PW-11-2156Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 166900 Permit Number: PW -11 -11 -2156
Scheduled Inspection Date: December 16, 2011
Inspector: Bruhn, Norman
Owner: NUGEN, JOHN
Job Address: 375 NE 99 Street
Miami Shores, FL 33138 -2436
Project: <NONE>
Contractor: ALLSITE ELECTRIC LLC
Permit Type: Public Works
Inspection Type: Final
Work Classification: Public Works
Phone Number
Parcel Number 1132060135530
Phone: (954)632 -6146
Building Department Comments
TRENCH AND BURIAL OF Electric LINE. CHANGE TO
UNDERGROUND SERVICE.
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Cc_
December 15, 2011
For Inspections please call: (305)762 -4949
Page 8 of 16
Miami Shores Village
RECEIVED
NOV 2 12011
BY
\it(9bri„o
Public Works Department
\ V t/ i -
10050 N.E. 2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Public Works
Permit Application
FBC 2004
Permit Type: Pub
fie Works
Owner's Name (Fee Se
Owners Address
City •
Tenant/Lessee Name
WATER
-501 $f-t?aiq NuureA.J Phone p Vet) 0 3a di
Nift_
Titleholder)
permitN3tt,-2.1 5
State
Phone it
Job Address (where the work is being done)
City Miami Shores Vit lege
Is Building Historica liy Designated:
r•I
Zip
YES
County Miami Dade
NO
Zip
Architect/Engineers Name (if applieable)
$ Value of Work For this Permit
%,..witw.olit,slittAiktrotiAAfra..404.44w,
;,1;i4v ),IA;z:1•r,
.TY.Pe °!1r,ftirIV.,:e
Addition 17)'Atteration 0 New n Repair/Replace 0 Demolition
:`•
_
r ---re.r.14c4-4 rstrz.toeL„ the.
1;/
Phone t.
Lineal Footage Of Work:
* 8. •,.‘• - .
IIKA c A '001 'r
Anix**04e,3101awnv,*
Submittal Fee
Notary $ Training/Education Fee
Scanning $ Radon $
Structural Plan Review
Ks-201.r?
w • —a ""wsr pyre
Fees
Permit Fee
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
CCF
CO=
Technology Fee $
Zordog
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
, Mortgage Lender's Address
City
N/A
WA
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. 1 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 This issuance of a Public Works permit with' an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of tha 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 sIle 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 reinsgection fee will be charged.
Signature
Owner or Agent
' � / Signature
contractor
The foregoing instrument was acknowledged before �me�this ,Z The foregoing instrument was acknowledged before me this
day of rW" 201 by 1' 1\1442W _ IW-' day of 004fcm))Q.1., , 20L, by k' 7 L,* 3O;LA.
Who is personally know to me or has produced •7R i s S . '
who i wn to me or who has uoed
as id-; ( • = on aiitillt[rg4 d3a((,an oath.
NOTARY BUC: '.\ '• 02i ••'� •. w ,
tW ®� 1'-
Sign.
? �° • /o j ass/ `/4'
1 /1 /11 /Illl■lllnt"
Print
My Commission Expires:
APPLICATION APPROVED BY:
11/17/2005
tag.;� '+h E PARNEII
, `e` Nor Public - State of Florida
• My Comatiasion Expires May 21 2012
Common 0 00 790851
gentled limo National Notary Assn.
P
as identifi
Sign:
'NOTARY PUBUC:
i8CLIPA LL.
Print: OttA-v.6 W/a E
My Commission Expires: M L n 2 -12,
Public Works Director or
his designee.
11/22/2011 11:52
3053627386
FEDEXOFFICE1507
1 ;OWARD COUNTY LOCAL BUSINESS TAX RECEIPT
11 ;. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33.301- 1095 — 954,831 -4000
VALID OCTOBER 1, 2011 THROUGH SEPTEMBER 30, 2012
Business
Owner
Business Loi
Business i
»e:ALLSITE ELECTRIC LLC
mite: PATRZCKSON M CANOVILLE
oh: 10757 NW 12 DR
PLANTATION
ne:
R is
Tex Amount
27.0
Seats
Employees
1
PAGE 01/01
Receipt #:181-3470
Business Type: ELRCTRI CAL /ALARMS /CON TRACZI
(ELECTRICAL CONTRACTOR)
Busine3s Opened:o1 /09/2009
State /Count y /Cert/Reg :EC13004023
Exemption Code:NONEXEMPT
Machines Prvf sionals
V�
For Vending Bus;ness Only
Number of Machines:
'riding Type:
Transfer Fee
NSF Fee
Penalty
Prtai Years
Collection Cost
Total Peld 7
0.00
0.00
0.00
0.00
0.00
27.0J
THIS CEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECO!
I A TAX RECEIPT
WHEN VALI! 'ED
Mailing Add 5:
PATRICK& M CANOVILLE
10757 NW DR
PLANTATIC FL 33322
This tax is levied for the privilege of doing business within Broward County and is
non - regulatory In nature. You must meet all County and /or Municipality planning
and zoning requirements. This Busin'sss Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is In compliance with State or local lows and regulations.
2011 - 2012
Receipt #04C -10 -.00004122
Paid 07/20/2011 27.00