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EL-10-1520BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) CCA�c \ rc-k(\c SC c5 Phone # '?S - 7 S7 - 4t3 Owner's Address (3 N cy IC) City I -k c& - S1h s State Los e Zip r33l3 `c5 Tenant/Lessee Name E -MAIL: )$1 Job Address (where the work is being done) ko3 Is Building Historically Designated YES Value of Work For this Permit $ ® £� .0o Type of Work: ['Addition ['Alteration i A A � /1 Describe Work: / � / i r/ Submittal Fee $ Permit Fee $ /j9,'0 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ['New Scanning $ Radon $ DPBR $ Permit No. Master Permit No. Phone # C City Miami Shores Villa e County Miami -Dade Zip 3 13 ES FOLIO / PARCEL # ( - 3 - CX2)( NO Square / Linear Footage Of Work: CCF$ Notary $ Training /Education Fee $ Technology Fee $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 1 13 111:T1 ) UG 421 BY:... ...... ......... t2P Contractor's Company Name NkOOCQ C C c \NC , Phone # 305- - S 606 Contractor's Address is (1•..Y.IJ 3 City ct r�-: State Zip - 31 l S Qualifier Name T \ c ■ T. Ii Phone # 3CSS- -) S k KC3C)O State Certificate or Registration No. •C C5C9C. k. c l Certificate of Competency No. E -MAIL: TN �c3��� �cx�c�e� -ec i c . CO ry . Architect/Engineer's Name (if applicable) Phone # ) p Repair /Replac ❑ Demolition eve �� *** .. xxxxxx** **xa*dcxxxax Feesxxxxxx**** x x xxxxxxxx****ot****xx*xxx9:xxe * CO /CC Zoning $ See Reverse side - Bonding Company's Name (if applicable) Bonding Company's Address City Signature Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip (Revised 02/08/06) State The foregoing instrument was acknnowledgf d before me this Z3 day of /� '' , 2010, by &kV dina5i0 Sign: Print: My Commission Expires: Owner or Agent who is persona ly known to me or wh As identification NOTARY PUBLIC: .*. xx x x xxxxx x Kxx xx xxxxxxxxx* WW xxx xxxxxxxxx* APPLICATION APPROVED BY: 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. 1 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 approved and a reinspection fee will be charged. t . " ". r Ur- ' Contractor The foregot _ instrument was acknowle day of 1� ' 200, by who is personal . known to me or who as identification and NOTARY PUBLIC: Sign: )94 Print: My Commission Expires: before me this 3 :xxxa:xxxxxxsYxxxxxx x x **war** war x xx**xxx *.xxx xx **xx .. -Z 6'/ / ' Plans Examiner Engineer Zoning Inspection Number: INSP - 151447 Scheduled Inspection Date: September 21, 2010 Inspector: Devaney, Michael Owner: FRANCISCO, CAROL Job Address: 637 NE 92 Street 10 -C Miami Shores, FL Project: Contractor: Building Department Comments September 20, 2010 <NONE> MOODY ELECTRIC INC Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Number: EL -8 -10 -1520 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060430060 Phone: (305)758 -2000 NEW 100 AMP MAIN REMOVE FUSE BOX UNISTALL BREAKER BOX NEW SUBFEED. SMOKE DETECTORS GFC1 OUTLETS REMOVE CLOTH WIRING. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 9/ Page 31 of 33 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. t1 3 O(, STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 11 11111 111111 111111 1111111 111111 11111 1111 11 11 CFN 2010R0572 1228 OR Bk 27397 Ps 0516; (l:+a ) RECORDED 08/24/2010 10:20:47 HARVEY RUVI Ii r CLERK OF COURT MIAIII -DADE COUWTYe FLORIDA LAST PAGE Space above reserved for use of recording office 1. Legal description of property and street/address: (a3 N �. c 2 S -4- ( l r�� �' (C� C ter.:. S�a�eS, FL — 53 k 2. Description of improvement C c n c rs• 3. Owner(s) name and address: Cc r j ` Interest in property: Name and address of fee simple titleholder: 0 'As 4. Contractor's name, address and phone. number. Yv Lr �� - t om ��� ( Coq ir_S cAS Ra c 3" t S 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number. 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(6), Florida Statutes. Name, address and phone number: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS :TO -YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST. BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT Signature(s)zof er(s) or I rized Officer/Director/Partner /Manager q„ n Prepared By v 1 1� �i. e�f' PPrepared By ,d'(J f Y F Print Name C'c rc k.. ct5crs Print Name y / G "� : Title/Office Title/Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The fo oin ystnP s t was acknowledged before me this / day of By I � ..Vr SC O Individually, or ❑ as for ❑ Personally known, or a produced the following type of identifica Signature of Notary Public: Print Name: (SEAL) VERIFICARON PURSUANT TO SECTION 92.52.5. FLORIDA � � �a 1 Under penalties of perjury, I declarsthat I have read the foregoing anti J E rely &o 1 Off la3 Seat ,. 7. that the facts stated In it are true, to the best of my knowledge and *•,,, Signatu f Owner(s) !Pager r Owner(s)'s Authorized Officer /Director/Partner ager who signer above: By . 1'�C` .b a By 123.01-52 PAGE 3 10/09 e\ - SC _C)