EL-09-243Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Scheduled Inspection Date: May 29, 2009
Inspector: Devaney, Michael
Owner: LEVEROCK, JAMES
Job Address: 320 NE 97 Street
Miami Shores, FL
Project: <NONE>
Contractor: LIGHTGATE INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060135860
Phone: 305 - 554 -4820
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
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BUILDING
PERMIT APPLICATION
FBC 2004
Miami Shores Village
Building D epartment
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. rt. 01-M
aster Permit No.
Permit Type: Electrical
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Owner's Name (Fee Simple Titleholder) N( %,7E e
Owner's Address /20
City yyl 1. it /1 t State -' L }q
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done)
City
Zip
33 138
Phone #
Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
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Is Building Historically Designated YES NO
Zip 33 ? 3 8
Contractor's Company Name / Phone # a (D.J. -654.4 (90
Contractor's Address "4%94 �a../j®70� *70i
City L-727/a/ 7 / State Zip ,2,41/74
Qualifier Name lei P2e, Asee, ,Q. h i./ Phone # a ®v.s- .6 a ,2 - lL6 e,
State Certificate or Registration No. % ene
E -MAIL:
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $
- ;Type of Work: ❑Addition
Describe Work:
Certificate of Competency No.
Phone #
Square / Linear Footage Of Work: k L ' 1 e
Alteration ❑New
J
Repair /Replace ❑ Demolition
C ASS
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'°Submtal Fee $
Notary $ t'
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;_ Scanning $
_fond $
a►
Permit Fee $ /‘.: ' 'C", CCF $ 1.6D CO /CC
Training /Education Fee $ a (00 Technology Fee $ 5'25
Radon $
DPBR $ Zoning $
Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 124 5
See Reverse 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 °wbi-k aril rnsCailatrotiras 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 properly 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 occur seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection wfjot be approved and reinspection fee will be charged.
Signatur
ent •
The forego ' instrument J as ac iowledged be re me this S
day of
00 by L,011104 V
or who has produced
As identification and who did take an oath.
NOTARY BUBLIC:
Sign:
Print:
My Commission Expires: ,�.Nn,GG q'
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APPLICATION APPROVED BY:
(Revised 02 /08/06)
Contracto
The foregoing instrument was acknowledged before me this
day of , /l , 20 07, by
who is personally known to me or who has produced
as ident catign and wile, did +aL.
NOTARY PUBLIC:? MY COMMISSION #ADD 7¢66992
• ��.. �- EXPIRES March 1'1,2012
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My Commission Expires:
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/','j Plans Examiner
Engineer
Zoning