EL-07-1985BUILDING
PERMIT APPLICATION
FBC 2004
City
FOLIO / PARCEL #
Miami Shores Village
Is Building Historically Designated YES NO
Value of Work For this Permit $
Submittal Fee $ Permit Fee $ AO. 0.
Notary $ cJ'Ct)
Scanning $ 5 ° W
Bond $
Structural Review. $
-Training/Education Fee $
Radon $
IVilami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
$d3 ,0 /d
Architect/Engineer's Name (if applicable) Phone #
� . '
County Miami -Dade
(/•
DPBR $
Code Enforcement $ Double Fee $
-- map .
Master Permit No.i O)- /Ri
Rc 7 -/?
Permit No.
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder) J ,. e s i Phone #
Owner's Address 26 A
City ,,� ,.� s�'� State /4'
Y / /��t � Zip 3/.y
Tenant/Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done)
9a �T
Zip
Contractor's Company Name / /-4 ,e74 Phone #
Contractor's Address / 7'3 6 � vs Sys'
City s ..q. --,......- State P/&
Qualifier Name " 7 7 Ie r .?ez S s KW . `t 7 D
State Certificate or Registration No. e 3t!. /8 87,3 Certificate of Competency No.
E -MAIL:
Zip ?7 6'/
Phone #
Square / Linear Footage Of Work:
.sys:
94/9-4;_r73
Type of Work: ['Addition ,Alteration ['New ❑ Repair/Replace
0 Demolition
Describe Work:
enrA4 y hi / /�;,e /4. ■'/, --,.� a; ‘4 g.... e-j / 7,e
-7
*** ** * * * * * * * * * * * ** * *** * * * ** *** ** ** * * Fees * * * * * * * *** * * *, * ** * * *** * ** * ** *** * * * ** * * * * * * *
CCF $ aeo Co /CC
Technology Fee $ •75
Zoning $
Total Fee Now Due $ f e2 ' i5
See Reverse side
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 by
APPLICATION APPROVED BY:
(Revised 02/08/06)
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: 1 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection, fee will be charged.
Contractor
The fore:oi g instrument was acknowledmi bef re me this2 I
2 0j, byjS MV OS bv
who is personally known to me or who has produced who is ersgqnally known to me or who has produced qQ'
As identification and who did take an oath. lT, r'I5( ac i :r,
NOTARY PUBLIC:
Sign:
Print:
day of
0
ification and who did 4111~'.;
4P ,6 4b `o
My Commission Expires: My Commission xpires: „,,.. .
Ipt c - '$ Plans Examiner
Engineer
Zoning
1
Inspection Number: INSP- 150291
Scheduled Inspection Date: August 23, 2010
Inspector: Devaney, Michael
Owner: GORDON, ROXINE
Job Address: 863 NE 92 Street
Project <NONE>
Contractor: P&M ELECTRIC INC
Building Department Comments
August 20, 2010
Miami Shores, FL 33138-
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 Number: EL -9 -07 -1985
Permit Type: Electrical - Residential
Inspection Type: Ro � ,
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060050040
Phone: (305)949 -6373
ELECTRICAL WORK FOR BATHROOM REMODEL
off
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments 1;7 A/ G
3 /
Page 35 of 40
- Ma #c - A - Akp
Miami Shores Villa e
APPROVED
B_ , D`TE
/'ff
All BLDG ® 6 /- 0
ZONING DEPT
DEPT lfa�
SUBJECT TO •'
STATE AND COUNTY
%f • CE WITH ALL FEDERAL
RULES AND REGULATIONS
CEP 1 9 2001
BY: _ . 19•
J t� Ve-f
I