ELC-11-1954Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 165764 Permit Number: ELC -10 -11 -1954
Scheduled Inspection Date: November 28, 2011
Inspector: Devaney, Michael
Owner: , Pc90 - /
Job Address: 9830 NE 2 Avenue
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060132240
Phone: (786)3313967
Building Department Comments
BURGLAR ALARM INSTALLATION
ply, &to e),-1 T«�
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
November 23, 2011
For Inspections please call: (305)762 -4949
Page 11 of 23
435 VOW tE, MSG
CC =2011
Miami Shores Village
Building Department��
/0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 •
BUILDING
PERMIT APPLICATION
FBC 2004
Permit No. F 11 aiS24- Master Permit No.
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder) 1-A, ChVv11 Cr (DF li`rg'(N vt )-01 LL hone #
Owner's Address I 0 -7 ) S t a vt .3 -9
City t--1 On State F Zip 33 Li 1
Tenant/Lessee Name The. fl / beairl 71444,e_ Phone # -72567-
E- MAIL: ph)/
/�
Job Address (where the work is being done) 9 /i%� i/ r'-eiut e-'
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL # ): // 3Z f 6 0/3 ft
Is Building Historically Designated YES NO
Company Name NW SEC1*1l i OsivtiCE9 Phone # 305 .3 S 41
Contractor's Address 10).i5i rtny6 VJP1(
City M11Z,tAttik State FL Zip 3 OoEs
Qualifier Name GMMkt. Y'r hiqlt O l.l.% Phone #
State Certificate or Registration No. Ef 0001111 Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $
Type of Work: ❑Addition
oo
Square / Linear Footage Of Work:
Alteration ❑New ❑ Repair /Replace ❑ Demolition
Describe Work: R011MiNik MAR Y1
fY: F*fYllrlYfFx fYlYlF1t14If *1Y' h' 1Fif% i[ ltlilifl [lhif*%Pfliit** *****F eeS•*** Vf*** it% ltltriff hlYffl4feiflYlt'L'* ***1Y1}***** *11[iK1FfiiTtklLd***
Submittal Fee $ Permit Fee $ 14'&7 ' 4- CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Total Fee Now Due $
Sce Reverse side -->
Structural Review. $
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 cert{fed 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 $ (j j. /L /L/LA
Owner or Agent
The foregoing instrument was acknowledged before me this
day of �$'t , 20 if , by ref a e'er" yehe Z
1/
Signat
ice; /i
Con or
The foregoing instrument was acknowledged before me this
day of %/ 20 // by
who is personally known to me or who has produced who is p
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: V1 p�
Print: 6 r. 4- PNI�PA1
" ►o'o�� ORIT MIMOUN
Commission # 00 946g¢ :
V ommission Expires
oso Docembar 14, 20filint:
• 01 Zoe ()� my commission Expires:
My Commission Expires:
******************************* w************** * * * * ** * ** * * * * * * *** * * * * * * * * * * * ** *iii * * ** *ir+t***Aix'v x.ruxa4 * * *x*
APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning