDA
Permit No. EL-9-18-2356
Permit Type: Electrical - ResidentialPenmiWorkClassification: Alteration
Permit Status: APPROVED
Issue Date: 9/13/2018 1 Expiration: 03/1212019
Project Address Parcel Number 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-
Contractors) Phone Cell Phone
MOODY ELECTRIC INC (305)758-2000
pe of Work: REMODELING OF BATHROOM & KITCHEN
dditional Info: REMODELING OF BATHROOM & KITCHEN
lassification: Residential
canning: 1
Fees Due Amount
CCF 2.40
DBPR Fee 2.25
DCA Fee 2.00
Education Surcharge 0.80
Permit Fee - Additions/Alterations 150.00
Scanning Fee 3.00
Technology Fee 3.20
Total: 163.65
Valuation: $ 3,500.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-9-18-68769
09/13/2018 Credit Card $ 113.65 $ 50.00
09/04/2018 Credit Card $ 50.00 $ 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 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 cs7ing. hermg,,anthorize t bove-named contractor to do the work stated.
September 13, 2018
Signature: Owner / --Kpplicant / Contractor / Agent
Building Department Copy
September 13, 2018 1
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
RECr-'
VED
SEP 0 4101
FBC 2017
BUILDING Master Permit No.
QQ PERMIT APPLICATION Sub Permit No.
BUILDING IX ELECTRIC ROOFING REVISION EXTENSION RENEWP5
PLUMBING MECHANICAL PUBLIC WORKS []CHANGE OF CANCELLATION SHOP
Q A/
CONTRACTOR DRAWINGS
oaJOBADDRESS: 7 D /(/ /O/ 5
City: Miami Shores County Miami Dade Zip:
Folio/Parcel#: It — 3 " 013 O Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): i fP IiGI% iota 12 Phone#:_
Address:
City: AGI r `S- alp S State:/D/'/ LL Zip: 33I3?
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
A
Address: , % /
City: f70F//
Qualifier Name:
one#:
2RIO • 4
i
State Certification or Registration #: 00 Il e& Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 5v` Square/Linear Footage of Work:
Type of Work: Addition Alteration New Repair/Replace Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ Zr oO CCF $ CO/CC $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
Revised02/24/2014)
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
N
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 personwhosepropertyissubjecttoattachment. Als , a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs sev ) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be a qved and a r ns ction fee will be charged.
Signat
OWNER or AGENT
The foregoing instrument was acknowledged before me this
daffy _of C
1 3cO
20t by
11V ' ,s na know to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: ZL71
Print:
Seal:
ss****s*s*****
At
e s°
yq 6o N .
Sf
CONTRACT
The foregoing instrument was acknowledged before me this
day of , 20 1 g by
Ohy'1 J . M (10 (,ii , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC: \\
Print: d
Ji" n(,^ Notary Pu sic State of Florida
roSeal: RPbera Munoz
My f,.ommiss:on FF 916344
of o Exp(res 09108f2019
1111151NH\\\.
APPROVED B .mil
Plans Examiner
Structural Review
s**s**s**ss*ss**s*s*ss**s***s*ss*s*******
Zoning
Clerk
Revised02/24/2014)