RC-13-2102 (3)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
RECEIVED
DEC 13 2013
Permit No. / 3 -097.-72,
Master Permit No.)? _/, _ c/
Permit Type: Electrical r�
OWNER: Name (Fee Simple Titleholder): ��a d�'�-d` / 4 Phone#: gv.5. a f��'
-
Address:
City:
o1,10/21-44State: TG Zip:
Tenant/Lessee Name: / f /L Phone#:
Email:
JOB ADDRESS: ggor.9-5 ,'d2-4 44/ `o z Ok •
City: Miami Shores
County:
Miami Dade
Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO /k'. Flood Zone:
CONTRACTOR: Company Name: Pfgiee.,&-e---/iv/. Phone#: i55gaCXx
Address: (OCA % /t44') qD T
City: dState: 7/1e5-z/dig- •
--.73-1).) --r— /"le)o
Qualifier Name:
State Certification or Registration #: )1199 . Certificate of Competency #:
Contact Phone#: 005 7 8 vac) Email Address:
DESIGNER: Architect/Engineer: /4d5r/4 ' ,4SS)G , Phone#:
Phone#:
Zip: g1/3 -d
758".c'
Value of Work for this Permit: $
Type of Work: DAddress
Description of Work:
0p 2
❑Alteration
&v
�- has �oLr
a�o/%D/T 6&
Square/Linear Footage of Work:
*Kew ❑Repair/Replace
42, 6fto{i to slr••`-Id v K `
1/1
aa
❑Demolition
PlekI S J 7 /aD t'o' pie �,,a a• . .022.,,.)/04„...6,
pc/1 *�*****************************Fees***' ** * * *� ***************
3tA-S1')
Submittal Fee $ � cic) Permit Fee $ 2 as/ e' CCF $ CO/CC $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
&Les«?6
Bonding Company's Name (if applicable)
Bonding -Company's Address
City State Zip
Mortgage Lender's Name (if 'applicable)
Mortgage Lender's Address
Al
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 appy d ar : :inspection fee will be charged.
Signature
Owner or Agent Contractor
The foreg • g instrument was acknowledged before me this _/ The foregoing instrument was acknowledged before me this /1
day of le , 20, 3, by O74t • [ �Anok • day of 02 , 20 '3by Sohn -
who is personally known to me or who has produced who is personally known to
As identification and who did take an oath. as ide
NOTARY PUBLI :
NOTARY P IC
Sign:
Print:
My Co
c
mission Exp
**********************
APPROVED BY
Notary Public • State of Florida
My Comm. Expires Aug 31, 2015
• Commission 9 EE 92676
Sign:
Print:
My Commission Expi
roduced
y• *ndMlw . e
"'°f1tiV Bonded
�
�6j00MM��B�Th�Oepaoath.
�Yp
6/A-tr
UndPnt.ters
P�#
MARY PAT BRIGGS
t.t v COMMISSION # DD 979267
EXPIRES: May 11, 2014
• 6 Thru Notary Pubic Underwriters
*****************************************************************************
1,c ..2G:/3,
400/11,111
5 Plans Examiner
Structural Review
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-204524
Permit Number: EL -12-13-2797
Scheduled Inspection Date: January 26, 2015
Inspector: Devaney, Michael
Owner: CASSOLA, OMAR
Job Address: 9325 N BAYSHORE Drive
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1132050270540
Phone: (305)758-2000
Building Department Comments
NEW ELECTRICAL FOR ELEVATOR
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
January 23, 2015
For Inspections please call: (305)762-4949
Page 2 of 34