EL-11-1935Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 166970
Scheduled Inspection Date: November 22, 2011
Inspector: Devaney, Michael
Owner: KODSI, NEIL & CLARICE
Job Address: 547 NE 105 Street
Miami Shores, FL 33138 -2103
Permit Number: EL -10 -11 -1935
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1122310140270
Building Department Comments
INSTALLATION OF BURGLAR ALARM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
November 21, 2011
For Inspections please call: (305)762 -4949
Page 45 of 46
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Miami Shores Village
Building Department e ,,.� . ,� 93 y
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 0 C T 20 i"' 1
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical -�
OWNER: Name (Fee Simple Titleholder): �Ve tI - 4 _ ee Qd4%t Phone #:3 OC'7st _ S3is—
Address: '/% WE /0.5--
City:
Permit No.
Master Permit No.
Ci4-44e4-1 (3k f 5 State:
Tenant/Lessee Name:
Email:
l
Zip: 3-3
/ O
Phone #:
JOB ADDRESS: 67/ -2 A)6 lo5 s-
City: Miami Shores County: Miami Dade Zip: 33�
Folio/Parcel #: ! ! 23/0/40 ,i9g.7 0
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: /�'7f) 1 �i 5 A V .0 Phone #: Q7/ ` 4 a 'O2
Address: /4078r ni Mud
�Vf
City: t x
Qualifier Name:
State Certification or Registrat
Phone #:
Zip: ,3 30)-6"
Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $
Type of Work: UAddress
Description of Work:
&iteration
0 Square/Linear Footage of Work:
❑New ❑Repair/Replace
❑Demolition
/A 1.
******** * * * * * * * * * * * * * * * * * * * * *x * * * * * * * ** Fees***********xx * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ (e = CCF $ 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)
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 no be a ' i roved and a�ryeinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ,2W' ,by
Signature
Contractor
The foregoing instrument was acknowledged before me this C,
day of � , 20 j__, by 6e04,50
,
who is personally known to me or who has produced who s p ersonally knit o me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPROVED BY 0
7
r Aar Pps�n MARIA TERESA GROSSO
• * MY COMMISSION 9 EE 091861
EXPIRES: May 9, 2015
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
as identification and who did take an oath.
Plans Examiner
Structural Review
NOTARY PUBLIC:
Sign:
Print:
M
90,11Rgs l 1+I "5: RAMI
MY COMMISSION # EE 091724
niTil
a --��: EXPIRES: May 9, 2015
ARP
• Bonded Thru Notary Public Underwriters
* * * * * * * * * * * **
Zoning
Clerk