EL-10-475Email
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder)
Owner's Address 3
City Gil'h /
S40)- State
Tenant/Lessee Name
City Miami She es Villa. e
FOLIO / PARCEL # \\/ 320 --
Is Building Historicallyesignated YES
Contractor's Company Name 1 %1J cE`att
Contractor's Address / v 2j sibs
City /-1/ ,774 State
Qualifier Name ' d
State Certificate or Registration No. - -F3U17
01.01.1 24
Contact Phone . — l37/ 5 E -mail
Describe Work:
Submittal Fee $
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
Permit No 10 415
Zip
Job Address (where the work is being done) 399 - 77. e . q T `'`e
County Miami -Dade Zip
D/. 3— (#43e)
NO
PC�
Zip
Phone #
Value of Work For this Permit $
Type of Work: ❑Addition ❑Alteration
3 a eae-ehi
Master Permit NQ.
Phone # (s 73
33a e?
Phone #
Flood Zone
/2/ Certificate of Competency No.
actu ,j I a ca+.
SOWN
MAR 232010
Architect/Engineer's Name (if applicable) Phone # ' _ana (l/ l (1l rti"..,.
Square / Linear Footage Of Work:
] w ❑
6 °
epair/Replace
****** * * * * * * * * * * * * * * * * * * * * *** * * * * * * ** * F ees * * * * * * * * ** * * * * * *i. ** *4, * * * * * * * * * * * * * * * * * *4,* **
Permit Fee $ /d Crr 4 CCF $ a •(a0 CO /CC $
Notary $ Training/Education Fee $ • Technology Fee $ C
Scanning $ 3 IJ�J Radon $ DPBR $ Bond $
Double Fee $ Violation date: C j� 2.4-0
Structural Review. $ Total Fee Now Due $ U V1
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: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a re- inspection fee will be charged.
caner or Agent
The fore oiing instrument was acknowledged before me this /
day of) Z , 20/' by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: ,, ` n
Print: f'"P'/ /' qfze l7d
------NOTATYBLInTailsoOF FLORIDA
My Commission V. • Alba Aguila
Commission #DD682830
' ` 4 1 •° Expires: JULY 26 2011
BONDED TBHUAT1 NTICBON DINGCO.,1NC.
(Revised 07 /10 /07)(Revised 06/10/2009)
* * * * * * * * * * * * * * * * * * * * * ** ********************************************* 9e3c*3t*3e*: Yk3: 3:* **9c*&4r4e9r*9e*3e:Y3rk*de*a ***
APPROVED BY 4 / off • Zoning
Engineer
►'J(�, if J v ^ J1
/
lans Examiner
Signature
The foregoing instrument was acknowledged be
day of c"9...)-- , 20j O , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Contractor
j
- n •-1
164 > /A
NOTARY PUBLIM TATE OF FLORIDA
" , Alba Aguila
My Commission Expirel$
g
_ Commission # DD682830
•' Expires: JULY 26, 2011
BONDED THRU ATLANTIC BONDING CO., INC.
Clerk checked
Inspection Number: INSP- 149766 Permit Number: EL- 3- 10-475
Scheduled Inspection Date: August 09, 2010
Inspector: Devaney, Michael
Owner: JONES, WILLIAM
Job Address: 379 NE 94 Street
Miami Shores, FL
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
alarm installation
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
August 06, 2010
For Inspections please call: (305)762 -4949
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1132060136130
Phone: (786)331 -3967
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