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EL-04-36Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 163561 Scheduled Inspection Date: August 22, 2011 Inspector: Devaney, Michael Owner: IMPORT, IMPORT Permit Number: EL2004 -36 Job Address: 9818 NW 1 Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: KLM OF SOUTH FLORIDA INC Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number Parcel Number 1131010240070 Phone: (305)232 -1114 Building Department Comments RE -WIRE ALL ELECTRIC OUTLETS AND SWITCHES Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 19, 2011 For Inspections please call: (305)762 -4949 Page 26 of 32 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 • AUG 1 2011 Permit No. � i11Q4 -n Master Permit No. Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): 'kinr..a) A L. _, CAPr L Coq) l) Phone #: 1 1'.-f - 3 g Z- - 10 (f3 Address: ©t E CA- 1 -11141) 611, g-T• , su'i't 1 9 8b City: OICAhta a State: C., Q Zip: 9 2. Si'(, g Tenant/LesseeName: 1ALAt4 Gr(t.EG.4Itg %RZecto Gets +R6 Phone#: (112- )4Qt °3`�it Email: 4 l�rAc 5 t.�. @ k.0 ND A tAJt • cttw-1 • Ch ° l�:. 1�lOR%1^ JOB ADDRESS: 9%1.1 IS o1 }4 WEST 1 4 Pc VI City: Miami Shores County: Miami Dade zip: 33130 Folio/Parcel #: 41 —3tO 1- 82..44 , eta O Is the Building Historically Designated: Yes NO X Flood Zone: CONTRACTOR: Company Name: LOA OF --7‘1% e (b Phone#: ( �) ' ° 4 5 Address: Z(5r City: M State: E L— Qualifier Name: sili i$ 5 State Certification or Registration #: "t72 'co 15 0 Certificate of Competency #: Contact Phone # :( D'i 5 Email Address: Zip: 33e 5 Phone#: DESIGNER: Architect/Engineer: Vim/ ' Phone #: Value of Work for this Permit: $ CC .n Square/Linear Footage of Work: Type of Work: DAddress DAlteration New DRepair/Replace DDemolition Description of Work: 4, / ae• //) d'vC 7 /7 JI/ ' eriki ,q ******** * * * * ** * * * * * * * * * * * * ** * * * * * ** * * ** Fees ***** ********+ x. x**** ** *a+**** ** *** *a **+x ****** Submittal Fee $ Permit Fee $ / . -e" e Coe' CCU' $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) 14 (t\ Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N 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 $2500, the applicant must brochure will be delivered to the person mencement must be posted at the job site the absence of such posted notice, the promise in good faith that a copy of the notice of commencement and construction lien whose property is subject to* attachment. Also, a certyied copy of the recorded not for the first inspection which occurs seven (7) days after the building permit inspection will not be app oved and a reinspection fee will be charged. Signature wner or Agent The foregoing instrum» " was acknowledged before me this The fore 9 oing in Signature day of 4 20 ___, by , day of who is person' y known to me or who ha produced who is As identification and who did take an oath. 4 1 NOTARY PUBLIC: Contractor ment was ackqwigg befor , 20 1) , by to me or who has produced entification and who did take + oath. LTC: . • Sign: s`d''C c /"/ OKAILO/ /*Lhd ivit �lyLI Si Print Print: My Commission Expires: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY * * * * * * * * * * * * ** * * * * * * * ** spa ** *** * * *** * * * * * ** * * * ***** * **** ** * * * *** * * * ****o* PIans Examiner Zoning Structural Review (Revised 07 /10(07)(Revised 06/t0/2009)(Revised 3/15/09) Clerk 11 C dms f6,1- yoJ iqed-ed all 4-6 Noyk, Iry bVkR'(, comvvieA-Js 1,\ ciS)RA4k dam Svc) 'CO(&1 fl1S /100 f04 Ix) oIcYC- . A- Iloo4ed,pltQSe, NA6 Gi con of ill COmmeivh riv(al Po{ r xl 22J2.O11. TrActuk State of California County of Orange ACKNOWLEDGMENT On / (4J-i 1/1 2_0 1/ before me, Melissa Bloch, Notary Public 99�� / (insert name and title of the officer) /L personally appeared 4 L4 a lo k ke J I , who proved to me on the basis of satisfactory evidence to be the person(fwhose name$ee subscribed to the within instrument and acknowledged to me that4 e1O/thcy oxecuted the same in authorized capacity(ipsj, and that by-194/ - • signature( 'on the instrument the person, or the entity upon behalf of which the person(s)'acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my han Signature ial seal. rob+dialia"1141""1"11"4"."1 MELISSA BLOCH Commission # 1857605 • Notary Public - California A Orange County My Comm. Expires Jul 12, 2013 (Seal)