EL-10-1331Ics.)k,‘
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Electrical v'° /�^++
Owner's Name (Fee Simple Titleholder) '��r�_ . �Nf i yc Phone # 3t - - e9 - F}'4 L(
Owner's Address c ri %,„:>-
City Y � k.Z-C I S o1 s State (....C1 A-c-,
Tenant/Lessee Name
E -MAIL: (y S h^* � . . cc
Job Address (where the work is being done)
City Miami,, Shores Village County Miami -Dade
FOLIO /PARCEL# it ^? 6-0( — %. "k
Is Building Historically Designated YES NO
Contractor's Company Name'Cx ,.Ls C4 \c \`+\c - Phone # 3(s.s - - )ST--- '''''
Contractor's Address kL,c, lI QC's S` -�
City (C,-[.1/4.c- State k kGr cx�1 Zip 3 -NS 0
Qualifier Name — 36". i-- : - S F ' `c- c-.3 .
Phone # 3�S- 7 Sg
State Certificate or Registration No. EIC C c'( Certificate of Competency No.
E- MAIL r\: cc5k4_1;1 Mc)c)r - 'e Q is . cc
Architect/Engineer's Name (if applicable)
Value of Work For this Permi
Type of Work: ❑Addition
Notary $
Scanning $ 5'
Bond $
[Alteration
Structural Review. $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
t
Square / Linear Footage Of Work:
[New
Permit No. 1 -"tQ" 1 33 1
Master Permit No.
Zip 33 1
Phone #
Phone #
Zip
ja, Repair /Replace
U 0 0:1!.
Qom.'
❑ Demolition
Describe Work:
*nc** * **x*** *** ,r. *x *** * *:ax,r,r**,; * ***** Fees *** ** * * *** *x. *m xes * **** * *** *** * *,.*, ,r ***
t
Permit Fee $ / S' CCF $ ' 90 CO /CC
Technology Fee $ ) •`
DPBR $ Zoning $
Submittal Fee $5O• OC°
itgar
t wining /Education Fee $ .
Radon $
Code Enforcement $ Double Fee $
Total Fee Now Due $ 1 Val • •O
See Reverse side --
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address Y \ \
aaaJJJ P\
City State ip
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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. 1 understand that separate permit must be secured for ELECTRICAL WORK. PLUMBING. SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEAVERS, 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
ner or Agent
The foregoing instrument was acknowledged before me this
day of *1 ' 1r'/ ,2010, by 61, Pal
who is personall known me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Comn
APPLICATION APPROVED BY:
(Revised 02/08/06)
Signature
Contractor
The foregoing instrument was acknowledged before me this 20
day of 541 "/ , 20 /O , by Jd ## V inC70 / ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Comm
MARY P
*;. MY COMMISSION D
res: EXPIRES' May 11, 2014
Aikev,toMTAti Notmy Publlcundmwdten
**iv***
Plans Examiner
Engineer
Zoning
Inspection Number: INSP- 149702 Permit Number: EL -7 -10 -1331
Scheduled Inspection Date: August 05, 2010
Inspector: Devaney, Michael
Owner: PENDLETON, CARL
Job Address: 9717 NE 1 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CHANGE OUTLETS IN HOUSE ADD TWO EXHAUAST
FANS IN BATHROOMS CHANGE SWITCH TO DIMMERS
August 04, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132060132420
Phone: (305)758 -2000
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