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EL-14-1798 r Miami Shores Village Building Department .� T � 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 j � ��' Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 BY TBC 20'�O BUILDING Permit No. � PERMIT APPLICATION Master Permit No. �� Q�- 1 o Permit Type: Electrical JOB ADDRESS: e� f `76s / City: Miami Shores County: Miami Dade Zip: _43 5Y Folio/Parcel#: v 3,806 -001 0010 Is the Building Historically Designated: Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): ,_BAR t'L W Phone#: Address:_ `l_'1 gL �i City: dIM I NNi b sf ttme' .t- State: FL Zip: 3'_-t'1.:5 3 TenanvLessee Name: Phone#: Email: CONTRACTOR:Company Name: aim c'j llv0wz Phone#: '7 S(s•3 tl T'Qro j Address: —7g0to w-..,'I S E- U6,jr ftS �4(Aus"- (4 12(. City: a' .t ra64 a State: Zip: It, I tL Qualifier Name: I�a-U a ej �111:4 Phone#• State Certification or Registration#: S Zee9 a®a ?V 7 Certificate of Competency#: Contact Phone#: q Y& -'a17. 76'7'/ Email Address: rj& a� ®w, c4'11 At(Et w C. e.d1w DESIGNER:Architect/Engineer: ✓i k F9.4we® Phone#: ..42r_S`3/ Value of Work for this Permit-$ r.000 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New ®Repair/Replace ®Demolition Description of Work:_ Ems+ ld t� Fe'4_ (C_ Submittal Fee$ Permit Fee$ Xo&l CCF$ CO/CC$ 92 Scanning Fee$ .9 CP Radon Fee$ 14 DBPR$ pBond$ Notary$... Training/Education Fee$G-'-A C) Technology Fee$ GO Double Fee$ Structural Review$ q TOTAL FEE NOW DUE$ � � Bonding Company's Name(if applicable) °/r/ 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 cotmnencenzent must be posted at the job site for the first 'inspection which occur `sVen (7) days after the building permit is issued. In the absence of such posted notice, the inspection will t be appro d and a ret spectio fee will be charged. Sign Signature Owner or Agent Contractor The foregoing iinstrument was acknowledged before me this The foregoing instrument was acknowledged before me this --2- 20 of c� / ,20/ ,by day ofv5h ,20�,by who is personally 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. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: I Sign: 'ti` Sign: SUN SMWMR Print:® J C _ COMMISSION#EE 129586 Print: v l.•ow b 6� My Commission Expires: �/ Bonded Thru Notary Public Underwriters My Co , W.' ' Expire ACWELINE CORA MY COMMISSION i FF 099383 ? EXPIRES:Match 22,2018 Rt� ,, hooded ThN trtmy Punic Underwrhers �xaga��aa�s38'�R�ic�sa��am�au�arFsaxks�aa��sria,F,sR,Rsa�s€azsrkgca�,rzsRza�sa3*3Xs,�s.:,3€-s,�Ra,�,aSs�N�assk�,sa,�Ea+�sAzaac# � .,��x�aa�,�a=,k�, APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012XRevised 07/10107)(Revised 06/10/2009)(Revised 3/15/09) lefn tt d E -14-179 ven°REs L�� Miami Shores Village Petr it Elect (-kilis)dent) ) �� 10050 N.E.2nd Avenue NE t+Vot�Dlassiiftcetitlr�,New Miami Shores,FL 33138-0000 er, Permit Status.-APPROVED nN Phone: (305)795-2204 �`RivA FEx Iration: 11/2 /2015 p 2f201 P Project Address Parcel Number Applicant 912 NE 95 Street 1132060010010 RICHARD EFFS BARCLAY GRAI Miami Shores, FL Block: Lot: Owner Information Address Phone Cell 912 NE 95 Street 1= RICHARD EFFS BARCLAY GRAEBNER (305)490-3299 E MIAMI SHORES FL 3338- 912 NE 95 Street MIAMI SHORES FL 3338- Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 ON CALL ELECTRICAL CONTRACTOI (786)388-5880 Total Sq Feet: 0 Type of Work:NEW ELECTRIC FOR POOL Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:3 Meter Box Alteration Relocation Fire Alarm Service Change Underground W.W. Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-8-14-52656 DBPR Fee $4.50 DCA Fee $4.50 08/18/2014 Credit Card $50.00 $271.20 Education Surcharge $0.40 06/02/2015 Credit Card $271.20 $0.00 Permit Fee-Additions/Alterations $300.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $321.20 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 ab�vZned i actor to do the work stated. June 02, 2015 Authorized Signature:Owner / Applkanfontrac r Agent Date Building Department Copy June 02,2015 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246278 Permit Number: EL-8-14-1798 Scheduled Inspection Date: October 22, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: BARCLAY GRAEBNER, RICHARD EFFS Work Classification: Pool - Private Job Address:912 NE 95 Street Miami Shores, FL Phone Number (305)490-3299 Parcel Number 1132060010010 Project: <NONE> Contractor: ON CALL ELECTRICAL CONTRACTORS INC Phone: (786)388-5880 Building Department Comments NEW ELECTRIC FOR POOL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed , Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 21,2015 For Inspections please call: (305)762-4949 Page 49 of 55