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PL-10-709Project Address Owner Information Contractor(s) HOME OWNER Phone CeII Phone Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Scanning Fee Technology Fee Total: Amount $0.60 $0.71 $0.20 $100.00 $0.71 $3.00 $0.80 $106.02 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy May 20, 2010 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Parcel Number 10667 NE 11 Avenue Miami Shores, FL 33138 -2120 1122320280310 Block: Lot: MARIEDY MENDOZA Phone 10667 NE 11 Avenue MIAMI SHORES FL 33138 -2120 Type of Work: PLUMBING Type of Piping: KITCHEN REMODEL Additional Info: Bond Retum : Classification: Residential Valuation: Total Sq Feet: $ 1,000.00 142 Amt Paid Amt Due Pay Date Pay Type Invoice # PL -4-10 -37686 05/20/2010 Check #: 1463 $ 106.02 $ 0.00 Applicant Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory Underground 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 authorize the above -named contractor to do the work stated. May 20, 2010 Date Expiration: 11109 /2010 Cell 1 BUILDING Permit No, P " PERMIT AP PLICATION Master Permit No. , 1 a FBC 20 Permit Ty e: PLUMBIN /' /e® n Owner's Name - - ' °:: - ,. ehglder) , � �� `'''' Phone # � © ° � 02- — Owner's Address 6? City / CityfireW 1 5 State C Zip Tenant/Lessee Name Email A✓'ii-f°t 'i' y 93 e 4 ,,040-0 - Is Building Historically Designated YES Contractor's Company Name #t K Contractor's Address /t 7 4 // /' City /2 &Ci 5 State 7 Qualifier Name 5c( rbci c'IIS pOs 'i (. Submittal Fee $ Permit Fee $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Notary $ Training/Education Fee $ 0 ' go Scanning $5 Radon $ a ( DPBR $ o.(0,0 Double Fee $ Structural Review. $ Violation date: Phone # NO Phone # Architect/Engineer's Name (if applicable) Phone # Zip S 01.A Bond $ Total Fee Now Due _L11 ' =1J IVECIZEVIR BY: a ...............•...... Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Flood Zone 3 5 —/c e9 Phone # dos ° 2/ / t, State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Value of Work For this Permit $ k®®. Square / Linear Footage Of Work: Type of Work: ['Addition ❑Alteration New ❑ Repair/Replace ❑ Demolition Describe Work: ,i/le /yew s I 4)4 /S4 "rte s he fr 80 2 ( /it/c. ******** * * * * * * * *** * * * * * * * * * * * * * * * * ** * ** F * * * * * * ** * * * * * ** * * * * * * * * * * ** * * ** CCF $ O `(G CO /CC $ Technology Fee $ e K) See Reverse side -* Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 appr ' and a reinspection ee will be charged. Owner or Agen r Contractor The foregoing instrument was acknowledged before me this 1 The foregoing instrument was acknowledged before me this day of Mart , 20 10 , by rnagA _.6 Il(1k,N j A day of , 20 , by who is personally known to me or who has produced Fl-- 1D who is personally known to me or who has produced As identification and who an oath. as identification and who did take an oath. NOTARY PUBLIC: ® ° ° °a\`\` ',,,,,, . A: —, ......v • ps -. " ,c . c ' 0 o0 Sign: — _ , ® d —c.:.� = Sig n: _ Print: ?�� Eo ' ® Print: i NOTARY PUBLIC: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Signature My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * ** ************************************************* * * * * * * * * * * * * ** ** * * * * * * * * * * * * * ** Plans Examiner Zoning Clerk checked MOODY MOODY# ELECTRIC, INC. www.moodyelectric.com 669 N.W. 90 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax (305) 754 -1333 Proposal Submitted to: Shores Plaza East Condominium Association 745 N.E. 91 Street Miami Shores, Florida 33138 Attn: Robert Gonzalez Tel/Fax: 305-759-9069 Job Name: Miscellaneous Electric Location: 725 N.E. 91 Street Miami Shores, Florida 33138 Job Description: (To be scheduled in May 2005) 1.) Furnish and install a new 5 -gang vertical meter stack with five (5) 60-amp main breakers. 2.) Furnish and install new 3/0 copper wire in existing 2" riser pipe. 3.) Furnish and install new load gutter to re tap all existing subfeed wires. 4.) Furnish and install new house breaker box for hallway and outside lighting. 5.) All conduit, wiring and fittings included for a complete installation. Quote: $2,400.00 Notes: 1.) Patching and painting by others. 2.) FP &L coordination included. Power will be off for approximately 8- hours. 3.) Permit fee is cost plus $75.00 in addition to above quotation. 4.) Any additional services required by the Authorities Having Jurisdiction will be considered a change to the scope and will be quoted as a change. PROPOSAL WE PROPOSE hereby to furnish material and labor - complete in accordance with these specifications for the sum of See Above Payable as follows: Due Upon Completion In the event customer fails to pay this proposal when due, Moody Electric, Inc. shall be entitled to recover all costs incurred including attomey's fees for services rendered in connection with collection of payment of the debt as evidence by this proposal or enforcementIVloody Electric Inc.'s rights provided under law. NOTE: This proposal may be withdrawn by us if not accepted within 30 days. QUOTED BY: Barney Moody Moody Electric, Inc. Authorized Signature Acceptance of Proposal - The prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work specified. Payment will be made as outlined above. Si Print Print Date Page 1 of 1 Inspection Number: INSP - 141554 Permit Number: PL -4 -10 -709 Scheduled Inspection Date: May 21, 2010 Inspector: Hernandez, Rafael Owner: MENDOZA, MARIEDY Job Address: 10667 NE 11 Avenue Project: <NONE> Contractor: HOME OWNER Building Department Comments KITCHEN REMODEL Passed Failed Correction Needed Re- Inspection Fee May 21, 2010 Miami Shores, FL 33138 -2120 No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Comments For Inspections please call: (305)762 -4949 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1122320280310 Page 6 of 12