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EL-07-11234, Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -50945 Permit Number: _EL -5 -07 -1123 Inspection Date: 06/18/2007 Inspector: Devaney, Michael Owner: NEWMAN, MARY Job Address: 140 95 Street NE Miami Shores Village, FL Project: <NONE> Contractor: MOODY ELECTRIC INC Permit Type: Electrical - Residential Inspection Type Rio, Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132060132850 Lot: Phone: (305)758 -2000 Buildinct Department Comments REWIRE BACK BLDG. ONE BEDROOM �� Jui192001 Passed Inspector Comments -- --� mv r (67;;; Ye;(/C'' e .6" 7 1�' Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Friday, June 15, 2007 Page 1 of 2 BUILDING IT AP 4 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 %JO lOriki,L, LIGATION kit cA'k) Permit Electrical Owner's Name (Fee Sim Owner's Address \q.C� City Tenant/Lessee Name E- MAIL: �� 1 MAY 3 1 2007 Permit No. L /19-1/43 Master Permit No. le Titleholder) \ o \CAS Ne,....s,.1c,4\ Phone # Je._. ctS 5 State `� -(0.c-t [ : Zip '3313 �C tis-, \ P" Phone # Job Addr City FOLIO /I Is Buildin s (where the ork is being done) 1'C3 \ ckS Miami S ores Village County Miami -Dade Zip '33 t3� C,--- 613 -DSO Historically 1 esignated YES NO RCEL # Contractor's Company ame '(\c■c t:1& kr.L Phone # 305 Contractor Address L 69 N t c(O S�v� -QSL F City dNN:Z. State (,c,{ cQck_ Zip 3Sl SO Qualifier l•iarne 3. l(�oc c Phone # 30S - State Certifcate or Registration No. O(_ C) tS Certificate of Competency No. E -MAIL: Architect/ ngineer's Name (if applicable) Value of Work For this Type of Wprk: Describe N1/ork: Permit $ tN Web. Do Phone # Square / Linear Footage Of Work: ['Addition DAlteration ❑New ❑ Repair /Replace ❑ Demolition 7 i, et1PW/a .„6?-4 Submittal Notary $_ Scanning 9r******** hir****** **** ***olt4toY****it******* Fees" firiririr4e4ri1r********4+ k***4e #*xnk****tkvt*alr** ******** Fee $ Permit Fee$ (68,00 Training /Education Fee $ i • (�� Bond $ Structural Review. $ Radon $ DPBR $ CCF $ 3 -n CO /CC • Technology Fee $ a J Zoning $ Code Enforcement $ Double Fee $ Total Fee Now Due $ 111 . O See Reverse side -› Bonding Company's Name (if applicable) Bonding Company's Address L' 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 reinspection fee will be charged. Signature ',72. )eto wner or Agent The foregoing instrument was acknowledged before me this day of , 2067 , by IN-r.)-Q& 1■I-e.,3\N -0,-, , day of who is per .ally kno, n to me or who has produced who is per As identification and who did take an oath. The foregoing instrument was acknowledged before me this�'b , 20 C5-.), by . z,S\Ne,- S , u ts=564-1, na ly know o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: c a M Vs. MY MMI ION 9 DD 441715 *.gmn lan }pryJ 2, 2009 't;t y �� BaWBG*ThNn X APPLICATION APPROVED BY: (Revised 02/08/06) xxxxxxxxxxxxx,exxxxxxxxxxxxxx Sign: Print: %■_Y Pj-(2A- jo11iJ,n i SS ig0(t13PA.r@IIA6ERT MY COMMIS lCN ADD 4417,5 Qe rt i kxxx,�y7��x exicP4n * •-�c�• o t1A�tY'' �U1y �, 'LUUB ' i e,�y4 •,` Bonded Thru Notary PubYio Undenwttera xxxxxxx e/filans Examiner Engineer Zoning ADDENDUM TO BUILDING PERMIT APPLIUMIUN AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM, IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL TEM ATH TUB UNIT FEE ITEM UNIT SWITCH OUTLETS FEE ITEM SPACE HEATERS UNIT FEE IDET LIGHT OUTLETS CENTRAL HEATING ISHWASHER p RECEPTACLES f ` j l A/C (WIND) ISPOSAL SERVICE TEMPORARY A/C (CENTRAL) RINKING FOUNTAIN SERVICE SIZE IN AMPS / e/4 DUCT WORK LOOt MAIN SERVICE REPAIR/METER CHANGE REFRIGERATION ;REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING NTERCEPTOR RANGE TOP UNDERGROUND TANKS .AVATORY OVEN ABOVE (ROUND TANKS .AUNDRY TRAY WATER HEATER / U.F.. PRESSURE VESSELS :LOTHES WASHER MOTORS 0- 1 H° / STEAM BOILERS ;MOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS 3ITlK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION ;INK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES 1 A/C WIDOW 1 REI:NSP,ECTJON WATER SUPPLY T0: 1 AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS-TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COM44ERC I AL WATER SERVICE SIGN TUBES SEWER CONNECTIONS 1*SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK _J UTILITY -WATER F I XT..RES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS GRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN 1 ROOF INLET 1 SOLAR WATER HEATER FIRE STANDPIPE I I POOL PIPl1G LAWN SPRINKLEP, SYSTEk' f GAS RANGE 1 METER SET (GAS) I GAS PIPIN ■�v � �vs, yr I � �i�ll' ��1�� �II�I ii��t ����� ���il1111111111111 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION' PERMIT NO. TAX FOLIO NO. II- 3W)(o- 0(3 —a&SO STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. C IFtni 200780541541 OR BF: 25657 Ps 2160 Ups) RECORDED 05/30/2007 12 :45:46 HARVEY RUVINi CLERK OF COURT MIAMI -DACE COUNTY? FLORIDA LAST PAGE 1. Legal description of property and street/address: tL(C.5 yJ c S S 1N`:1 0L^A`_ . 33 t3fs 2. Description of improvement: \i\- cs ALccs 0- S E( c 6- cet.` U r& C �c Rc7� • 3. Owner(s) name and address: rr\OLk N -Qc. MSC j4/0 / Interest in property: 1 Name and address of fee simple titleholder: (4N.` 4. Contractor's name and address: ( -c EL2c -c .� &4 S 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)47., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration different date is specified) l?c- Signature of (diner Print Owner's Named ��e4.� r� n Sworn to and subscribed before me this aC) day of 1`NEs.st , 2061. date is 1 year from the date of recording unless a Notary Public Pri My 123.01 I �ti0.r " yt NCO A - 6S.. • tiJ EXPIRES: July 2. ' Bonded nett Natal RING Underwriters STATE OF FLORIDA, COUNTY OF DAOE I HEREBY CERTIFY that this is trucopy of the origin=t l�ms'sol�ceon day of Ir4111.X ice~ . 20 O 7 JlTN Ofclal el. y., Circu' a r aunty Courts :1'1/ D.C• Prepared by \‘..cstS..o Address: oay Cs2C(r%c_ the &lice. . EL(r7 c& 33(S0 To (- 305 --?SB= UU