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ELC-10-318 t Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 136599 Permit Number: LC -3 -10 -318 Scheduled Inspection Date: March 11, 2010 Permit Type: E ctrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: GUALANO, ANTONIO Work Classification: Addition /Alteration Job Address: 1700 NE 105 Street 503 Miami Shores, FL Phone Number Parcel Number 1122300500790 Project: <NONE> Contractor: MOODY ELECTRIC INC Phone: (305)758 -2000 Building Department Comments Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 10, 2010 For Inspections please call: (305)762 -4949 Page 13 of 20 y gg ° h Miami Shores Villages 1 10050 N.E. 2nd Avenue - "" Miami Shores, FL 33138 -0000 �j ItiS s Phone: (305)795 -2204 f y E b 00 Expiration: 0910412010 Project Address Parcel Number Applicant 1700 105 Street Number: 503 1122300500790 Miami Shores, FL Block: Lot: ANTONIO GUALANO Owner Information Address Phone Cell ANTONIO GUALANO 1700 NE 105 ST #503 MIAM SHORES FL 33138 -2142 Contractor(s) Phone Cell Phone Valuation: $ 600.00 MO ODY ELECTRIC IN (30 -2000 - °-�--- -_- Total Sq Feet: 0 Type of Work: 2 RECEPTACLE For Inspections please call: Additional Info: ELECTRICAL (305)7624949 Classification: Residential Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground W. W. Fees Due Amount Invoice # Invoice Total Amt Paid Amt Due CCF $0.60 ELC -3 -10 -37157 Education Surcharge $0.20 $183.17 $183.17 $0.00 Permit Fee - AdditionatAlteraUons $128.57 Check #: 18087 Scanning Fee $3.00 Submittal Fee $50.00 Technology Fee $0.80 Total: $183.17 Building Department Copy March 09, 2010 2 Miami Shores Village Building Dep artment MAR © 1 g lie p 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY-... ..... ...... Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: f305),762.4949 BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 20 Permit Type ELECTRICAL rpm &4 (Ovneo Owner's Name (Fee Simple Titleholder) _ _Phone # A,05 Owner's Address 00 W46 05 -5 7 /r 66 3 p City / &W State 1Q12e Zip Tenant/Lessee Name ( U r8m ( a / Q nei 16 Phone # Email Job Address (where the work is being done) X70 City Miami Shores Village County Miami-Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zane Contractor's Company Name /Yl6(S Phone # Contractor' Address 1 A City State �s Zip f� Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E-mail Architect Engineer's Name (if applicable) Phone #. Value of Work For this Permit $ �0� Square /Linear Footage ir lace f Work: Type of Work: Addition DAlteration ONew [ a/Re ep p El Demolition Describe Work: " V Submittal Fee $ Permit Fee $ �-� r�� g CCF $ CO /CC $ 0111lu O-C Notary $ Training/Education Fee $ - lJ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address IV t - v 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) 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 Signature Sign Owner or Agent / Contractor The foregoing instrument was acknowledged before me this / The foregoing instrument was acknowled before me this day of . l a , 20 /� , by PAM day of AP , 20 V, by �J who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: e .e Sign: :.�. Sign:. Print: Print: ,, "., I r « Notary Public - State of Ftodda a °' .' NOWY Public - State of Flodda My Commission Exp' a F ; . y Commission Expires May 11, 2010 My Co Z 2, y y y Commission Ex i P � Ma 11,2010 Commission # DD 531936 F %,FOV i °;� Commission # DO 531936 " " "`" Bonded B Bonded By National Notary Assn, y National Notary Assn. APPROVED BY Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009)