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REV-10-22-2779, 100 NE 101st StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date:11/04/2022 Location Address Parcel Number 100 NE 101ST ST, Miami Shores, FL 33138 1132060132020 Contacts Permit No.: REV-10-22-2779 Permit Type: Revision Work Classification: Electric Permit Status: Approved Expiration: 05/05/2023 BRYON THOMAS Owner MOODY ELECTRIC INC Contractor 136 NE 101 ST, MIAMI SHORES, FL 331382321 JOHN B MOODY bryon.thomas@gmail.com 603 N 21 STAVE, HOLLYWOOD, 33020 Business: 9543675989 barney@moodyelectric.com ___-.-_-,—_--,__-- _ Ins ection Requests: Description: INSTALL AFCI BREAKERS PER REVISON PLAN WITH ' Valuation: $ 500.00 305-762-4949 NEW RECEPTICALS AND LIGHT FIXTURES/DRAWINGS WIH Total Sq Feet: 0.00 71 -IRCUITS I _: ees Amount Payments Date Paid Amt Paid itevision: Minor Change of Plans $60.00 Total Fees $69.00 Scanning Fee (Manual) $9.00 Credit Card 11/04/2022 $69.00 Total: $69.00 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 you ing. Futhermore, I authorize the above named contractor to do the work stated. ., �✓ n if ,� . , i . / _ Z Applicant / Contractor / Agent November 04, Page 2 of 2 Miami Shores Village cFivE;iD Building Department oc► c 2022 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 FBC 20 Master Permit No. L_ Sub Permit No.]2)1(�,V_ I1� REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR ��3- DRAWINGS JOBADDRESS: 102 � /®f St dfil�� Miami Shores Folio/Parcel#: I r Occupancy Type: Load OW. Add Co V Miami Dade Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: BFE: FFE: City:�C�•��-CJ,(_tJ�9�� State: �L Zip: Tenant/Lessee Name: Email: Phone#: CONTRACTOR: Company Name: Phone#: 3011 _ I s & _ c0.ru Address ® 210 Af nor02 Email: irf rr k�i(�a_%. T� ��i 11t 1� i C�f [7 ') Qualifier Name: hl Phone#: - OS - State Certification or Registration #: F, (©-1 Certificate of Competency #: 1-2& 000 3 C1 DESIGNER: Architect/Engineer: N Phone#: Address: City: State: Zip: Value of Work for this Permit: $ "')Oo Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revised04/05/2022) Permit Fee $ DCA Fee $ _ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ P&Z Review $ Bond $ TOTAL FEE NOW DUE $ • Bonding Company's Name (if applicable) Bonding Company's Address City State �/� Zip Mortgage Lender's Name (if applicable) W104 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 approved and a reinspection fee will be charged. Signature + Signature 1{ OWNER or AG CONTRACTOR The foregoing instrument wasacknowledgedbefore me this The foregoing instrument was acknowledged before me this dayof %CIO,,C-1� 20 2'L by st day of C CAO.-'C r 20 by who is personally known to , C) h n &Mond _ who is personally known to ,. a tho has produced as who has produced as identification and who did take an oath. identification and who did take an oath. NO PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: REBECA MUNOZ Seal: :"� L �., Notary Public - State of F orida t 9+,•.9�� Commission # GG 366700 Seal: :.;� v REBECA MUNOZ Notary Public State of Florida o My Comm. Expires Sep 8, 2023 qP,- Commission # GG 366700 Bonded through National Notary Assn. W".. My Comm. Expires Sep 8, 2023 Bonded throe h National Notary Assn. APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)