EL-18-2097Miami Shores Village
10050 N.E. 2nd Avenue N
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. E L-8-18-2097
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: APPROVED
issue gate: 8/13/2018
Expiration: 02/09/2019
Parcel Number
Applicant
9325 N BAYSHORE Drive
Miami Shores, FL 33138-
1132050270540
Block: Lot:
OMAR CASSOLA
Owner Information
Address
Phone
Cell
OMAR CASSOLA
9325 N BAYSHORE DR
MIAMI SHORES FL 33138-2950
(305)206-2754
Contractor(s)
MOODY ELECTRIC INC
Phone
(305) 758-2000
CeII Phone
Valuation:
Total Sq Feet:
$ 2,000.00
0
Type of Work: REPAIR AND REPLACE EXISTING RECEPTA
Additional Info: REPAIR AND REPLACE EXISTING RECEPTA
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Amount
$1.20
$2.25
$2.00
$0.40
$150.00
$3.00
$1.60
Total: $160.45
Pay Date Pay Type
Invoice # EL-8-18-68465
08/07/2018 Credit Card
08/13/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 110.45
$ 110.45 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
I
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 e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction ar z ig. F - ore, = uthorize the above --named contractor to do he work stated.
a--4/9
Applicant / Contractor /
orized Signature:
er /
ent
August 13, 2018
Date
Building Department Copy
August 13, 2018 1
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
Address:
City:
Qualifier Name:
g <- ,0 02? .04-1/'e
spa-1 /4
State: IC2-04
o Lt.)
State Certification or Registration #: EC-oe60 4ei
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit:'$ =' oleo*" • 4=2•0
Miami Shores Village
Buildirng(Department
I
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING x ELECTRIC ❑ ROOFING
;Master Permit No.
Sub Permit No.
❑ REVISION ❑ EXTENSION
❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION
JOB ADDRESS:
City:
CONTRACTOR
93;25 , J ,S, x ,L/Lie
Miami Shores County:
Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type:
Load:
Construction Type: Flood Zone:
BFE:
PIED
AU;;. 0 7 2018
2c�
❑ RENEWAL
❑ SHOP
DRAWINGS
NO
FFE:
/f
OWNER: Name ee Simple Titleholder): /1/Aj� d,4. 5Q�%, l Phone#:
Address: 7 6/0 PAvie
City: 44LO r ;c /^
State: �G� Zip: ��'i 38
--- —Phone#:
�i�e Phone#: 575-8 ®
Zip: 5P42.00 •
Phone#:
Certificate of Competency #:
Phone#:
City: State: Zip:
Square/Linear Footage of Work:
ype of Work: ❑' Add tip ❑ Alteration ❑ New R/Repair/Replace
;,� ,.. ,,.,3:�': } RifEl Demolition
�n;of Work: `' •� / J� /�� ,4�rt,� �i
ice^
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ r • 4 S
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City' State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address s"M X4I*.
Ei � ,� State -
s — X
Zip
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€pf all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,,,
FURNACES, BOILERS, HEATERS, TANKS, 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. Ns . .., c �,, ^',
N 1 i Ere 4 r S.,i` 1 '` '*, +
"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 valuerceeding*$2,p, the applicant must
4, rHti .
promise in good faith that a copy of the notice of commencement and construction ben law brochure will be deliere d 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. i k',,..\
r
' Sign
OWNER or AGENT CONTRACTOR
, •,. ~ - t , -.. .' . l -..
The foregoing instrument was acknowledged beforre� me this a <• 'Tiie foregoing instrument was acknowl edged before me this
,1h PA) �1C day of �t ,20<�D.;221,by' , 7tt-Th dayor A-U` 'U T ,20 is ,by
who is personallyknown to i h \I `lodcJ� , who is personally known
(1m(�r CUS.SO� , JC \ .�J',
_me or who has produced as me riwhoo,,haproduced f
identification and who did take an oath.
NOTARY PUBLIC:
identification and who did take an oath.
NOTARY PUBLI
...`% Sign:`" �.
Print:
Sear
<'l
»Sign: `r\
Print:
Seal:
as
*****************************************
d yl
APPROVED BY v -/ .Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)