EL-08-1597Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: January 23, 2009
Inspector: Devaney, Michael
Owner: FALDAS, MARION G
Job Address: 400 NE 100 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor: PINNACLE SECURITY LLC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1132060170380
Phone: (801)437 -1020
Building Department Comments
0�
1
t
Passed
Inspector Comments
CC
,.�
y JAI' ep
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
January 22, 2009
Page 1 of 1
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10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATIO
FBC 2004
Permit No. Eta-- 1511
Master Permit No.
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder) Elm/. IA tng fit\ 4 j Phone #
'
Owner's Address ()V uE. 10 C
CityNJM S State Ft. Zip 'Y3%3D �/
Tenant/Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done) SitAkt a oh*
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
20s- - jsl -latl
Is Building Historically Designated YES NO
Contractor's Company Name k 6Gtikt�/ 1-1t, Phone # o7l 4.31-10a
Contractor's Address 1.21 b 3Wllti1 T i1
City Orstotot State Zip �'4DS tC
Qualifier Name 61140C ft V(e✓ Phone #
State Certificate or Registration No. EC. 0 ,3J
E -MAIL:
Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $
9y. 00
Type of Work: ❑Addition ['Alteration
Describe Work: 'i Arltl4
Square / Linear Footage Of Work:
I New
❑ Repair /Replace ❑ Demolition
*** * * * * *r. * * * * ** * * * * * * * ** * * * * ** *'*******Fees********************** ** *****
Submittal Fee $ Permit Fee $ / '.' P Q'4" CCF $ 0.6 0 CO /CC
Notary $ S. W Training /Education Fee $ QtLo Technology Fee $ '63
Scanning $ o� Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $
Structural Review. $
Double Fee $
Total Fee Now Due
See
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 OE' COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. W 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 comme . ii. nt roust be posted at the job site
for the first inspection which occurs seven (7) days after the buil i ing p -- I
inspection will not be aaproved and a reinspection fee will be chi • ed. 0 )
Signature
ner or Agent
The foregoing instrument was acknowledged before me this 1C
day of S(5 , 2006 , by a °'r' H day who is pets
who is personally known to me or who has produced rr % , who i as identification and who did take an oath.
Lz. JQ 6L 8 As identification and who did take an oath.
NOTARY PUBLIC:
Signature
Sign/ Contractor
The foregoing instrument was acknowledged before me this(
The day of , 20 by C K i�r - Ou vC +f" ,
da o ona lv known to me or who has produced
Sign:
Print:
My Commission Expires:
NOTARY PUBLIC:
Y. Y.xxxx x x x *x*xxx x xx x*xxx
*xxx x x xxxxxx?.-xxxi:Se *xxxxxx rxxxxxa:xxxxxxxrx xxW^:ICW
APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning