EL-10-539Inspection Number: INSP- 148153 Permit Number: EL -3 -10 -539
Scheduled Inspection Date: July 13, 2010
Inspector: Devaney, Michael
Owner: CURZON, ANDREW
Job Address: 10050 NE 12 Avenue
Project <NONE>
Miami Shores, FL
Contractor: ADT SECURITY SERVICES, INC
Building Department Comments
July 12, 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: Alarm
Phone Number
Parcel Number 1132050190370
Phone: (786)331 -3967
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
/I aLy /a
Page 13 of 17
Project Address
10050 12 Avenue
Miami Shores, FL
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Owner Information
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Submittal Fee
Submittal Reversal Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$100.00
$3.00
$50.00
($50.00)
$0.80
$104.60
Building Department Copy
Address
Parcel Number
1132050190370
Block: Lot:
PATRICIA FRENCH
10050 NE 12 AVE
MIAMI SHORES FL 33138 -2630
Contractor(s)
ADT SECURITY SERVICES, INC
Phone Cell Phone
(786)331 -3967
Authorized Signature: Owner / Applicant / Contractor / Agent
PROVE
Expiration: 09/29/2010
Phone
Applicant
Valuation:
Total Sq Feet:
Type of Work: BURGLAR ALARM SYSTEM
Additional Info: ELECTRICAL
Classification: Residential
Pay Date Pay Type
Invoice # EL -3-10 -37447
03/31/2010 Check #: 4678
04/02/2010 Check #: 4684
Amt Paid Amt Due
$ 50.00 $ 54.60
$ 54.60 $ 0.00
PATRICIA FRENCH
April 02, 2010
Date
Cell
$ 850.00
0
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
April 02, 2010 1
Available Inspections:
Inspection Type:
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: ELECTRICAL
Owner's Address
City (6t a ...CA- State
Tenant/Lessee Name
Email
Job Address (where the work is being done) /0 OR) . 77' g /21'' -z -e
City Miami ores Village County Miami -Dade Zip
FOLIO / PARCEL # //' 3 245 0/ 9 03 5
Is Building Historic y. Designated YES NO Flood Zone
&r
/I37g3 ..(7z, /fit' ea
j fv el 1 4/' State
6 2 - 6 6
Contractor's Company Name
Contractor's Address
City
Qualifier Name
Value of Work For this Permit $
Type of Work: ❑Additi
Describe Work:
itleholder) � � O Rea h 7tL «31-/dC1 0
E /2
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
p
dt
Master Permit No.
Zip 33/.3,
Phone #
Zip, 62-
Phone #
State Certificate or Registration No. ` 000 /2/ / cat, of Competency No.
Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
Square / Linear Footage Of Work:
['Alteration [New / � ❑ Repair/Replace El Demolition
iig(zz/� / A 4/
ass
it MAR 3
BY : ...odisaiduee4ee +40,111
Permit No. f .. ,C) —'
(91- 757/
******* * * * * *** * * *** * * * * * * * * * * * * * * * * * ** *F * * * ** ******* * * * * * * * * * * * *** *** * * * * * * * * * * * * **
Submittal Fee $ . Permit Fee $ /4P00-46 e CCF $ 0 • � o C) CO /CC $
� Avg �
Notary $ Training/Education Fee $ C) • Technology Fee $ 0. S
Scanning $ 3 .00 Radon $ DPBR $ Bond $
Double Fee $ Violation date: I
Structural Review. $ Total Fee Now Due $ 5 4 • to 0
See Reverse side -->
Bonding Company's Name (if app r.. ble)
Bonding Company's Address
City State \ Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City r 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 edified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven ays after the building permit is issued. In the absence of such posted notice, the
inspection will not be approv and a re -i etion fee will be charged.
Signatur
Owner or Agent
The foregoing instrument was acknowledged before me this ?) The forego
day of. 20(" , by day of
who is personally known to me or who has produced who is . ersonally known to me or who has produced
NOTARY PUBLIC:
As identification and who did take an oath.
Sign: • ,. _ Sign: t; E acr'
Print: /�` �/.Ae•< A A Print: ,9744 A ��,a
GO► i i : • " , NOT `PPIU TBBLIC - STATE OF FLORIDA
My Commission Expires: ,•••• Alba A
- ' Commission #DD682830
,
,, �/ Expires: JULY 26, 2011
BONDED MU ATLANTIC BONDING CO,INC.
My Commission Expires:
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
; ;, ;;,,, Expires: JULY 26, 2011
BONDED THRU ATLANTIC BONDING CO.,INC.
Engineer
Contractor
instrument was acknowledged before me thi
, 20/0 , by
NOTARY PUBLIC:
as identification and who did take an oath.
•
/ /eP Plans Examiner ° Zoning
Clerk checked