EL-09-344Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Scheduled Inspection Date: March 10, 2009
Inspector: Devaney, Michael
Owner: PRICE, ELIZABETH
Job Address: 1000 NE 96 Street
Miami Shores, FL
Project: <NONE>
Contractor: BRINKS HOME SECURITY INC
Permit Type: Electrical - Residential
Inspection Type: Fire Alarm
Work Classification: Alarm
Phone Number
Parcel Number 1132060143560
Phone: 305 - 887 -8455
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 09, 2009
Page 15 of 15
Miami Shores Village
Building Department
/0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
N5ECTgrWrgilli
R MAR 0 6 2009 11,11
Permit No.
Master Permit No.
Permit Type (circle): Building Plumbing a
Owner's Name (Fee Simple Titleholder) El l ZQ f 7 k R. 9)/`/ CC Phone # �" 1 s (- 1 0 O g
Owner's Address 1060 N t env- r
City Ka; Lfhoptes State �(
Mechanical Roofing
Zip 3 3 1 3g
Zip
Tenant/Lessee Name Phone # 3 0 S - 75/- 4 8'OC
Job Address (where the work is being done) \ O 0 D A CIGo4 h �T
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name & 1 r11-S R MQ.
Contractor's Address 31.9.l N1U17 11 Sr ' 1a�1
'City 0 i CA State -
Qualifier bas61CLS BG.SSC-44-
Phone #ws -- d1O(Q -3gg0
zip 3312- Cv
Architect/Engineer's Name (if applicable) S Phone #
$ Value of Work For this Permit 3(� S ' 0 0
Type of Work: DAddition ❑Alteration ❑New
Describe Work:
Square Footage Of Work:
❑ Repair/Replace ❑ Demolition
****************************Fees******************************
Submittal Fee $ Permit Fee $ /®.‘,''
Notary $
Training/Education Fee $
Scanning $ Radon $
Code Enforcement $
Total Fee Now Due $
CCF $
Technology Fee $
Bond $
Structural Plan Review. $
(Continued on opposite side)
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 «livered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement mus •e posted at the job site
for the first inspection which s seven (7) days after the building permit is issued In the absence if such posted notice, the
inspection will - •t be appr. •ed a reinspection fee will be charged.
_ -. -
Signatur�/ / "�'
v
p
er or Agent
The foregoing was acknowledged before me this
day of � , 1, by �I � Z� =,�a� 1" A I�C�E' , day of
TY
who is . ersonally known to me or who has produced who is p
As identification and who did take an oath.
Signature
Contractor
The foregoin: in ; i ent was acknow edged ,y or a this %
6l
20 by�OU',Qb t2
onally known to me or who has produced
as identification and who did take an oath.
NOT
Sign:
Print:
LI
00
s r Poo Frank ar Marrero
State of Florida
NOTARY P
Sign:
Print:
My Commission Expires:
40,,to'_ Expires 09/30/2011
My Commission Expires:
State Certificate or Registration No.
Public State of Florida
Frank Marrero
(Certificate of Competency Holder)
Certificate of Competency No.
APPLICATION APPROVED B Al" '�� "' /6 ,,,— Plans Examiner
Engineer
Zoning
Chc 10/14/03
ADDENDUM TO BUILDING PERMIT APPLICATION
• AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE
OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.
PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR:
PLUMBING
ELECTRICAL
PERMIT #
MECHANICAL
ITEM
UNIT
FEE
ITEM
UNIT
FEE
ITEM
BATH TUB
DISHWASHER
DISPOSAL
FLOOR DRAIN
GREASE TRAP
INTERCEPTOR
LAVATORY
LAUNDRY TRAY
CLOTHES WASHER
SHOWER
SINK. POT /3 COMP.
SINK, RESIDENCE.
SINK, SLOP.
TEMPORARY WATER CLOSET
URINAL
WATER CLOSET
INDIRECT WASTES
WATER SUPPLY TO:
NC UNIT
SWITCH OUTLETS
LIGHT OUTLETS
RECEPTACLES
SERVICE TEMPORARY
SERVICE SIZE IN AMPS
SPACE HEATERS
UNIT
FEE
CENTRAL HEATING
A/C (WIND)
NC (CENTRAL)
SERVICE REPAIR/METER CHANGE
APPLIANCE OUTLETS
RANGE TOP
OVEN
WATER HEATER
MOTORS 0 -1 HP
MOTORS OVER 1 -3 HP
MOTORS OVER 3 -5 HP
MOTORS OVER 5 -8 HP
MOTORS OVER 8 -10 HP
MOTORS OVER 10-25 HP
MOTORS OVER 25 -100 HP
MOTORS OVER 100 HP
NC WINDOW
FIRE SPRINKLER
HEATER -NEW INST.
HEATER - REPLACE
LAWN SPRINKLER -WELL
SWIMMING POOL
WATER SERVICE
SEWER CONNECTIONS
UTILITY -SEWER
UTILITY -WATER
SEPTIC TANK
RELAY
FAINFIELD, 4" TILE/RES.
PUMP & ABANDON SEPTIC TANK
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
AIR CONDITIONERS
DUCT WORK
REFRIGERATION
PROCESS AND PRESS PIPING
UNDERGROUND TANKS
ABOVEGROUND TANKS
U.F. PRESSURE VESSELS
STEAM BOILERS
HOT WATER BOILERS
MECHANICAL VENTILATION
TRANSPORTING ASSEMBLIES
ELEVATORS /ESCALATORS
FIRE SPRINKLER SYSTEMS
COOLING TOWERS
VIOLATION
REINSPECTION
STRIP HEATER
GENERATORS TRANSFORMERS
GENERATORS TRANSFORMERS
GENERATORS TRANSFORMERS
SPECIAL PURPOSE.
OUTLETS COMMERCIAL
SIGN TUBES
SIGN TRANSFORMERS
SIGN TIME CLOCK
FIXTURES
ANTENNA
TELEVISION OUTLETS
VIOLATION
REFECTION
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