EL-07-1840‘11
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
••••
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Inspection Date: 09/12/2007
Inspector: Devaney, Michael
Owner: GARDNER, ROBERT
Job Address: 465 96 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: BRINKS HOME SECURITY INC
Block:
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1132060170120
Lot:
Phone: 305-887-8455
Building Department Comments
BURGLAR ALARM 1 MASTER AND 8 DEVICES
SEP 1 a 2511
Passed
Inspector Comments
e../..---to..._
Ai°
.,....,,,7
Failed
/
Correction
Needed
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled
re-inspection fee is paid .
until
Tuesday, September 11, 2007
Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
APPLICATION A
FBC 2004
Et AN 2 9 2007 AS
BY: Vi
Permit No. .k., r\ 840
Master Permit No.
Permit Type: Electrical I /
Owner's Name (Fee Simple Titleholder) Pa 10e'7T/ (..�/ 1-i) AIey
Owner's Address 1-16S AO E; R 6 sr
Phone #
3os- 7.r7- ayt./y
City #1 /Am/ SkreS State FL_ Zip -33/ 3 g
Tenant/Lessee Name Phone (
E -MAIL:
Job Address (where the work is being done) 4-6-- IE c (a -
City Miami Shores Village County Miami -Dade Zip `` (
FOLIO / PARCEL # 1 t —- - f —Cct` c'
Is Building Historically Designated YES • NO
Contractor's Company Name
Contractor's Address
City k.✓11
Qualifier Name
State Certificate or Registration No. A;re, 6 6a 6 91101-/
State C _
E -MAIL:
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $
Zip _ l
Phone # °3 D•� f, I/. 3
Certificate of Competency No.
Phone #
Square / Linear Footage Of Work:
Type of Work: ['Addition ['Alteration ❑New ❑ Repair /Replace ❑ Demolition
Describe Work:
r * * * ** * *** ** * * * * * ** *** * ** *** * * ******** Fees * ***** * ** ** ** *** * * * ** * * * * * ** * *** * * ** *fir * * * * **
Submittal Fee $ Permit Fee $ I eo
Notary $ Training /Education Fee $ 040
Scanning $ Radon $ DPBR $
CCF $ 0• (00 n CO /CC
Technology Fee $ 2'50
Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ )0(0
See Reverse side -a
Bonding Company's Name (if applicable)
Bonding Company's Address
City e 3
Y 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 b posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of . uch posted notice, the
inspection wi11 not be approved and reinspection fee will be charged
Signature Signature
Owner or Agent giZelf----62.4.-diA-ej'
The foregoing instrument was . - - dged before me this
day of , 20 by
who is personally known
me o ' ho has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
„or Po®, Nintar ' ' Vic State of Florida
a m ®.nr '9na
•
4 f r" imission DD667276
4.0F OP
My Commission Expires: D y
APPLICATION APPROVED BY
(Revised 02 /08/06)
'..
Expve 0412512011
ontractor
The foregoing instrument was ackno
day of 20 0", by
is personally known -,to me or
eAfri-
efore me this
7
has produced
as identification and who did take an oath.
oosY pv ®4 Notary Public State of Florida
My Commission 0D667276
NE n. °°6 Expo 04125/2011
NOTARY PUBLI
ign:
Notary Public State of Florida
Angel Pena
mmission DD667276
0412512011
tint:
Afar
�, ✓a
y Commission Expires: •
* * ** * * * * * * * * * * le* **
Plans Examiner
Engineer
Zoning