EL-08-1779Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP-96891
Permit Numbe'
-10 -08 -1779
Scheduled Inspection Date: May 27, 2009
Inspector: Devaney, Michael
Owner: JOHNSON, STEVEN
Job Address: 145 NE 95 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
ne Number
Parcel Number 1132060132740
eN c4°
Phone: (786)331 -3967
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
RENEWAL WAVED BY LETTER.
sJL
y � yoYo%
.. _.. .f..• ffn..
tO(71t'g
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: El • ctrical
Owner's Name (Fee Simple Titleholder) AE' c /9g,',,»,),9
Owner's Address ! 4/5-- /t/ E 7S £,
City /4 /'441,' 4/40/ s State ‹.o/t.c�A
Tenant/Lessee Name
E -MAIL:
ECCIEEVIEll
IR OCT 0 3 2000 gl
BY:
Permit No.
f O' YTJCI
Master Permit No.
Phone # ! <_90..r- 3/ f-- y�/r
Zip 3313e
Phone #
Job Address (where the
City Miami S
work is being done)
hores Village
FOLIO / PARCEL #
/ `/s 4' fs Cf.
County J . Miathi- Dade','.
/13.2O 6 O 13274'b
Zip .13/3
Is Building Historically
Designated YES NO SK
Contractor's Company Name 4o'' ..44•r2.'1'
Contractor's Address t- a/ (4i4,,w, 7 Is�tI'6
City Posua•,�ae, �e�/ State
Qualifier Name 44 6- NlgAi; A) du
Phone # .41a,r - 7F C-
f'l®r, -duo
Zip
Phone #
Sop. - &3
State Certificate or Regi tration No. zer- 000 / /y/ Certificate of Competency No.
E -MAIL:
Architect/Engineer's N me (if applicable) Phone #
Value of Work For thisl Permit $
Type of Work:
Describe Work:
/1064.1 Square / Linear Footage Qf Work:
['Addition ['Alteration
AS 791/ ,d u2a a - AG444'
P46 c /_ ix , r C,rs
[New
❑ Repair /Replace
❑ Demolition
***** x * *xx * * *x * * * *** * * *x * * * * * *xxxx** *Fees******** ******
Submittal Fee $�IU
Notary $ 0
Scanning $ 3•00
Bond $
Permit Fee $ /r'✓�� OG
Training /Education Fee $
Structural Review. $
Radon $
Code Enforcement $
****t4**********************
**
CCF$ aGD CO/cc
Technology Fee $ 2.50
DPBR $
Double Fee $
■ Zoning $
Total Fee Now E e $ 10M
See Reverse side -4
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. l 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. l 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
0 ner or Agent
Signature
Contractor
The foregoing instrument was acknowledged before me this 3 6 The foreg ing i rument was acknowledged before me this 320
day off ,200r,by , day of tP ,20 CV, by
who is personally known to me or who has produced
As identification and who did take an oath.
0
who is personally known to me or who has produced
NOTAR BLIC: D , 4 .14 21So 0 460 iz ®
Sig ,►�._
Print: ,'
My Commission Expires:
HUBERTO NUNEZ
EXPIRES: September 11, 2009
on
* Y. as** x w x*xx xxx *WIC** x]:xxxxitxx*XXx* *x Tx x Y. *x*WW *Xx *x W WIC W*fl Wx
APPLICATION APPROVED BY:
(Revised 02/08/06)
NOT
R
as identification and who did take an oath.
PUBLIC:
Print:
My Commission
in MY COMMISSION # DD 460279
>i t' flood Tiro Ndtorl Poblig Underwriters
XxX W W W W W Xx XX *xxxxx WW *x xxxxwY. x *Y. WW
.��/49 Plans Examiner
Engineer
Zoning