EL-20-103Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
issue Date: 01/24/2020
Location Address Parcel Number
960 NE 95TH ST, Miami Shores, FL 33138 1132050070130
Contacts
Permit NO.: EL-01-20-103
Permit Type: Electrical - Residential
Work Classification: Temp for Test
Permit Status: Approved
Expiration: 07/22/2020
PAUL WEIMER Owner MOODY ELECTRIC INC Contractor
960 NE 95 ST, MIAMI SHORES, 33138 JOHN MOODY
3812A N 29 AVE, hollywood, FL 33020
Business: 3057582000 barney@moodyelectric.com
Description: 30 DAY TEMPORARY ELECTRIC SERVICE Valuation: $ 150.00 Requests:
Inspection 305-4949
Total Sq Feet: 0.00 11
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
01/24/2020 $110.30
Amount Due:
$0.00
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 construefi n and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Owner / Applicant / Contractor / Agent
Date
January 24, 2020 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
❑BUILDINGELECTRIC ❑ ROOFING
ENTERZD
JAN 16 2020
�Yz
FBC 2011-
Master Permit No. aO- -" (JJ - 2
Sub Permit No._ L- 0 k - 2-0 ` l C)3
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: ` C4�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: //J 02 Z-S i3 C) Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): \ a, C�(/ �E� Phone#:
Address10c /1%� 2s= CET_� _t
City: AAA "L- ti ' �{(Oq_E5 State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: %�
City:
Phone#:"J.,/Odd
�L� • Zip: '9
Qualifier Name: -_/4211A) -/ /'!� Phone#:
State Certification or Registration #: DGt^J Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: Staie: Zip:
/�
Value of Work for this Permit: $ ` 5 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
t
Spe�* color of color thru tile:,
Submittal Fee $ ~4 "" Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $_
Structural Reviews $
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ � 16 ' 30
(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
Zi
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 sevet*(7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not bVapproved and a reinspection fee will be charged.
Sign
OWNER or
The foregoing instrument was acknowledged before me this
day of a A►' 20 20 by
L w o personally known _q
Gm or who has produced as
identification and who did take an oath.
Signatu Lj:;
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of J QJ3 U 20 -If) by
Jobn Jo o is personally known tom.
_Me -or who has produced
t b9
identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
—:T�
Sign: Sign:
Print: � U'�� ('/ �Q Print: ft�
Seal: Seal:
kBY4
F47Z-A4��
APPROVED Plans Examiner
Structural Review
RE8KA MUNOZ
Notary Public - State of Florida
Commission tf GG 366700
My Comm. Expires Sep 8, 2023
Bonded through National Notary Asw
**********************************
Zoning
Clerk
(Revised02/24/2014)
Building
MIAMFDiADE 11805 SW 26th Street
Miami, Florida 33175-2474
786-315-2100
I miamidade.gov
AFFIDAVIT FOR 30 DAY TEMPORARY ELECTRIC SERVICE
ELECTRICAL CATEGORY 26
ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION
UNLESS APPLICATION IS RENEWED OR CERTIFICATE OF OCCUPANCY OBTAINED.
P'I�A�1 sift �
It is understood that the temporary electrical approval by the Miaff444a4e•-Buildin Department is given in connection
with the building being constructed under the Building Permit # - �- - and Electrical
Permit# at address
for owner: AL,_( and is being given only for construction purposes or for
testing the following equipment in said structure: 40—
The owner does hereby agree to assume the responsibility of maintaining the installation in such manner that there
is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the
purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been
called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion
is obtained.
The undersigned also understands that the temporary electric approval is subject to rescission and cancellation
and electric power can be cut off at the discretion of the Building Official and will be disconnected if the building
concerned is occupied before final inspections are approved and/or a Certificate of Occupancy or Completion
is obtained. t
being first duly sworn, depose and say that I am the owner of the above
described property, and that I agree that the structure covered in this agreement shall not be occupied until the
building contractor has obtained approval of final inspections and/or obtained a Certificate of Occupancy or
Completi n. No : Failure th comply with the provisions of this affidavit wi I result in your be in unable to obtain
future mpo f r st permit
natur of Owne�7�1`laea2lv,
Signa ure of Notary
MyC`ommissionExpires:�t!'i,���t 3�
I, �JQX AIbeing duly sworn, depose and say that I am the Electrical Contractor for
the above -described property and thaf the electrical installations as now existing will jLgLjWAt�La_safety hazard if
to aq service is c nnected.
�'jr'd"•..• REBECAMUNOZ
otary Public - State of Florida
�• Commission x GG 366700
Signature of Electrical Contractor Signature of ary "So ded hrough Nat ai eP fn.
My Commissi n Expire
I, being first duly sworn, depose and say that I am t e Building Co tractor
of the above described property and that I will not permit occupancy of this building until final inspections have
been called for by the contractors and sub -contractors concerned and final approval by the inspection division
obtained and that I have the authority insofar as the owner of said property is concerned to prohibit occupancy until
such final inspections are obtained and/or a Certificate of Occupancy or Completion is issued.
Signature of Building Contractor
Signature of Electrical Inspector
123_01-124 6/06
Signature of Notary
My Commission Expires:
Date:
Date released to FPL:
�s�'"�Q"���
SANDRA OTERO
MY COMMISSION k GG276021
orc d�
EXPIRES. November 13, 2022