EL-19-1728Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
URI
Issue Date: 08/01/2019
Parcel Number
960 NE 95TH ST, Miami Shores, FL 33138 1132050070130
Contacts
Permit NO.: EL-07-19-1728
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 01/28/2020
PAUL WEIMER Owner
960 NE 95 ST, MIAMI SHORES, 33138
MOODY ELECTRIC INC Contractor
JOHN MOODY
3812A N 29 AVE, hollywood, FL 33020
Business: 3057582000
Description: ELECTRICAL REPAIRS, REMODELING KITCHEN Valuation: $ 16,000.00 Inspection Requests:
Total Sq Feet: 1,000.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$9.60
DBPR Fee
$8.40
DCA Fee
$5.60
Education Surcharge
$3.20
Permit Fee
$510.00
Scanning Fee
$3.00
Technology Fee
$14.00
Total:
$603.80
Payments
Date Paid Amt Paid
Total Fees
$603.80
Credit Card
07/26/2019 $50.00
Check # 1246
08/01/2019 $553.80
Amount Due:
$0.00
Building Department Copy
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 an oning. thermore, I authorize the above named contractor to do the work stated.
Authorized Signature: O ner / Applicant / Contractor / Agent Date
August 01, 2019 Page 2 of 2
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
BUILDING
PERMIT APPLICATION
❑BUILDING KELECTRIC ❑ ROOFING
FB/C 20
Master Permit No.
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
�1
CONTRACTOR DRAWINGS
JOB ADDRESS: 6 a A16—
City: 1Miami Shores
County: Miami Dade Zip:
ia
Folio/Parcel#: /l - �� 6 - ��� �113& Is the Building Historically Designated: Yes NO l"
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): It a- / Phone#:
Address: l/ e— ? d
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: a r —Tel C Phone#: 3vs-� 7;4"000
Address: /3 '� A o�
City: 1~/� WOo tate: / Zip::? 330 6
Qualifier Name: n A06PIA Phone#:
State Certification or Registration #: zG OQ 4L1 7-7, Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
Address: City: Stat
Value of Work for this Permit: $ l to/ �1'00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration A �❑ New ElRepair/Replace
Description of Work: A� C, P/l�/ G r��c9Qlrs:
/ - /
Zip:
❑ Demolition
911'Ale—%,
Specify color of color thru tile:
Submittal Fee $ Dal Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
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
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 not be approved and a reinspection fee will be charged.
Signature
OWNER or
The foregoing instrument wa nowledged before me this
day of 20 % by
U/ oe;, h a /J k/e.,M rwh�sonally known to
me or who has produced /'i� Ti r ,"tom C e(t-5-gas
identification and who did take an oath.
NOTARY PUBLIC:
Signa u
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of JL) U 20 11 by
—bn mo In At 1 who is personally known to
-rr er who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: AAA OE:4� Sign:
Print: en Gl—r,ro Print:
Stephen C. Guerrero
Seal: ebece noz
State of Florida y, ,, � n: ,Commission FF 916344
MY Commission Expires 08/06/2022 fa :ices osioar2o�s
1'cr Commission No. FQ P46573 '^'�''•'"
If
APPROVED BY 7j� �%LPl Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)