ELC-09-22-2343 CanceledENTERED
CANCELLED
SEP 14 2022
Miami Shores Village
rcplac�r by
�cc oy-2z_
Building Department BY: r�
Z3ys-
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-9972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING
Master Permit No. LL'-G`7 Z2--23-I3
PERMIT APPLICATION
Sub Permit No.
❑BUILDING ® ELECTRIC
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[]PLUMBING ❑ MECHANICAL
[:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Barry University - Wiegand - Electric
City: Miami Shores
County: Miami Dade Zip. 33161
Folio/Parcel#:
Is the Building Historically Designated: ycs._ NO
Occupancy Type: Load:
Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Barry University Phone#: 305.899.3995
Address:11300 NE 2nd Ave _
�AnC_ :7 Sys-- 0! Z
City: Miami Shores
State: FL Zip: 33161
Tenant/Lessee Name:
_ _ _ _ _..._ _.. __,_Phone#:-____
Email: lyao@barry.edu
CONTRACTOR: Company Name: R & R Electric of Broward, Inc.
(954)319-5630
Address: 7958 Pines Blvd., Suite 238
City: Pembroke Pines State: FL Zip: 33024
Qualifier Name: Erin Richardson Phone#: (954) 319-5630
State Certification or Registration #: EC13nn6319 Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
Zi p:
Value of Work for this Permit: $ 2,400.00 Square/Linear Footage of Work:
TypeofWork: ❑ Addition [XI Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: Install 400 amp breaker with hardware into existing 1200 amp panel for temporary power .
Specify coloroffcco`lor thru tile,..:' f 7
Submittal Fee $ V - Cjr Permk Fee $ *-.3. v + GU CCF $ ( Q--O CO/cc $
Scanning Fee $ -CCU Radon Fee $ Z C?!T DBPR $ Notary:
Technology Fee $ L O . (YJ Training/Education Fee $ " qD Double Fee $
Structural Reviews $
(Revired02/24/2014)
Bond $ _
TOTALFEENOWDUE$ I2-2. 70
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. 1 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 c56"ayL T�d¢JLl/GOG
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of .SOP IY I�I�i� , 20 ZZ , by
.iU fJ SFtv�dAL ,who is Personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Print:
JEFWJ.YAO
Cammbslon f 00249916
Evir" No"mbor 12,2622
ew4W1hyTMyFdfl Yrrw/0saSms
as
i
Signature
CONTRACTOR
The fopgoing instrument was acknowledged before me this
day of�FM S 1 'lam 20 ZZ by
t21N Q JCViQ21l9.SbN who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLLII
Print: V,J'
Sea ::......•, JEFFRYJ.YAO
CommissionAGG249916
::. `; Expitestbninber12,2022
.'•'.tofi�?�'` BordeClhuTro/Fdn MlUmxe 9tS7019
APPROVED BY jf 5/k lam/ S �'y Plans Examiner
Structural Review
(Revised02/2412014)
as
Zoning
Clerk