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ELC-20-526Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 � � IIIII arum Issue Date: 03/13/2020 Location Address Parcel Number 1132060460001 :ontacts Permit NO.: ELC-03-20-526 Permit Type: Electrical - Commercial Work Clossif►cation: Repair Permit Status: Approved Expiration: 09/09/2020 Miami Shores Condominium Owner MOODY ELECTRIC INC Contractor Association JOHN MOODY Miami Shores Condominiun 3812A N 29 AVE, hollywood, FL 33020 Association Business: 3057582000 barney@moodyelectric.com 9022 NE 8 AVE, Miami Shores, FL 33138 ti Description: REPAIR CONDUIT FOR EXISTING PARKING LOT Valuation: $ 4,400.00 on Requests: Inspection 4949 LIGHTS Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $3.00 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.00 Permit Fee $82.00 Scanning Fee $3.00 Technology Fee $3.30 Total: $146.30 Payments Date Paid Amt Paid Total Fees $146.30 Credit Card 03/10/2020 $50.00 Credit Card 03/13/2020 $96.30 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 constructidfi and zoning, , t rmore, I authoriz a above named contractor to do the work stated. i Authorized Signature: Owner / App ipdnt-/ Contractor / Agent Date March 13, 2020 Page 2 of 2 Miami Shores Village ENTrSRED Building Department wi R 10 2020 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201-4 lest" BUILDING Master Permit No.__ LC- 03 20-5210 PERMIT APPLICATION Sub Permit No. ❑BUILDING [-;!ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: - Q/� % I /1 L% /¢„v City: Miami Shores County Miami Dade zip: Folio/Parcel#: �� J 0 �O tf Is the Building Historically Designated: Yes NO C Occupancy Type: Load: Construction Ty./pe: Flood Zone: BFE: FFE: GV izli enalW/ MT W me: 01VA none „Cu�raity-9 Gnu c .rQ Q '7/1 R Idr-UL CONTRACTOR: Company Name: Phone#: J Q Dog Q Address: _/ / / City: /✓a�/y /yo .e State: Zip: Qualifier Name: O U Phone#: c30r' State Certification or Registration M Certificate of Competency M IfIlA DESIGNER: Architect/Engineer: 4&1 Phone#: Address: ' / City: State: Value of Work for this Permit: $ ry a0 , t�'t^j Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace of Work: c .!L .R' _ _ r / i Zip: ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ " 1 (0. 3 C ) (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 tAhe issuance of a building permit with on estimated value exceeding $2500, the applicant mu t promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered t64he 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 w1kch'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. 1 11) • �� ienature 4�Att Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this Uth day ofc__r0(JflC� 20 Lb by (/�' ,� �� , , Ja ►-0�4- , who is personally known to me or who has produced identification and who did take an oath. NOTARY Sign: \ Print:11-1 �r a ' REBECA MUNOZ Seal:' • `F= Notary Public • State of Florida '• Commission # GG 366700 '?cv My Comm. Expires Sep 8, 2023 Bonded through National Notary Assn. e*l The foregoing instrument was acknowledged before me this 10 th day of iY1�rL� , 20 1-0 by Jnhn 1"1 0 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC:. n Sign:� Print: 1-1- Seal ******************** APPROVED BY �d Plan Examiner Structural Review "� Notary Public - State of Florida Commission # GG 366700 My Comm. Expires Sep 8, 2023 Bonded through National Notary Assn, *************** Zoning Clerk (Revised02/24/2014) 2020 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT# 726513 Feb 07, 2020 Entity Name: SHORES VILLAS CONDOMINIUM ASSOCIATION, INC. Secretary of State 1463101869CC Current Principal Place of Business: 8901 NE 4 AVE. ROAD MIAMI SHORES, FL 33138 Current Mailing Address: FLORIDA ADVANCED PROPERTIES, INC. P.O. BOX 770010 MIAMI, FL 33177 US FEI Number: 59-1548009 Certificate of Status Desired: No Name and Address of Current Registered Agent: KAYE BENDER REMBAUM, P.L. 1200 PARK CENTRAL BLVD. SOUTH POMPANO BEACH, FL 33064 US The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: ROBERT KAYE 02/07/2020 Electronic Signature of Registered Agent Date Officer/Director Detail Title PRESIDENT Title VP Name COLON, IVETTE Name JOHNSON,VANESSA Address P.O. BOX 770010 Address P.O. BOX 770010 City -State -Zip: MIAMI FL 33177 City -State -Zip: MIAMI FL 33177 Title SECRETARY Title TREASURER Name SENATUS, LOUBERT Name SERDA, WILLIAM Address P.O. BOX 770010 Address P.O. BOX 770010 City -State -Zip: MIAMI FL 33177 City -State -Zip: MIAMI FL 33177 Title DIRECTOR Title DIRECTOR Name SAMADA,JUAN Name DUMAS,JERROLD Address P.O. BOX 770010 Address P.O. BOX 770010 City -State -Zip: MIAMI FL 33177 City -State -Zip: MIAMI FL 33177 Title DIRECTOR Name SUSAR, VIKTORYA Address PO BOX 770010 City -State -Zip: MIAMI FL 33177 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: IVETTE COLON PRESIDENT 02/07/2020 Electronic Signature of Signing Officer/Director Detail Date Shores Villas Condominium, Inc. c/o Florida Advanced Properties, Inc. P.O. Box 771566, Miami, FL 33177 Ph: 305-233-5959 Fax: 1-305-517-3417 March 5, 2020 To whom it may concern. Miami Shores Village permits Department. William Serda, Treasurer for Shores Villas C.A. and the Association Board of Directors voted unanimously to hire Moody Electric to procure electrical permit to repair and bring up to code the electrical conduit and wiring for the parking lot lights at 8901 NE 4 AVE RD Miami Shores 33138, please feel free to contact us if you require any further assistance. Felix Giralt CAM felix@floridaadvanced.com or by phone at (786)222-9265 Sincerely, William Serda Board Treasurer Shores Villas Condominium Inc.