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ELC-10-1297
BUILDING PERMIT APPLICATION FBC 20 JOB ADDRESS: Is the Building Historically Designated: Yes 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 ©o 41. City: Miami Shores County: Miami Dade Permit No. '001SEV Jlil l 5 2pdW BY: tutI-12_99 Master Permit No. CC 10 - 4 13 a Permit Type: Electrical (('�� ` OWNER: Name (Fee Simple Titleholder): J, 3).cr!4 �/n1 )d I `l�‘l Phone# 3 0 S' g "' Tenant/Lessee Name: Phone#: Folio/Parcel#: NO Flood Zone: Zip: 3 3 b CONTRACTOR: Company Name: / l Ca E C (C f / ? / c Phone#: 3/ n 'G ° Address: / 6 9 /e7 Siai //3 City: ' /4 pri / State: FL a Qualifier Name: � A ,/b� , A/14 50 A✓ Phone#:3 ( 2 3 3 " 01) 45 State Certification or R gistration #: /E / 3 / e/ .S° Certificate of Competency #: 00fere, / t7 5 q Contact Phone#: 3 9 ezie re) a 7 Email Address: DESIGNER: Architect/Engineer: Phone#: Zip: 3 7 /.5"7 Value of Work for this Permit: $ ` S ll 00 ' Square/Linear Footage of Work: Type of Work: OAddress J - � Alteration ONew URepair/R ❑ eplace Demolition Description of Work: AC �zz) dv � j 43C c 2ee 1t r 4 tm . (1) 1°j T s-,r i 4-c�. o r /let) p4r i 4i 40A . (J Submittal Fee $O '00 Permit Fee $ /-CePr 4P42 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ T i* s ning/F.duc ation Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ n4.61( (O( 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In absence of such posted nonce, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent The foregoing instrument was ackno ledged before me this day of 0;/4- , 201 b, by 7 � o e who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print My Commission Expires: gp Melanie James t i t o 1 : 4 COMMISSION i`l3D734951 -` '- EXPIRES: NOV. 18 2011 ** ***** * *********** 9�k****k*kd��9$& 0444 �s3b*9*8+9+W8$*M*4Rp$zl *W @B**xbga,k8+&* +3+k*d***$*wRW*b d4Ywki'+* APPROVED BY Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15109) Contractor � I The fo ;,. mg instrument was acknowledged before me this I 1 day of L + , 20 in by 9 ( L) 1-S 07J , who is - ly known to - or who has produced as identification and who did take an oath. C: t urd ,R43‘ trEIGNMW.A.OVERS * MY COMMISSION 0 DD 939170 EXPIRES: Match 10, 2014 ''S BmaedThru Budget Notay SerVICes Zoning Clerk Inspection Number: INSP- 148651 Permit Number: ELC -7 -10 -1297 Scheduled Inspection Date: August 09, 2010 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Wiegand & Annex Miami Shores, FL 33138 -0000 Project: <NONE> Contractor: WILCO ELECTRIC Building Department Comments ADD DUPLEX RECEPTACLES AND ONE LIGHT SWITCH FOR PARTITION Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 06, 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 - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 -09 Phone: (305)233 -0056 Page 16 of 32