EL-11-819Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 164885 Permit Number: EL -5 -11 -819
Scheduled Inspection Date: October 04, 2011
Inspector: Bruhn, Norman
Owner: CARROLL, BARBARA
Job Address: 1461 NE 103 Street
Miami Shores, FL
Project: <NONE>
Contractor: SKY ELECTRIC, INC.
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132050310190
Phone: 305 -542 -0060
Building Department Comments
NEW UNDERGROUND ELECTRICAL SERVICE TO
EXISTING POLE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
//
October 04, 2011
For Inspections please call: (305)762 -4949
Page 17 of 26
.'►Miami Shores Village
A«— Ui Buildin g Department artment M4 0 6 2!x'11 I
_
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. �-A./ ` I �1 j
Master Permit No.
BUILDING
PERMIT APPLICATION
FBC 20
BY:____
Permit Type: Electrical I
OWNER: Name (Fee Simple Titleholder): 9' I a,Y'dJ� 'ti & rl tr'(. i'c'<o
Address: 4- I, ! E, (0 3 rG ST
Phone #:3 0 5 -'?ST - 1 (o (o c
City: M, i a.m i, S %( o ireS State: F /I t
Tenant/Lessee Name: - Aid+ 4 p
Email: 1:30_ Y `r ( l P as t t Cowi
JOB ADDRESS: T 61 ME /03 S r
City: Miami Shores County:
Folio/Parcel #: % 3 a os - D 3l - o t/ W
Zip: 3 31 3 E-- b.2 S'
Phone #:
Miami Dade
Zip: 33/3k-
Is the Building Historically Designated: Yes NO
Flood Zone:
CONTRACTOR: Company Name: � Elm t`G �nC, i Phone #: 3 5 SToZ��t� tp�
Address: �0 WV 1 Sty ST
City: M i a fvt t (&v l S State: Fl-
Zip: 3 / t
Qualifier Name: "-R Ca.1r
i �at tt-y Tr.
Phone#:
State Certification or Registration #: EC t 3 b 0 2.7 6P. Certificate of Competency #:
Contact Phone #: Si r °s 4' 2 O 1 b 0 Email Address: /2 Sls- 0gigo P c ' A/ & C'®',
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ t2 6-01) • Square/Linear Footage of Work:
Type of Work: ❑Address []Alteration
Description of Work: 1 _ IUV. No 4 12C0y. O J M0
5 sig._ v Iu ri' s r tAif
❑New URepair/Replace
C3Demolition
* * * * * * * **** **** **** ** :: *** *******:x*****Fees****** *m ************ :x****:x****** ********** **
Submittal Fee ; 6"-P Permit Fee $ /1-6. re,
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ 11
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Miami Shores Village
APPROVED
BY
ZONING DEPT
BLDG DEPT
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DATE
SUBJECT TO COMPLIANCE WITH ALL FEDERAL
STATE AND COUNTY RULES AND REGULATIONS
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APPROVED BY DATE
ZONING DEPT
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No. —4/
Job Name - -/ %a_c°G
CRITIQUE SHEET
IA° / ,4/'9
'7-',471)/.07/*
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 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 issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
a.
Owner or Agent
The foregoing instrument was ac
day of , 20 IL, by
Sign
The fore g ins,
day o
!w person 1 known to me or who has produced
(1 in 01' tAs identification and who did take an oath.
NOTA
Sign:
Print:
ment w
,20II,by
Con i < or
dge before me this f
6Z/3®va762-
who is personally known to me or who has produced
as identification and who did take an oath.
My Commission Expires:
APPROVED BY
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My Commiss
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Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk