EL-12-769BUI[DING
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 APPLICATION
FBC 20 j C>
Permit Type: Electrical
i
MAY 0 1 20i2 i
Permit No. IF— U 2 —7 (D 5
Master Permit No.
OWNER: Name (Fee Simple Titleholder): 6oRPO'd % %oYeA Phone#: 30.;'— 416 7-392/
Address:_ S�- 6- 9? W 57 -
City: M f *,,q i -A-65 State: � L zip: 33/ 3 2
Tenant/Ussee Name:
Email:
JOB ADDRESS:. S'f 9 9
City: Miami Shores County: Miami Dade Zip: 33139
Folio/Parcel#:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
Address:
NO x Flood Zone:
3D,,zQq &447
City: State: Zip.
Qualifier Name: 'JO t? '09- Phone#:
State Certification or Registratio� C' 6,0 3 Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value,, of Viii& for this Permit: $ �s�oo Square/Linear Footage of Work:
Type of Work: ❑Address, QAlteration ❑New. ARepair/Replace ❑Demolition
Description of Work:
Submittal. Fee $ w. ( Permit Fee $ �✓'�®� �� CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ u
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
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or i0stallation 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 approved and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this lli5l
day of &V L- , 20 LZ, by 6rL— ,
who is personally known to me or who has produced R, I D
Signature
Contractor
The foregoing instrument was acknowled d before me this
day of , 20, �by
who is personally known to me or who has produced &�c
As identification and who did take an oath.
NOTARY PUBLIC: i+triyri,,
\`•�O\� ..... ?!D��b
Sign: Np SS/l�� •;`'da =_
Print:
My Commission Expires: 's co✓••.sa
�// � ••.,,fid X?� • • `\\
wwwwwwwwwwwwwwwwwwww.acasay.ww...ww.ewswwwwwwmm--------------- -
APPROVED BY
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Plans Examiner
Structural Review
as identification and who did take an oath.
NOTARY PUBL •- +.•+
ALMA LLMES
cam;ISSION # OD96970
Sign: 2014
Print: can
My Commission Expires: AA
r/ky �� l
Zoning
Clerk
TYPE: Lug Only
MTG:
MAIN: 200
cln ��n
PANEL MA 1 �� IZ
VOLTS: 120/240
BUS: 200 AMP
LOAD:
LOAD COND
WIRE
TRIP
POLES
DESCRIPTION
CKT.
CKT.
DESCRIPTION
POLES
TRIP
WIRE
COND
LOAD
7000
3/4
#6
60
2
C HANDLER
1
2
C CONDENSOR
2
40
#8
3/4
5000
C HANDLER
3
4
C CONDENSOR
5000
2
WATER HEATER
5
6
SMALL APPLIENCE
1
20
#12
1/2
1500
1500
3/4
#10
30
2
WATER HEATER
7
8
SMALL APPLIENCE
1
20
#12
1/2
1500
1500
1/2 1
#12
20
1
RECEPTACLES
9
10
RANGE
2
60
#6
3/4
8000
1500
1/2 1
#12
20
1
RECEPTACLES
11
12
RANGE
5000
12
#12
20
1
WASHER
13
14
DISPOSAL
1
20
#12
12
1500
3/4
#10
30
2
DRYER
15
16
DISHWASHER
1
20
#12
1/2
1500
DRYER
17
18
RIFRIDGERATOR
1
20
#12
12
5000
19
20
21
22
23
24
25
26
27
28
1 v 1 AL LUAU: Llauu
GENERAL LIGHTING
F` - —,:-=:
2-4Z, MAOU
m
Man, .^u_bcgss
IUTAL LOAD: Z4uuu
FIRST 10,000 WATTS
40% OF 22475
8990
A/C: 1
(@ 12000 WATTS= 12000
TOTAL WATTS:
30990
TOTAL VA:
129.1
USE AMPS FOR
200
30B: GORDON MOYER
ADDRESS
54 NE 99 ST
MIAMI FL 33138
SIGNATURE:
CITY LIGHTS ELECTRIC INC.
MASTER ELECTRICIAN
1 �06E000935
ALWA LLAHIES
•+: NAY COMMISSION # DD988728
May 04,, 2014