EL-11-561Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 157803
Scheduled Inspection Date: May 23, 2011
Inspector: Devaney, Michael
Owner: STOCK, MICHAEL
Job Address: 268 NE 102 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Permit Number: EL -3 -11 -561
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Repair
Phone Number
Parcel Number 1132060134720
Phone: (305)758 -2000
Building Department Comments
METER CAN REPAIR
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
May 20, 2011
For Inspections please call: (305)762 -4949
Page 12 of 18
4111
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
liplanV1111
!� MAR 3 ! �U
B Y:
Permit No. l (
Master Permit No.
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) in ®4e/ C Phone # �O� ° 3 Cig -q 3 7/6
Owner's Address 2- C S ME l D2- af
City �� ' 41to 5 State Zip ;31.3k
Tenant/Lessee Name lk
Email
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
6yerme.
Phone #
County Miami -Dade
Zip
Is Building Historically Designated YES
NO
Flood Zone
Contractor's Company Name ' A
Name /AM,- ,- Phone # ��= /�ci p
—2006
Contractor's Address JO U R ' Q /7
City Ali I f l � State FL Zip 5 3
� I
Qualifier Name 10 N-� I V 1 QQ Phone #
State Certificate or Registration No. EC, 000 1 1q17 Certificate of Competency No.
P Y
Contact Phone E -mail
Architect/Engineer's Name (if applicable) A) /A
Value of Work For this Permit $
40. 'c
Phone #
Square / Linear Footage Of Work:
Type of Work: DAddition []Alteration ONew E iepair/Replace ❑ Demolition
Describe Work: ftiE t1 L}/U P ,4 /i.,
********* * ** * * * * * * * * * * * * * * * * * * ** * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * ** * * * * * * * * * **
Submittal Fee $-�� Permit Fee $ e/6' 0 tom. CCF $ CO /CC $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $
/•
See Reverse side -3
Bonding Company's Name (if applicable)
Bonding Company's Address
City State h Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby : de 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 AFi 'DAVIT: 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 inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will no be ap #roved and a' inspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of1Y`lr ,201, ,by)11)614 SZ.
who is personally known to me or who has produced 0
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
• % %4 \ %65,4 '4
SOpp�F <C
T.,
11
/NA""-,P--- Plans Examiner
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 2010 , by -J NCO
who is personally known to me or who has produced
as identification and who did take an oath.
Engineer
(Revised 07 /10 /07)(Revised 06/10/2009)
NOTARY PUBLIC:
Sign:
Print:
My Co
11
, L/f,P
Q. MARY PAT BRIGGS
COMMISSION 5DD979267
fir. a_ EXPIRES: May 11, 2014
Bonded Thru'VotaryPublic Undarw5ta S
Zoning
Clerk checked