EL-06-595Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 04/18/2006
Inspector: Devaney, Michael
Owner: BOLTON, JOHN AND JENNIFER
Job Address: 1202 101 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: BENNETT ELECTRIC SERVICES CO
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)754 -2136
Parcel Number 1132050210030
Lot:
Phone: 305/759 -1665
Building Department Comments
Monday, April 17, 2006
Page 2 of 2
Passed
Inspector Comments
7g 0,17.- CG''
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Monday, April 17, 2006
Page 2 of 2
4
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
la, ' 2:1 3 14. l 06 Tel: (305) 795.2204 Fax: (305) 756.8972
A r-1 BUILDING - Permit No. E LG ^ 5a S
PERMIT APPLICATIO', �,�,,,� Master Permit No.
FBC 2001
Permit Type (circle): Building c ` cal ' lumbing Mechanical Roofmg
Owner's Name (Fee Simple Titleholder) b a... 14 Phone # -as-4i ! a c,
Owner's Address D o d.. P 01 S "e7
City Aar a. C L- State F 1
Tenant/Lessee Name
Zip T5) ) 3
Phone #
Job Address (where the work is being done) 1:)...6 1-' - `® l
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO y
Contractor's Company Name Bit N Ele-ci, ti Phone # ' o
Zip
Contractor's Address
City MR41 Y
Qualifier ,, J s 1. , ,
(C ®0 1a!t ti
State F
Zip 3 v3 le
State Certificate or Registration No.t.C- Cis 0 0 0 C
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
w�q
Certificate of Competency No.
Phone #
Square Footage Of Work:
Type of Work: ['Addition ['Alteration ['New -in Re air/Re lace
p p ❑Demolition
Describe Work: I 43 ,gyp' e - p t c, f'-5 e, cej'- u P 1P-v --
D �c., "--® 5 f' o v
,
kc
* *,* ** * * ** * * * * * * * ** * ** ** * ** ** Fees * ** * * * ** ** * * * *,* * * * * * * * ** * * * ***
Submittal Fee $ Permit Fee $ aPre.N3 CCF $ 1 - 2-:CD CO /CC.
Notary $
Scanning $ 3. 0c7 Radon $
Training/Education Fee $
- 40 Technology Fee $ �- —1S
Code Enforcement $
Total Fee Now Due $
I.S.
Zoning Bond $
Structural Plan Review. $
(Continued on opposite side)
Oft i 4 PAID
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 AA'11'IDAVIT: 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 inspects hich occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will n. ' e pp/ ved and a reinspection fee will be charged
Signature
Owner
The forego rostrum n was acknowledged ed before e this
day of 200 6 , by O A jr./ et/t— ,
who is
NOTARY P
Sign:
Print:
My Commissi
ho has produced
As identification and who did take an oath.
Ali '
i 1 y t'I • h 'A* c ,a
I 01
COMMISSION # DD 355174
t :_rg
EXPI ^S:Octo e�s��:
ditttosss Bonded Thni Notary Public Underwriters
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY-
chc 05/13/03
Signature
✓'
Contractor
The foregoing instrument was acknowle s ged ,� fore me this
day of o.P / • 20061 by T L' G®/`s `� - a--�'
who i : ° ovally kno . o, a or who has produced
as identification and who did take an oath.
*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
cloG' Plans Examiner
Engineer
Zoning
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