EL-11-1700Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 165439 Permit Number: EL -9 -11 -1700
Scheduled Inspection Date: November 14, 2011
Inspector: Devaney, Michael
Owner: HOLT, JAMES
Job Address: 112 NE 93 Street
Miami Shores, FL
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (828)944 -2112
Parcel Number 1132060133140
Phone: (305)758 -2000
Building Department Comments
RELOCATE PANEL FROM KITCHEN TO HALLWAY, ADD
NEW SMOKE DETECTORS, CHECK RECEPTACLES
SWITCHES FOR PROPER OPERATION. GROUND
SCREEN ENCLOSURE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 164543.
November 10, 2011
For Inspections please call: (305)762 -4949
Page 18 of 34
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
j I' 114e/ INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No. LI tt —I
PERMIT APPLICATION Master Permit No.
FBC20
Permit Type: Electrical _II G //
OWNER: Name (Fee Simple Titleholder): �.1 a {� es E E. 1-b1-1- Phone #: 025 .'9Q `i' —G%/5"
Address: 11;2 /V 6 a j
City: M I Dail l .S- State: FL-
Tenant/Lessee Name: N/A
Q
Email:
zip: 33/3
Phone #:
JOB ADDRESS: 112. 6
City:
Folio/Parcel #:
Miami Shores
County:
Miami Dade Zip:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: (1/060-61 ebeCTRJC. )!l)
Address: 66 g PLO q0"1"
City: l PriM
State: F
Phone #: 505---15g -2600
�33/5O
Qualifier Name: r4004.1 Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: 3o f 53 -zono Email Address:
DESIGNER: Architect/Engineer: /1/4-/4"
Phone #:
Value of Work for this Permit: $ 2460.00 Square/Linear Footage of Work:
Type of Work: Address ❑Alteration UNew Eliepair/Replacee` ODemolition
Description of Work:
�D C �� v'l�S?�1 4 ' Ae. �) �c,
friev zi. v `5® lei .
* * * * * * * * * ** * * *** *, * x014 * * ** *** **** * Fees************** ***** * * * ** * * * * * * * * * * * * * *** ****
Submittal Fee $ Permit Fee $ /- ?-40,0" v CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ I k 2 • 3D
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Ki A
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
Signa ure
Owner or Agent r,
/1 / Contracto
The foregoing i strument was acknowledged,befo e me this /T The foregoing instrument was acknowld before - thi
day of _�, 20 , by %e1
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: �n
Print: 1 V )
My Commission ' pires:
day of , 20 L, by 6
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commis i ,:
' ''••. MARY PAT BRIGGS r MARY PAT BRIGGS
•' MY COMMISSION # DD 979267 it MY COMMISSION # DD 979267
r -.- !EXPIRES: May 11, 2014 `' _x, EXPIRES May 11, 2014
BondedTFw
* ** * ** * * * * * * * * * ** * *** x* eg �M �x xxxxxn****xxxxxxxx*
:kakaks
APPROVED BY YA Y / " ' 5W' " Plans Examiner Zoning
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Clerk