EL-11-618Inspector: Devaney, Michael
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Building Department Comments
May 03, 2011
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 159014 Permit Number: EL -4 -11 -618
Scheduled Inspection Date: May 04, 2011 Permit Type: Electrical - Residential
Inspection Type: Final
Owner: GUILFOY, THEO Work Classification: Alarm
Job Address: 9825 NE 4 Avenue Road
Miami Shores, FL 33138 -2438
For Inspections please call: (305)762 -4949
Phone Number
Parcel Number 1132060170190
Phone: (786)331 -3967
LOW VOLTAGE BURGLAR ALARM SYSTEM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 14 of 21
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder)
Owner's Address
City 1.t
Tenant/Lessee Name
Email
FOLIO / PARCEL #
02.5
tate
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade
//- -3,,P-a6 - - OM - C/96
Is 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
NO
Master Permit No.
Phone #
Zip 33/3?
Phone #
Zip
Permit No.F.1 1- 01E
APR 07 2011
ll Flood Zone
Contractor's Company Name T Phone # f / 2-49k
e
Contractor's Address
City
.teiaz‘u4)
Architect /Engineer's Name (if applicable)
State ‘1 -
Qualifier Name J G/Yj9 /17e`/j
State Certificate or Registration No. Cr O p // 2/
Contact Phone fiSzf) 2 5j Gj E -mail
Zip 3362—
Phone # ( C / 26' - 57/
Certificate of Competency No.
as jui l a 0?
Phone #
Value of Work For this Permit $ DUb • °�� , Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New
❑ Repair/Replace ❑Demolition
Describe Work: (1) L - 2g/ 44
* ** * * * * * **** * * * * * * * * * * * * ** F * * * * * * * * * * * * * * *** * *** * * * * * * * * **
Submittal Fee $ Permit Fee $ 42G0i`.e, CCF $ CO /CC $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $
See Reverse side ->
7 e
Bonding Company's Name (if applicable)
Bonding Compy's Address
City State Zip
Mortgage Lender's Name (4 applicable)
Mortgage Lender's Address
City ' State
Signatur
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
c,11 77,07,1311
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 approved and a re- inspection fee will be charged.
D. L. -tl /o -au b L et - /2 p
Signature
Owner or Agent' Contractor
i S-7
The foregoing instrument was acknowledged before me this / The foregoing instrument was acknowledged before me this
day of ' / ' , 20 1' % , by f/i- T" 6ur c. re t- , day of � � , 20 if , by f
who is personally known to me or who has produced _brj wis who is personally known to me or who has produced `Ze it
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Zip
Aibq
(-c,Ll
My Commission Eptp'i 5. Pu"'tn rTr or A 07.1
,,g / a
3s _
* * * * * * * * * * * * * * * * * * * * * ** _ * *- * * * * * * * ** * * * * *, * * * * * * * * *, * *, * * * * * ** * * * * * * * * * * * **( * * ** c * * ** i(41,0-44******
Plans Examiner Zoning
Engineer Clerk checked
CUMULATIVE SUBSTANTIAL IMPROVEMENT
VERIFICATION WORK SHEET
In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all
improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed
improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished
materials (include those donated), labor (including volunteer and self - performed), construction supervision and
management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is
attached for your reference. (A Copy of the Contract must be attached)
PROPERTY OWNER:
PERMIT #
ADDRESS: % '2
FOLIO NUMBER: t/1 3..)-0 to % FLOOD ZONE:
BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL:
COST OF PAST IMPROVEMENTS (12 MONTHS):
COST OF PROPOSED IMPROVEMENTS:
(ATTACH COPY OF CONTRACT)
TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed):
VALUE OF PRINCIPAL STRUCTURE (attach appraisal):
OWNERS SIGNATURE: DATE:
PLANREVIEWER:
PLAN REVIEWER SIGNATURE: DATE:
Created on June 2009