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EL-08-1951r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Scheduled Inspection Date: February 12, 2009 Inspector: Devaney, Michael Owner: MAIRENA, HENRY Job Address: 45 NW 96 Street Miami Shores, FL 33150- Project: <NONE> Contractor: ADT SECURITY SERVICES, INC Permit Type: Electrical - Residential Inspection Type: Fire Alarm Work Classification: Alarm Phone Number Parcel Number 1131010330420 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 CC ezfi February 11, 2009 Page 7 of 13 Miami Shores Village Buildin g Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33 l38 Tel: (305) 795.2204 Fax: (305) 756.8972 ( i BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) Owner's Address Permit No. rEsnE 12008 Permit No. 27.4 4>ZELPhone # L /1 C City /:, `';. L �Jf'c� 064 to • Zip %' Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) City Miami Shores Village /is N-,,,)9 Phone # County Miami -Dade FOLIO / PARCEL # // 3,'G'/— Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Qualifier Name NO Zip (31_0>Y-4 —yes Zip -:3C)&,` Phone # L) d2 L.3 State Certificate or Registration No. ' �''/ /'/Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Phone # �?i Value of Work For this Permit $ // ��� Square / Linear Footage Of Work: Type of Work: Describe Work: ❑Addition ❑Alteration Nevi place Demolition 4/ tY. Y. %XY. W W• *Y .Y. %%7[ Y. Fees"' /""Y. Y. KXY. 9C Y. Y. XY. Submittal Fee $ Permit Fee $ El&e, 'Z., 4 Notary $ Training /Education Fee $ Scanning $ Radon $, Bond $ ode Enfrcement Structural Review. $ V 2 12008 DPBR $ CCF$ CO /CC Technology Fee $ Zoning $ Double Fee $ Total Fee Now Due $ 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. 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 -fliciA:Ackuk.) Owner or Agent The foregoing instrument was acknowledged before me this day ofd, 20 6V , by , day of A As , 20 d , by who is personally known to me or who has produced who i 'p rsonally known to me or who has produced As identification and who did take an oath. Signature The foregoing instrument was acknowledged before this NOTARY PUBLIC: Sign: Print: NOTARY PUBLIC -STATE OF FLORIDA " Alba Aguila ;14 mission #DD682830 s: JULY 26, 2011 My Commission Expires: :xxx xY.x * WY. x ,cW * xx, xW x xx xxx xxx x** c APPLICATION APPROVED BY: (Revised 02/08/06) as identificlba NOTARY PUBLIC: e °,..It, Sign: Print: C-STTiIDA . Alba Aguil .Alba #DD2830 MIMING 2662011 1C IMING'CO.,INc. My Commission Expires: • ac acrr • • • x x xx Y.WW W W x xxx xxx x Y.xx x WY.x x W xx Plans Examiner Engineer Zoning