EL-11-958Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: I NS P- 163597
Scheduled Inspection Date: August 23, 2011
Inspector: Devaney, Michael
Owner: GARCIA, RICARDO
Job Address: 436 NE 93 Street
Miami Shores, FL
Permit Number: EL -5 -11 -958
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number (305)756 -5301
Parcel Number 1132060140210
Phone: (786)331 -3967
Building Department Comments
Burglar Alarm
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
August 22, 2011
For Inspections please call: (305)762 -4949
Page 20 of 29
4L
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 Type: Electrical
OWNER: Name (Fee Simple Titleholder):
Address:
Permit No.
Master Permit No.
Phone#:
sw-ifurt
City: eL1.�i
State: Zip: 33/.0
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: / —ae
City: Miami Shores County:
Folio/Parcel #: ?✓ /' 3 ®f — 0/ /— co9-/0
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
/0 ':5-
City: State: a
Qualifier Name: oe / � _ /7 2e-g i
State Certification or Registration, / #:: / /i' Certificate of Competency #:
Contact Phone#: ,4-- a) 74° Email Address:
DESIGNER: Architect/Engineer: Phone#:
Address:
Miami Dade
NO , Flood Zone:
aeA %,,,r 7' a Phone #: C /S 2-66 -'37l 5
Zip: `®°
Phone#:
Value of Work for this Permit: $
4
` Are) -4-'- `e"-- Square/Linear Footage of Work:
Type of Work: ❑Address DA1 tion ONew ORepair/Replace
Description of Work: Co �✓ �'
(i)
Demolition
Submittal Fee $ Permit Fee $ /P eP a
Scanning Fee $ Radon Fee $
Notary $
Double Fee $ Structural Review $ ,
TOTAL FEE NOW DUE $
CCF $ CO /CC.$
DBPR $ , Bond $
Training/Education Fee $ Technology Fee $
r
.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 thalt 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 FT PCTRICAL 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 INTE TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATT RNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceedi zg $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure wgll 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 s . rs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and reinspection fee will be charged.
Signature X Signature
" �3- ?3/2.5" -®
er of Agent D�(� �p2!? �i Con• • for 1 The foregoing instrument was acknowledged before me this 25 The fore o' instrument w cknowl dged before me this 1 1
day of &l'9 , 20 jL, by SZ ►c (' GAO- l'o , day of _ � .r- - -- 20 Ttby � ri1, U 1 i
who is personally known to me or who has produced me or ' ho has produced
}"L -pc ) As identification and who did take an oath. as en ca+ n • d who did take an oath.
NOTARY PUBLIC:C*4P ! 111— 11 V-- b
Sign:
Print s Eft
My Commission Expires: * t , y% * MY COMMISSION # DD 777363
EXPIRES: August 9, 2012
d'q� Bonded Do Budget Notary Seim
********* k% t***** ***sF**Aa*** *s#N-* h**sR*. N. k***ge***ga,kskNcge,k*****eh**
//
: Plans Examiner
NOTARY
Sign:
Print:
P
OF FLORIDA
My Commission Expire
Structural Review
(Revised 07 /10 /07)(Revised 06110/2009)(Revised 3/15/09)
ires: ` MAY 03, 2014
THRU ATLANTIC BONDING CO., INC.
***** ***** ********** **
Zoning
Clerk