EL-11-1136Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 162776
Scheduled Inspection Date: August 09, 2011
Inspector: Devaney, Michael
Owner: PAUL, ANTHONY
Job Address: 1300 NE 105 Street 3
Miami Shores, FL
Project: <NONE>
Contractor: SAFE STREETS USA
Permit Number: EL -6 -11 -1136
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1122320810030
Phone: (813)514 -2693
Building Department Comments
LOW VOLTAGE ALARM
Passed
1/
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR I P- 162728. No one home.
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August 08, 2011
For Inspections please call: (305)762 -4949
Page 20 of 27
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Applicant
1300 NE 105 Street Number: 3
Miami Shores, FL
1122320810030
Block: Lot:
ANTHONY PAUL
Owner Information
Address
Phone
Cell
ANTHONY PAUL
1300 NE 105 ST #3
MIAMI SHORES FL 33138 -2144
1
Contractor(s)
SAFE STREETS USA
Phone Cell Phone
(813)514-2693
Valuation:
Total Sq Feet:
$ 174.00
0
1
Type of Work: LOW VOLTAGE
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.00
$2.00
$0.20
$100.00
$3.00
$0.80
$108.60
Pay Date Pay Type
Invoice # EL -6 -11 -41274
07/20/2011 Check #: 2329
06/22/2011 Check #: 2235
Amt Paid Amt Due
$ 58.60 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
July 20, 2011
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
July 20, 2011
1
7/
7.41361°
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
Permit No. 0 t M °
Master Permit No.
Permit Type: Electrical n�� "
OWNER: Name (Fee Simple Titleholder): fir? Patti Phone #: 1 1 .P. ` Mao
Address:123 ,� j`i'b ) oss+ • 3
City: t!c1 inaii t Q iL;S State: PL. Zip: 33131c
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: I_ 1 I C.)5 S'}"
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: 11
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: LThn ce Sk"re]e1 J USA' Phone #: t31 ' 5lW'D t,.(1''1 J
Address: + _41. . ! £ t " /�
City: ` -V -` State: r� Zip: `--1
Qualifier Name: V.)1 . a a. aU ;,K Phone #:
State Certification or Registration #: EC--1 tr oo t-10 ..j Certificate of Competency #:
Email Address: —h ,k;j, 11 ce,,S+ [ (A{
DESIGNER: Architect/Engineer: Phone #:
Contact Phone #:
Value of Work for this Permit: $ ! LI • C)Ci Square/Linear Footage of Work:
Type of Work: ❑Address
Description of Work:
OAlteration UNew URepair/Replace
w vo1 -cT, x(30 etl i
Demolition
* * * * * * * * * **
Submittal Fee $ - 44 f Permit Fee $ /49‘7' 9r94. CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 1
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, BOWERS, 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 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 issue ,{l. In the absence of such posted notice, the
inspection will not be approved and a reins i ection fee will be charged.
Signature e 174, PA-tA
Owner or Agent
The fore oing instrument was acknowledged b ore me this
l
day o ,20tI ,by rQ 1
who is personally known to me or who has produced 1,...
As identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC
STATE OF FLORIDA
Comm# DD959307
*** IIr®S 218/2014
********************** * * ** * ** ** * ** *** ** * * ** * * ** * * * *,,
Signature v.
Contractor
The foregoing instrument was acknowledged before me this
day o
who is personally known to me or who has produced .
as identification and who did take an oath.
201 ,byWl .f 1. 2a aeia, ,
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
TAE3ITHA VAP1l?EMI
NOTARY P, L
STATE OF Ft • J
(omm# * * ***** * *+x *** **
g
Clerk