ELC-16-1756 Miami Shores Village
g -
L Building Department
DEC ®2 2815
90050 N.E.2nd Avenue,Miami Shotes,Florida 33138
Tel:(305)7952204 Fag:(305)756.8972INSPECT BY:NUMBER:(305)762.4949
1 FBC 201 y 1N
Br Permit No.
PERMIT APPLICATION Master Permit No.CC_-7-15-- 17:56-
Permit
7 5Permit Type: Electrical
JOB ADDRESS: I o L 1 o ija G J" Acq L=k,,_)i7
City: Miami Shores County: Miami Dade Zip: 3 3£3
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder):_ Ar-24P�-bocci-t
Address fJ
Cityt t A-i 111 State: �L,40 t 8A
Tenanvlxssee Name: Phone#:
Email:
CONTRACTOR:Company Name: T?' Phone#: �S°7SR.L
Address: a9cz 1iz-
City: State L-c)AC c C).A Zip: 33t?2 0
Qualifier Name: - Phone#: . 76'IR
1
State Certification or Registration#: L' 060 //q q Certificate of Competency#:
Contact Phone#: 796 (ca ®�9 ,3 Email Address: 101 ,7 (f lex-f i-i G • c.�
DESIGNER:Architect/Engineer Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: DAddress OAltetation ONew Wfiepair/Replace ODemolition
Description of Work: `� (o►V Sr 11 (�J l r l la a �? rG 4 1 T 1� il)L�I,t J
(•7i&0 ? ` . 0 i•2,0/-2-405� e-Vti.. Wt 'r14 � nod-gar=,4 622/17G0i
kYAPZL1 f'.J Av t> 11 J A.'81 6 `3C 5
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Submittal Fee$ Permit Fee$ I—P#4 fr., CCF S. 49.°2-0 CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ °0"i Bond$!•
Notary$ 0 TraininglEducadon Fee$ Technology Fee$ ro 5 •to
Double Fee$�� Structural Review$
TOTAL FEE NOW DUE$ �— • .�c�
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 ap oved and a reinspection fee will be charged.
Sicmatin A Signal Z. etd�
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20 jam,by day of Z 3 .20 (S,by-Ityf•A4�
who is personally known to me or who has produced who' onally known to me who has produced
-- As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: -�Eu AlYt-,M
Print eQ 1NPrint:
My Commission Expires: LNAY a Mina Pwwic to of Fbdft
i My Commission Expires +„•• r $v�al�oorsis
Rebate MunPr
My Commission FF 188148 , W comaissron Cr 91(-144
02MO12019 •4� a E 20"!,r a ,a* ,r ,t Saar*a*,tw,t ts►*,t,rs tt*,r*r s*a *
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/122012XRevised 07/10/07X Revised 06/102009XRevised 3/15/09)
r
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That the most Reverend Thomas Wenski, as Archbishop of the Archdiocese of Miami, his
successors in office,a corporation sole,has made,constituted and appointed,and by these presents
does hereby make,constitute and appoint Sister Elizabeth A. Worley,C.O.O.,his true and lawful
attorney for him and in his name,place,and stead
Giving and granting unto Sister Elizabeth A. Worley, C.O.O., his said attorney full power and
authority to do and perform all and every act and thing whatsoever requisite and necessary to be
done in and about the premises as fully, to all intents and purposes, as he might or could do if
personally present,with full power of substitution and revocation,hereby ratifying and confirming
all that Sister Elizabeth A. Worley, C.O.O.,his said attorney or his substitute shall lawfully do or
cause to be done by virtue hereof.
In Witness Whereof, I have hereunto set my hand and seal this 20 day of February,A.D.,2015.
Signed,sealed and delivered in the presence of:
Witnes .
4
Witness ignature The Most Reverend Thomas Wenski
As Archbishop of the Archdiocese of
Ami Miami his successors in office, a
Printed Name corporation sole
Witness Signature J/
Printed Name
,
STATE OF FLORIDA )
SS:
COUNTY OF DADE )
I hereby certify that on this day,before me,an officer duly authorized to administer oaths and take
acknowledgements, personally appeared The Most Reverend Thomas"Wenski, as Archbishop of
the Archdiocese of Miami, his successors in office, a corporation sole, known to me to be the
person described in and who executed the forgoing instrument,who acknowledged before me that
he executes the forgoing m ent,who acknowledged before me that he.executed the same,and
an oath was not taken. s/ Said person is personally known to me Said person provided
the following type of identification: ---
Witness my hand and official seal in the County and State last aforesaid this 20 day of February,
A.D.,2015.
My Commission Expires: , ,
. Mllift tial"
Nrcoa►n FF wsua
IQs
Dec 02 15 10: 14a Moody Electric Inc 305-754-1333 p. 2
,� as
CITY OF HOLLYWOOD, FLORIDA
TREASURY SERVICES DIVISIONIL.00AL BUSINESS TAX RECEIPT
2600 HOLLYWOOD BOULEVARD,P.O.BOX 229045,HOLLYWOOD,I=L 33022-9045
TELEPHONE(954)921-3225, FAX(954)921-3056
i
BUSINESS NAME:Moody Electric,Inc.
MAILING ADDRESS: 3812 A N 29 Ave
MAILING ADDRESS 2:
CITY, STATE,ZIP:Hollywood, FL 33420-
DEAR BUSINESS OWNER:
THIS LETTER SERVES AS YOUR TEMPORARY LOCAL BUSINESS TAX RECEIPT FOR
THE CURRENT TAX YEAR. YOU WILL RECEIVE YOUR PERMANENT LOCAL BUSINESS
TAX RECEIPT IN THE MAIL WITHIN THE NEXT FIFTEEN (15) WORK DAYS. .PLEASE
POST THIS RECEIPT IN A CONSPICUOUS PLACE AT THE BUSINESS LOCATION. PLEASE
DO NOT REMIT ANY PAYMENT. TIUS IS NOT A BILL
CITY OF SOLLYWOOD/LOCAL BUSINESS TAX RECEIPT
Business Nam
e• Moody Electric,Inc.
RuscYAese Location: .3812 A N 29 Ave
Business Class:Cont mctor/Electrical
Tax Year: FY 2016
Expiration Date: 09/30/16
Total Amount•Piid: S
PURSUANT TO STATIC LAW,THE LOCAL BUSINESS TAX JIE CEIPT IS LEVMD FGIR
THE PRIVILEGE OF DOING BUSINESS WITHIN A CITY,S LIMITS, AND .IS NO)v
REGULATORY IN NATURE, ISSUANCE OF A LOCAL BUSINESS TAX RECEIPT IIS'
THE CITY OF HOLLYWOOD DOES NOT MW
AN THAT THE:CITYHAS UETER1YIIriz+;Il
THAT THE EXISTINGOR PROPOSED U �'S OF A LOCATION IS LAWFUL. ISSUArgCIC
OF A LOCAL BUSINESS TAX RECEIPT DOES NOT LEGALIZE OR CONDONE TU
NA'I'URE.OF THE BUSINESS BEING CONDUCTED IF CONTRARY TO LOCAL, STATE
OR FEDERAL LAWS OR REGULATIONS,
ISSUED: 9/30/2015
SIGNA RE