EL-10-10551071 NE 95 Street
Miami Shores, FL
1132060143610
Block: Lot:
DONALD S MCCORQUODALE JI
Project Address
Owner Information
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
DONALD S MCCORQUODALE JR &W & I 1071 NE 95 ST
MIAMI FL 33138 -2547
1
Contractor(s)
ADT SECURITY SERVICES, INC (786)331 -3967
Phone CeII Phone
Type of Work: ELECTRICAL
Additional Info: ALARM INSTALLATION
Classification: Residential
Scanning: 1
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$100.00
$3.00
$0.80
$104.60
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.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Address
Parcel Number
Phone
Pay Date Pay Type
Invoice # EL -6-10 -38153
06/09/2010 Check #: 5832 $ 50.00 $ 54.60
06/11/2010 Check #: 5838 $ 54.60 $ 0.00
Amt Paid Amt Due
Valuation:
Total Sq Feet:
$ 700.00
0
1
June 11, 2010
Date
Applicant
Cell
Available Inspections:
Inspection Type:
June 11, 2010 1
10
u9
el
BUILDING
PERMIT APPLICATION
FBC 20
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $
Type of Work: ['Addition
Describe Work:
Double Fee $
Structural Review. $
Miami Shores Village Alej
Building Department 06
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4
7 r'
Col "
Submittal Fee $ ✓0 Permit Fee $ /0 G 0.•
Notary $ Training/Education Fee $ Q•
Scanning $ 3 . tc30 Radon $ DPBR $
Permit No
Master Permit No.
-poofe-)
9,2t17
�11C} ids
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) e G / one #
Owner's Address , S�
/D 9/ , �. J±
City — `tate
Tenant/Lessee Name
Email
Job Address (where the work is being done) 1 011 NE V Sk
City Miami Sh s Village County Miami -Dade Zip
FOLIO / PARCEL # (//-343 e /C7 )
Is Building Historicall Designated YES
NO
Zip 3...9 /33
Phone #
Contractor's Company Name
Contractor's Address (� Gel
City � . L 1�1✓ State Zip 330
gie Qualifier Name
(a j !,L /7e Phone # (9j i
State Certificate or Registration No. ' o o // Z/ Certificate of Competency No.
Contact Phonerg5!)2.-.6
E -mail
th ajtii /a
Square / Linear Footage Of Work:
['New ❑ Repair/Re
Violation date:
Total Fee Now Due $
jeS , - X34 Z
Flood Zone
4 i4' C4 •
Phone #
❑: teration
* x ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $ a CO /CC $
Technology Fee $ O A J
Bond $
ace ❑ Demolition
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 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• it ion. .Lathe issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in : faith that a copy of the • of commencement and construction lien law brochure will be delivered to the person
whose
for
Signature
NOTARY PUBLIC:
* * * * * * * *** **** ** ** **
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
operty is subject to attachment. Also, a
first inspection which _occurs seven (7) days
pection will not be approved and a re- inspection fee w
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ,20_,by
who is personally known to me or who has produced
As identification and who did take - an oath.
y
Sign:
Print:
My Commission Expires:
flied copj\,of the recorded notice of commencement must be posted at the job site
ter the .- :silding permit is issued. In the absence of such postnd-notire the
I becha ed.
Signature
day of
Sign:
Print:
NOTARY PUBLIC:
Contractor
The foregping instrument was acknowledged before me this/__
/°
, 20 , by
who is personally known to me or who has produced
as identification and who did take an oath.
/* A4
rm : ' O T I . Y PUB Z OF RT.numA
gtl Alba £gods
My Commission Exp ires, . " ". Cz�oimissTAPE ion #DD682830
`. ° ,,' Aires: JULY 26, 2011
1`t; kU a \"11.ANTIC BONDING CO., INC.
******** *********** ********* *********** ********* *** * * * * * * * * * * * * * * * * * * * *** ** * ** ***
/ r1 Examiner
Engineer
Zoning
Clerk checked
Scheduled Inspection Date: July 21, 2010
Inspector: Devaney, Michael
Owner:
Job Address: 1071 NE 95 Street
Project: <NONE>
Miami Shores, FL
Contractor: ADT SECURITY SERVICES, INC
Building Department Comments
July 20, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 149012 Permit Number: EL -6 -10 -1055
For Inspections please call: (305)762 -4949
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1132060143610
Phone: (786)331 -3967
LOW VOLTAGE BURGLAR ALARM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 11 of 17