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EL-09-1619#T BUILDING PERMIT APPLICATION FBC 20 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) Owner's Address City /y /%9,N/ ,%0/--e, State z f /o 1)A9 Tenant/Lessee Name Email Job Address (where the work is being done) Contact Phone 305 -. .94.4 ,P© Architect/Engineer's Name (if applicable) Miami Shores Village 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. (.7 ® ® 94 c q aster Permit No Building Department Zip Phone # 126 /U 9'3 City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO ne # 2 / (0,'(;11 Occ Flood Zone Contractor's Company Name 4/7h A O /4G . phone # 2 ®a ° 6:64- .446).C.) Contractor's Address '- `� & c Q, / % ) / 3 QU Cit /;9/f/ 7 State /f7 R 0.49 Zip 3 7.5/ Qualifier Name // ?riG /•'5d.Z7 2 1e- C✓& . Phone # State Certificate or Registration No. 8G /.0®C -0/ O Certificate of Competency No. E -mail Phone # Value of Work For this Permit ,0 ® $� � Square / Linear Foota Type of Work: ❑Addition ['Alteration LJNew Describe Work: ? tE C . Cc v1n c,(4 V ► - ) S f Work: Repair/Replace ❑ Demolition * * ** * * * * * * * * * * * * * * *** * * * * * * * * * * * * * * ** Fe * * * * * * * *** * * * * ** * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ „2.° CCF $ CO /CC Notary $ Training/Education Fee $ 0 • Technology Fee $ '6 • a() Scanning $ 6 Radon $ DPBR $ Bond $ Double Fee $ Violation date: i !� Structural Review. $ Total Fee Now Due $ 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 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) d' s after the building permit is issued. In the absence of such posted notice, the inspection ill not be ap,roved and a r e , e will be charged. ' • / Signature The fo : g day o sonally known to me or who has produced r v _ 1 1 ' 1. Ol nn identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Plans Examiner Signature Contr - ctor The foregoing instrument was acknowledged before me this? 1 y of5C, ierP '9, by who is personal am to me or who has produced as identification and who did take an oath. 1, NOTARY PUBLIC: N Ga` ' 9 0�4,c Sign: pt. �e� den ' � � Cr"': 9 ,0 0 ° Print: %-e i 1 tP e2, p e V�,� , ,,,s, �p �,,� C p c e . a My Comb ig ! ATE OF FLORIDA Milena Paparani Commission #DD685086 ** o Ex ires: JUNE 13, 2011 Zoning Engineer Clerk checked Sa d `7 '6 Zqo 6 ti (t - Inspection Number: INSP - 144221 Scheduled Inspection Date: May 25, 2010 Inspector: Devaney, Michael Owner: _ HERNANDEZ, FRANCISCO Job Address: 126 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Contractor: LIGHTGATE INC Building Department Comments Electrical connections Failed Correction Needed May 24, 2010 Re- Inspection Fee 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 Comments For Inspections please call: (305)762 -4949 RC-to - 09 -1(0 t CL Permit Number: EL -10 -09 -1619 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: New Phone Number (786)282 -9014 Parcel Number 1132060133130 Phone: 305 - 554 -4820 Page 18 of 22