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EL-19-2043Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Location Address Parcel Number 257 NE 91ST ST, Miami Shores, FL 33138 1132060133450 Contacts Permit NO.: EL-09-19-2043 Permit Type: Electrical - Residential Work Class ati©a. iftrahon Permit Status: Aboroved Expiration: 03/02/ 2020 HENRY & FRANCES HARNAGE Owner MOODY ELECTRIC INC Contractor 10HN MOODY Other: 3059518915 3812A N 29 AVE, hollywood, FL 33020 Business: 3057582000 Description: REVISED LAYOUT AT EXISTING BATHROOM AND Valuation: $ 7,000.00 Inspection Requests: BATH AND MASTER BEDROOM. TO REPLACE PERMIT#EL18-313 305-762-4949 Total Sq Feet: 400.00 Fees Amount Payments Date Paid Amt Paid 100% Permit Renewal Fee $245.00 Total Fees $245.00 Check # 1277 09/06/2019 $245.00 Total: $245.00 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 and zoning. Futhermore, I authogzzgth_ above p6med contractor to do the work stated. Authorized Signature: Owner Contractor ' / Agent Date September 06, 2019 Page 2 of 2 Miami Shores Village 1RECEIVED Building Department SE 03 2019 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 $Y:... Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No. _6--?— j PERMIT APPLICATION Sub Permit No. E, - 2-0 � 3 ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF JOB ADDRESS: ca 5� /y E Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder):_1-7�'�r ❑ CANCELLATION ❑ SHOP DRAWINGS the Building Historically Designated: Yes NO Flood Zone: BFE: FFE: Phone#:36S_' 9EI City: 6-11, ft.yl.L 6*-Q�� .s State: Zip: Tenant/Lessee Name: _ one#: Email 1 CONTRACTOR: Company Name: I Phone#: -_to,5 !Jam© CJ Address: � ��� ��' City:10974TState: /� � " � Zip: Qualifier Name: V�yv d �d�j Phone#: State Certification or Registration M Certificate of Competency M DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip; Value of Work for this Permit: CD Square/Linear Footage of Work: Type of Work: ❑ Addftion ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolitior 1 Description of Work: V C SEb o. 1Cc'Y (ISv C... byc�7 ff �i ( S Specify color of COW ttir`u tile: L_ Submittal Fee $ v Permit Fee $ CCF $ l CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ (Revised02/24/2014) 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 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approv d and a reinspection fee will be charged. Signature ( 5igna ure OWNER or NT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of me or who has produced NOTARY 20 by who is personally known to as and who did take an oath. SiO&J-0t L 11'v Print: day of AtJA ]Z 20 by Air, ) �J, who is personally known to _Le_or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: �r Notary Public State of Florida Sea ,p &N Fredi M Novak Milberg +� `7� My Comrnisaion GG 085485 o,M1 Expires 0710912021 *s*s* * s s s s***s*s**sss****s****s* APPROVED B S� 1 Plans Examiner Structural Review (Revised02/24/2014) PC% Notary Public State of Florida Q,,$I a Rebeca Munoz d Commission FF 916344 7rq;�o Expires 09l0e/2019�:� ********** Zoning Clerk 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 ❑ ELECTRIC ❑ ROOFING RIEcrl,IVEI:) JU 2 4 291,9 BY: FBC 20 (-� Master Permit No.:W-0� -'!! - lWe Sub Permit No. ❑ REVISION ❑ EXTENSION 7RENEWAL PLUMBING ❑ MECHANICAL 7 PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ':g 5 -1 K)4E 6 L City: Miami Shores County: Miami Dade Zip: 33('J e Folio/Parcel#: %�3 [ �� Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type:: Flood Zone: BFE: Q FFE:�q OWNER: Name (Fee Simple Titleholder):�q 4��1%��IC-/V(a�Phone#: Address: 5� /�`)�, �� City: P�I siwtc 6vvS State: Zip:3-13 0 Tenant/Lessee Name: Phone#: Email: / �) CONTRACTOR: Company Name: ti-&eo t w6 &xxsn agT-tpt� A4an i� emz,&tw— Phone#: -30S Address: SN-o cs Lo j6Vl City: %YJrl4j/ULC Stater Zip: 33A,63 Qualifier Name: 14 State Certification or Registration #: C— l Sa a �6? Certificate of Competency #: DESIGNER: Architect/Engineer: �k*.64- a- H''+----9- Phone#: 3o-� -`15� d•3 f Address: .3?3 05� Lck City: kk State:-Fj Zip Phone#: 33i-9"6 Value of Work for this Permit: $ 1- i 0<9"0 Square/Linear Footage of Work: b ;5 4-- Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Demolition Description of Work: 2a..�4 O CtSWi k,-3- b,,t Q❑ Specify color of color.thru tile: f ,.a Submittal Fee $' Permit Fee $ CCF Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 4s. (go (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 abs suc osted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Sign W N E R or AGENT The foregoing instrument was acknowledged before me this � pp 1� day, of 201 -1 by who is personally known to me or w o has produced as identification and who did take an oath. NOTARY P The foregoing instrument was acknowledged before me this — day of dutt c 20 � 1 by who is personally known to me or who has produced as identification and who did take an oath. NOTARY,RUBLIC: -549a) / 1 Sign: Prim 'i;`tl . W-)A Print: " Seal: Seal: _ SANDRA GARCIA Notary Public Stft of Fbrias Notary Public -State of Florida Fred 1d NOS9 - Commission # FF 926203 c+ EGG OWN ;F My Comm. Expires Oct 11. 2019 Expires APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)