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EL-10-1863Inspection Number: INSP- 152656 Permit Number: EL -10 -10 -1863 Scheduled Inspection Date: October 28, 2010 Inspector: Devaney, Michael Owner: HOLDER, QUINTON Job Address: 10643 NE 11 Avenue Project: <NONE> Contractor: MOODY ELECTRIC INC Building Department Comments NEW 120 VOLT CIRCUIT FOR SEPTIC TANK PUMP Passed Failed Correction Needed Re- Inspection Fee October 27, 2010 Miami Shores, FL No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Co For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1122320280340 (0) Phone: (305)758 -2000 Page 8 of 11 BUILDING PERMIT APPLICATION FBC 2004 Architect/Engineer's Name (if applicable) 4,9 Value of Work For this Permit $ l‘d ' ©� Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Structural Review. $ Total Fee Now Due $ OCT Permit No. � L.O 1 3 Master Permit No. 0 i V9 Permit Type: Electrical 0:14/17 � Owner's Name (Fee Simple Titleholder � �- P/l.Phone # T( ,f I ®l � c Owner' Address cit �L/ ij f✓I f _it, State Zip 7 1 Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) / € k A/6 /Mile City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO__ Contractor's Company Name , Zi $/ �G,Oz�J' /� Phone # OS) 75 . Contractor's Address cc 9' 414J c 7 City /!f //9/,! / �y- -r State / Zip 1 ? 5a7 Qualifier Name ! ®/-it) ✓ lJfp��l�l �/ Phone # 04 .7,5 State Certificate or Registration No. 4:G' ®OO // 99 Certificate of Competency No. E -MAIL: Phone # Square / Linear Footage Of Work: Type of Work: ['Addition ❑Alteration ❑New Repair/Replace //�// ❑Demolition Describe Work: � /- 4710 ®4 T .d ******** * * ** *** * * * *x* *** * * * *xxxxxxx * * *x F Yxxxxxx* xxx xxxx *** ***x * * * * * * * * * * * * * * * * * ** Submittal Fee $ 3 —L Permit Fee $ / 0 e" CCF $ CO /CC • Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ 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 City State Zi Application is hereb 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 aiproved and a r^einspection fee will be charged Signature The foregoing instrument was acknowledged before me this 2 / The foregoing instrument was acknowledged before me this day of O C r r , 20 IL, b4 6 T P 4 M)J t/ jig, , day of Obi- , 20 by who is personally known to me or who has p 'used who is personally known to me or who h As identification # 'd take an oath. as identification and c n oath. , NOTARY PUBLIC: � �x NOTARY PUBLIC: 8 Sign: Print: My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) wner or Agent 1r fifirg Contrac or Sign: Print: My Commission Expires: : xxxxxx*** xxxxxxxxxxxxxxxxxxxxxx4cxxxxxxx �d ,x'�:�xd:xxxxxxxxxx xxxxxxxxxxxxa :rxxxxx4cx**** exxr.xxx**** Plans Examiner Engineer Zoning