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EL-10-134
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 \,0:76('` Inspection Number: INSP - 170891 Permit Number: EL -1 -10 -134 Scheduled Inspection Date: March 08, 2012 Inspector: Devaney, Michael Owner: Job Address: 637 NE 92 Street 12 -C Miami Shores, FL Project: <NONE> Contractor: MESA BROTHERS INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060430140 Phone: (305)345 -1974 Building Department Comments ELECTRICAL WORK FOR LKITCHEN AND BATHROOM REMODEL 5/05/2011 - PERMIT ON HOLD NO INSPECTIONS. NEED AN ELECTRICAL CONTRACTOR. Passed C7 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 156557. No access. S/2_ Plx zo March 07, 2012 For Inspections please call: (305)762 -4949 Page 28 of 33 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 Permit No. - BUILDING PERMIT APPLICATION FBC 20 .d BY: 00000 lo-)'4 Master Permit No. age— / — /' —' 7 • Permit Type: Electrical ff-� L/�-% -�4- .105 76 2-- 6/%/ OWNER: Name (Fee Simple Titleholder): � Phone#: Address: 1P-1 OVA- — 7 ? � e7 City: fr //a 7 State: Zip: 3_3,3' Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: G 3-7 —9z a�9 /2- e. City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: e CONTRACTOR: Company Name: f1e. ‘5,-01/1P--&-41-% TP-C • Phone#: mss' ate - /0.3 AZVe City: /41/A0-1; State: �d ,---ldQ Zip: �- /( aas' Phone#: 3 ' "r State Certification or Registration #: .k- e-/aer /87 a Certificate of Competency #: C - /�©o as % Contact Phone#: 3.13P5" -- '/J J� — ' Email Address: DESIGNER: Architect/Engineer: ( Phone#: Address: Qualifier Name: ©''C ael; Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: UAddress D ription of W k• Alteration UNew ❑Repair/Replace ODemolition x �x a�s� �xs��x�a�xx� �xx��x �x x��x e�u* xx� _ s00000* ***** **** **** ****** *x000****** * * *** *** Submittal Fee $ Permit Fee $ 1 4 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 5• 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 a r. hment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspect ' r !' i curs seven (7) days after the building permit is iss of such posted notice, the inspection will not nd a reinspection fee will be charged. Owner . a Agent The foreg iing instrument was ack704.4x1Vefixeathis +� day of V ,20 I I , by who is personally known to me or who has produced identific who did take an oath. C`l , My Commission Ex Signature Contractor '� The foregoing instrument was acknow before this day of ��i , 20 0 , by 1' / , who is personally known to me or who has produced dei V° as identification and who did take an oath. NOTARY PUBLIC: p (iY P�/ * ° " •y + • c , IRI M R NDORA 5f Y COMMISSION # DD 71 2966 :XPIRES: December 30, 2011 Sign: " `. %°jgorFo"`O Bonded ThruBudAat Notary Soto Print: D 2j t7'' My Commission Expires: °-- f ›-o/ ao /i APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) 1 ° A414Arf:i4Aq YMNIi.00113 61741iS14 E402 24140 itsl9P 6, yAlf,i-!■:1,1 ‘EC.F.OP fl!, rtieeifron3 1'7;41. °' > j� � I 4 artaION- (0040KZ-f- 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): Address: `'1 2-1 K..) E City: ( (i m 1 State: Tenant/Lessee Name: Email: CX ES zawnpnEr mA Y 3 1 BY: Permit No. I— f I-/ Master Permit No. l 0'°- Phone #: R G2 - 101 - l 1 JOB ADDRESS: City: Folio/Parcel #: Phone #: Miami Shores Ctica0 ( +'1a • corn riff Zip: County: Miami Dade Zip: f Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: I/ 3, City: 1 ' Qualifier Name: NO Flood Zone: hone #: S-' -4S (1 �! Zip: P Phone #: 30S- 2_42 L€c c State Certification o egistration #: C 010-3 bee) Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/ _eeyr:: Phone #: Square/Linear Footage of Work: ❑New ORepair/Replace * * * * * * * * * * * * * ** * * * * *** * ***** ** x**** * ** Fees * * ****** ** * * * ** *** * * * * **** * * *** * ******* * * ** Permit Fee $ X.4-■ 6. 4, Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ �► 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 coedit' promise in good faith tha whose property is subjec for the first inspection inspection will not be ap Signature to the issuance of a building permit with an estimated value exceeding $2500, he applicant must the notice of commencement and construction lien law brochure will be d, i � red to the person ent. Also, a certified copy of the recorded notice of commencement must e p fisted at the job site s seven (7) days after the building permit is issued. In the absence ! r, j; po d notice, the a reinspection fee will be charged. The foreg day of e me this '51 The fore ?.o ��' or who has produced ho is personally tification and who did take an oath. NO tft,,*45*C3%er Sign. 44; se 0,° Print: AA?", My Commissio (< ✓~ee/ Plans Examiner NOTA Sign: Print: My Commission Expires: Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk Miami Shores Village D mir -gW9 Building Department h!AY 1 12D 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305). 762.4949 BUILDING PERMIT APPLICATION FBC20 Permit No. Master Permit No. fee- /— ®g e Permit Type: ELECTRICAL Owner's Name (Fee Simla ple Titleholder) & �e �7� ��� Phone # Owner's Address 72-f ar. - 7 Add 7 �. City / i State 1� Zip a /-3 7 Tenant/Lessee Name Email 6/ i Phone # Job Address (where the ork is being done) `o 0 7 /V� - 72 / 2 " e City Miami S ores Village County Miami -Dade Zip 3 3 / 3' O FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name e , )4 & .- fc • Phone # 3®6-- 4- - 0°°' .2 6-47` Contractor's Address ' .4,e--, /O - 4,e- City '1t i State Zip �- ( - Qualifier Name // l� Phone # .,30 6 .363 °• -210.--cg State Certificate or Registration No. Are —A ') Ail° Certificate of Competency No. Gse-°/ ®( a 76 Contact Phone— 3 v el 7 54 E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ CO) 0 3 Square / Linear Footage Of Work: Type of Work: ['Addition Alteration ❑New El Repair/Replace El Demolition Describe Work: ("-i 40' -4; ' 4,.,. w104i1A �,t Fib di- ,yret.sd, wr4V -4 , .1 6' al ******* * * * * * * * * * * * * * * * * *• * * * * * * * * * * * ** *Fees * * * * *..* ** •** * * * * * * * * * * * * * *** * * * * * * ** * * * * * ** Submittal Fee $ Permit Fee $ Notary $ Scanning $ 13 -0\D Radon $ DPBR $ Double Fee $ Training/Education Fee $ Structural Review. $ CCF $ CO /CC $ Technology Fee $ Bond $ Violation date: Total Fee Now Due $ `off, b 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 wh• , ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not and a re- inspection fee will be Charged. Signature Own- o Agent The foregoing instrument was acknowledged before me this day of I f , 20 L , by Ct��, who is personally known to me or who has produced NOTAR Sign: Print: My Commission Ex As identificatio Signature Contractor 1 The foregoing instrument was acknowledged before me this t�`k day of GL , 20 % i , by ke�u . i1/44.52_,%14 who is personally own to me or who has produced as identification and who did take an oath. ho did take an oath. * * * * * * * * * * * * * ** APPROVED BY �. 4 ' ' : ry ' u c - State of Florida '�! . = My Comm. Expires May 26, 2013 N a, Commission # DD 893337 NOTARY PUBLIC: Sign. •. '�, ..MI Print: JOSE . RODRI '' , My Comma ,.,: tom ' i es•EXPIRES: March 14, 2012 ' , ° Bonded lbruNotary Public Underwriters * * * * *************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** / /(4 P /£ Plans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Zoning Clerk checked Permit N. Owner's Name (Fee Simple Title Holder): "`x..44 Owner's Address: .- / /L-77-- City: State : /2-7:7 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT %(9h Phone #: ' - 76 4 /FY Zip Code: 73 £ Job Address (Of where work is being done): 6 7 �� ' 7 2— 5 7 -e E l v City: Miami Shores State: Florida Zip Code: 3 / Contractor's Company Name: c�2 � G 'e Phone #: Address: �i °°o ®� z`—÷ sea- • City: State: Zip Code: r� Qualifier's Name : ���r/ e Lic. Number: h-e-,40 79 7b Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: - e I hereby certify that the work has been abandoned and/or the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the mi Shores harmless for all legal involv Signature ownero Signature Contractor or Architect The foregoing ins ment was a nowledge before me The foregoing instrument was aknowledged before me pia this ( ®day of rI I.: 2d1 ,by this a , 20 it lby 1R tt efais Who is personally known tsme or who has produced who is personally known t o°�ne or who has produced Not • bI' L`0 Seal: o: yr, 4 as indentification. 11 CRISM Y PASCARELLA � Note is - State of Florida � �T'f. Expires May 28, 2013 Commission N 00 893337 Notary, Sign: Seal: lic: as indentification. JOSE . �tlt Ali? ' MY COMMISSI EXPIRES: March 14, Banded TM Notan Public U 4111164-.*. • • ,7tle"; casau rbana5M DESIGN • RENOVATION • LIVING Moody Electric, Inc 669 N.W. 90th Street Miami, FL 33150 Re: Miami Shores Permit EL- 1- 10434 Attn: John Moody. Hello John: 921 N.E. 79th Street. Miami, FL 33138. Lic #06BS01115 T. 305.762.6191 F. 305.762.6190 Contact: Crismary Pascarella E. Crismary @casaurbana.com casaurbana.com 04/22/2011 This letter is to notify you that Moody Electric is no longer the Electrical Contractor for the job located at 637 NE 92 Street, Miami Shores, FI. 33138 with permit # EL -1 -10 -134. Thank you. II Carlos Aba a Casaurbana, Inc 305.762.6191 786.286.9510 ECEIVED APR 2 5 201 MOODY ELECTR!CI INC 6/#lri ;3/2411 /105FeercoN LE4) P(Zmr r IS 5T,L -c. /AI C /v riE www.11Itx?m [ .COM 669 N.W. 60 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax: (305) 754 -1333 October 12, 2010 V " _ ; of Miami Shores 10050 N.E. 2 Avenue Miami Shores, Florida 33138 Attn: Buil Po► r K • :k x ;o ent Tel: 305- 795 -2204 / Fax: 305 - 7564972 Re: A..: Resi nce 637 NE 92 Street #12C Subject: Cancellation of Permit L-1- 0 -134 It May Concern, P1 accept this letter as request to cancel the ve referen permit. Our customer Casaurbana, Inc has not returned our phone ... nor can ; ► so we finis d lir work as per our contract. We have not done any work at Jo to since our " u ion in March. At this time we would like to close our permit before it expires on October 16th, 2010 and more fees are incurred. Please send us some i in wriiing .. i . g this 't been clued out. Thank you for your time : consi John J. President License Number. EC0001199 JJM/nb cc: file via: fax 5 re me, this_ 1 dayof a Notary Public Wand °' County, Stateof MOODY ELECTRIC, INC, www.moodyelectric.com 669 N.W. 90 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax: (305) 754 -1333 April 7, 2011 Mr. Michael Devaney Village of Miami Shores 10050 N E 2 Avenue Miami Shores, FL 33138 Re: Permit # EL -1 -10 -134 637 NE 92 Street #12C Miami Shores, FL 33138 Dear Mr. Devaney, Per our telephone conversation on Wednesday, April 6, 2011, I am requesting to be relieved of our duties under the above referenced permit. This project was signed by contract over a year ago (see attached). We received a "rough" inspection on March 19, 2010. Since then, there has been no activity whatsoever on this project. Repeated calls have gone unanswered and apparently they have removed a load bearing wall and applied for new impact resistant windows. This project has gone on too long and the co- ordination and correspondence is lacking. Last October we made this same request but, to no avail! (See attached letter) Please close out this permit on our behalf or provide us with written statement of code compliance reasons for not having done so. We very much appreciate your assistance in this matter. John J. Moody President MOODY4 ELECTRIC, INC, www.moodyelectric.com 669 N.W. 90 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax: (305) 754 -1333 October 12, 2010 Village of Miami Shores 10050 N.E. 2 Avenue Miami Shores, Florida 33138 Attn: Building Department Tel: 305- 795 -2204 / Fax: 305- 756 -8972 Re: Abaca Residence 637 NE 92 Street #12C Subject: Cancellation of Permit #EL -1 -10 -134 To Whom It May Concern, 1/11/0 Kam+ has aacP red I- tome° °'n io la}�on� Please accept this letter as request to cancel the above referenced permit. Our customer Casaurbana, Inc has not returned our phone calls nor contacted us, so that we may finish our work as per our contract. We have not done any work at the jobsite since our "Rough" inspection in March. At this time we would like to close our permit before it expires on October 16th, 2010 and more fees are incurred. Please send us something in writing stating this permit has been closed out. Thank you for your time and consideration. John J. Moody President License Number: EC0001199 JJM/nb cc: file via: fax Subscri and sworn before me, this 1` day of �� , p Notary Public in and for �.5,��.,.. County, State of (Signature) NOTARY PNSLIM My Commission expires 3sk,c 9- , l3 MOLE A BERGERT MY COMMISSION # DD 892259 EXPIRES: July 2, 2013 Bondedlhiu Notary Public Undmwdtets 03/19/2010 07:43 3057626190 CASAURBANA ' far 19 10 02; 41310 mooei4 Electric Inc • # ELECTFIC, .MIC inww mootlyeteertc.com 669 N.W. 90 Street e MirTh. EL 33150-2106 Te1. (305) 759-2000 Fa'. (305) 754-1333 Pt open! Submitted to: Casaurbana 7/5 N. .9 SI:reet. Ste .t\&[..., Miami flotilla *3 3 1 38 Ann; ChurLo Alluea PAGE PROPOSAL March lb, 2010 TO/ Fov 78-6- 28(-9510 303-7(2-6190 Job N a kue: Ltiestiou: Abaca Resideni; 6371\',.E..., 92 Street rr 1 7. C Misceilaneow, E,12ctic:; Shote5. FL 33138 3. Juiiih and :vstal1 quadrupxy, oart1;:t midi two {2) 4,31°C4 gIceptacles on two (2) seri:drat:, dolicavz:ti oval the titd-ten ceunict. 4.) Furnish and Ins".:-,1( a new 2) amp 110 vet dediCated feceptacie lot the left-4MT/ m the kitchen. 4 .*,urnisl -. kaallti rwv.• O amp NO vett teteptacle for the range. 6 't Furnish and install two (2) 1.10 volt outlet jn :he master dose.:1 and inNtati 7.) Firmsh and iastall a nevi/ switch to the hiaAtri:1054.1 fixtures. R.) Fu:-1' ..,th inAtill a nvv. light -..tet with switch Or he wasIterldryer closet mid i.1.;:ita11.3.iston.texr froJircf; `••) Rem'.: nI i:.lo!h ) UV: t.lf,t5 365 CAco 03/19(2010 @7:43 3057626190 CASALIRBANA t'Aut. Maw ; 8 10 02!48p MO0KV1 t.—leotrie Inc DY417 ELECTRIC IN. 1 ofilliiiiingiff APIMIONIMIN".."1116"1"11621111.1"1"14117 vvvyvv.moodyelectric.com 1 569 N.W. 90 Street . 1VIarni, FL 33160.216E T i : (305) 755.2099 Fax (3,0e) 754-".331 1' PROPOSAL 10,) t'urnizin and all acw *I Lcr.ner ...vr-nta for the remaining. Twelve ( :2) reA:Qpilitele.; 1.'4! !-.witclo:s. 11 .11:u...nish and all tit. . dec.ra ,ienicec in uhite. 1.7.v Frni intnet:Lit is t9itiS $10C.00 1.) 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I i I • fv11;:univ If 1;i4ts:. ity, Ao1.7.-.(1,4:ii I ,,,;,.......,,.:;,!,\. .:. ■„„, i ....4,,,,,) •■■••••Ws WO P.N. ••■■ orices, s AtC hltilt.rf.Ct:/r and ist. he.:rery i wrti. 111.,Ide sy ittvcrvz- ; aitt ‘.7% tat 1 ..j Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING' PERMIT APPLICATION FBC 2004 Permit No. R---1 c- Master Permit No. I 0 Permit Type: Electrical -^ t Owner's Name (Fee Simple Titleholder) C,44S-19-0_ (2 lo3't Phone # c.7 DS • /O2_ - 61q 1 Owner's gA1ddress q a 1 l� G City 1 '11am) State Zip 3 c3I 3 8 Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name ititoort.it 6 ` &' i ic., he C. • Phone # 36 .7 - -Z0 Contractor's Address IO6.9 dJ - L�9 713e:4 S T— City LC //i'tii'I State fL • Zip 33 /fc Qualifier Name .:$ &,i A/" 4 Phone # jo ''.S, •2da-a Certificate-o GompetencyNo. a c: ;'149 E -MAIL: JOhh& CcG ic..e-' _ State Certificate or Registration No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: . Type of Work: ❑Addition DAlteration Describe Work: ❑New Q 'Repair /Replace. Demolition •� d PZ€- ?? - €? p, 1? ftLMa ec..—t -o— (34 *** ******x*xxxeYx********* Y****xxxxxxx** Fees****w x'°** ***xxxxxxxxxxxxxxxx:l9e****eY***oFxxxxx. Submittal Fee $ Permit Fee $ Notary $ Scanning $ . Radon $ Training /Education Fee $ DPBR $ CCF $ CO /CC Technology Fee $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side -* Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip 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. l 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: l 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachme/ t. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which • ,, ' even (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ap ..:. • , • , einspection fee will be charged. II Signature �*A j�%► Owne The foregoing instrument was ackno ' ,-dged before me thisZO day of �201Q , by 0341t7) 4bQ'COk , day of �� • f M kzw- , 20 16 , by ''� —,��. Vv C who is personally known to me or who has produced who i personally to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: The foregoing instrument was acknowledged before me this E5 Sign: Print: My Commission Expires: :xr.x * xxxxxxx,t ,,iovs+ ue4�� CRISMARY PASCARELLA f Notary Public - State of Florkla ,s �T mytbilif rip'r s �. of 0. ?;$ Commission # DD 893337 Si Print: My Commi " ;fires: NICALEABERGERT �}y� � ,, " MY COMMISSION # DD 892259 xXXXY. ity. - I'v N_.w*wwe . ryto,'nf:'/fYN1h XX% 414:07 4 Bonded Thru Notary Public Underwriters APPLICATION APPROVED BY: (Revised 02/08106) %r.XY,:X Plans Examiner Engineer Zoning 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 1 BUILDING PERMIT APPLICATION FBC 20 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) ,SAN 27 'LW BY: V.... Permit No.� I 0 . t ?)4. ` Master Permit No. I0 ° ZC1 k16914(ick 1-nc, Phone # 335-.7Ga 6Pt I Owner's ddress (tS 1` me* 4- City larn) State Zip , Tenant/Lessee Name Phone # Email C( 1S of Csx . yx • hr)--, Job Address (where the work is being done) City Miami Shores Villa e &.-3) County Miami -Dade Zip FOLIO / PARCEL # `-33-C*- (0 '+3— ®1 4-0 Is Building Historically Designated YES NO Flood Zone Contractor's Company Name ' ' l rP Lf-G tc. di G Phone # -2-Ar 7.. Ze,--z:30 Contractor's Address 7 fit/ w , City /24 'i'!� State G . Qualifier Name ft*) N%/ State Certificate or Registration No. Contact Phone Zip 3 3 1 ) Phone # . ' zr • Certificate of Competency No. d - 6 zf 1199 E -mail 'e, iv ter Architect/Engineer's Natne (if applicable) Phone # Value of Work For this Permit $ G'?a-zi Type of Work: ❑Addition Alteration Describe Work: i?eriQ,L,6•trt. Square / Linear Footage Of Work: ❑New ❑ Repair/Replace Lw7 a- ❑ Demolition • `,0i,j e 4 ofii u . etJ4/0.0J Alikaw k7 ..1.3ro......:t.9e4cdc .......,9e...,,.9 ... . °... '•' ',D'. d:. k4.... --... k/�dr/d:....3e a 4c9e r 14/ '"1 x .7 //vs!' / 1 -7C7 1 (/ Submittal Fee $ Permit Fee $ Z2.> oo ®® CCF $ UlJ Training/Education Fee $ O{Q° Radon $ g.--k9 DPBR $ OC . ) Bond $ Violation date: Total Fee Now Due $t • W Notary $ Scanning $ 'O0 Double Fee $ Structural Review. $ CO /CC $ Technology Fee $ a " 10 See Reverse side --> Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage L'ender'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 w h occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b eland a re- inspection fee will be charged. Y : r or Agent Signature The for - _oing instrument was ac sY owle day o ,.i, '1i\► , 2010 , by Contractor The foregoing instrume t was acknowledged before me this day of az J ° 1�I/, 20 JO, by -4(9111-kk) MOCO, who p� is ersonally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTARY P� C: Sign: Print: My Commission Expires: as identification and who did take an oath. Y '� ` ry Publo • State tit Flo a`' My Comm. ►oe ,,,,;� Commission lye8 0888333713 �Y�YY�iu1;g`�. * * * * * * * * * * * * * * * * * * ** APPROVED BY - 9 a Plans Examiner Engineer (Revised (Revised 07 /10 /07)(Revised 06/10/2009) NOTARY PUBLIC: Sign: )44 Print: My Commissi •1 ,,,,,,,,, MARY PAT BRIGGS 1PaY PU9 .' o �. Notary Public - State of Florida u, ; • �y Commission Expires May 11, 2010 aYy i, : 3F *�r *gg�a� sier*8»tkLLlx 1:0:* qr � . %ci s's Bonded By National Notary Assn. Zoning Clerk checked SENDER: COMPLETE THIS SECTION • Complete items 1, 2, and 3. Also complete item 4 If Restricted Delivery Is desired. • Print your name and address on the reverse so that we can retum the card to you. a Attach this card to the back of the maiipiece, or on the front if space permits. COMPLETE THIS SECTION ON DELIVERY X B. Received by (Wtinted N Agent Addresse ate of Dellvei 1. Article Addressed to: ,41 040 6Q1 rim �Io` Z Article Nurnber (Transfer from service Label) 0. Is delivery address different from item 1? 0 Yes If YES, enter delivery address below: 0 No 3. Service Pgpe 0 Certified Mall 0 Express Mail 0 Registered 0 Retum Receipt for Merchandts 0 Insured Mall 0 C.O.D. 4. Raatririerl nalluan/T IPetrn Faal 7010 2780 0001 1834 5689 0 Yes PS Form 3811, February 2004 Domestic Return Receipt 102595- 02 -M -16 UNCTED STATES POSTAL SERVICE First -Class Mall Postage at Fees Paid LISPS Permit No 0-1.0 • Sender: Please print your name, address, and ZIP +4 In < this box eASA1..) ez. .6.Ain l t1 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY • Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery Is desired. • Print your name and address on the reverse so that we can retum the card to you. • Attach this card to the back of the maiipiece, or on the front if space permits. 1. Article Addressed to: Hoo 60'1 c;)01---t � . Agent Addressee ate of Delivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Certified Mall ❑ Express Mall 1 ( t4 1 e ❑ Registered ❑ Retum Receipt for Merchandise 1 ❑ Insured Mail ❑ G.O.D. 4. Rastrh:tPri ndrvwwl /FYr b ❑ Yes 2. Article Number 7010 2780 0001 1834 5689 (Pander from service Iabe° PS Form 3811, February 2004 Domestic Retum Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First -Class Mail Postage & Fees Paid LISPS Permit No. G -10 • Sender: Please print your name, address, and ZIP +4 in this box • eotkAl.)Q..kmettnA °12- n®I s • Ml \ . �1�a 111111111111111111111111111111111131111111111111111111111 11111