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EL-11-431Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 160776 Permit Number: EL- 3- 11-431 Scheduled Inspection Date: June 08, 2011 Inspector: Devaney, Michael Owner: THOROGOOD, DANIEL Job Address: 635 NE 105 Street Miami Shores, FL Project <NONE> Contractor: PROJECT MANAGER & ASSOCIATES INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1122310120070 Phone: (954)341 -1655 Building Department Comments ELECTRIC ALTERATION KITCHEN AND BED Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. 91 -7" 9I� June 07, 2011 For Inspections please call: (305)762 -4949 Page 22 of 24 Ad a Permit PermitR7 Ritedaterl Permit turetmaffen Permit bra Main Pemca Parcel Pewit Type Wu* Caw Pemdt States Square Feat Valmatan eNONE� gi AppOcatem Dale Fildratims Date Issue Date Feuded Date Comments Lam Ittspeetem CiRtCAi. SHOWS CHINE +... r lh t3 3 PANEL &LSE OLD W1RING FOIE RESILIENCE MUMMY SYSttd1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit No. EL-ft-VP' Master Permit No. 11 -342 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): Dan Thorogood Phone#: 954-646 -4290 Address: 635 NE 105 St city: Miami Shores state: Dade County zip: 33138 Tenant/Lessee Name: N/A Phone#: Email: JOB ADDRESS: 635 NE 105 St City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO X _ .,,od Zone: CONTRACTOR: Company Name: Proiect Manager & Associates, Inc. Phone#: 954-341 -1655 Address: 3212 NW 90 Ave City: Coral Springs State: FL Zip: 33065 Qualifier Name: James E Joyce Phone#: 954 -608 -2639 State Certification or Registration #: EC13003604 Certificate of Competency #: Contact Phone#: 954-341 -1655 Email Address: james©pmaelectric.com DESIGNER: Architect/Engineer: Arpe Engineering Inc. Phone#: 305- 4449809 Value of Work for this Permit: $ 3600.00 Square/Linear Footage of Work: 400 sq ft Type of Work: ❑Address C7 Alteration UNew ORepair/Replace ODemolition Description of Work: Remodel for kitchen and adjacent bed room Submittal Fee $ Permit Fee $ d 5'e CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ V VE ' h 0 4 1 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 4 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 nwtice 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 roust be posted at the job site for the first inspection which occurs seven (7) days after the building is issued. h f .e nce of such posted notice, the inspection will not be approved and a reinspection fee will be charg d. Signature The fore day of 16A,, pers NOTAR c_ 1 -J ing ins OwI¢er or Agent ment was c owpl ed bef �qe this yy® 20 _0_, by 1 WI Jl/ °Antome Sign: Print: My Commission Expires: who has produced f I cation and who did take Signature r Contractor he foregoing instrument was acknowledged before me this 1.644 day of ft , 20 I.( , by SGIANe- ISOUICe My is personally known to me or who has produced (P1 . YJ Citj CC1-S,e as identification and who did take an oath. Q4 z7 a ,\,yt4,0.#. NOTARY PUBLIC: * * * * * * * * * * * * * * * * * * * ** APPROVED BY i Sign: lam. 1 1 /Lr� Print: ►1 Am ii. I My Commission Expire ***************+ xw ******m *****************,x****** * ******* * * *** x * ** ******* *,x*** ******** Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 'Return to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Bill To DANIEL THOROGOOD 635 105 Street MIAMI, FL 33138- 636 106 Stroet MIAMI, FL 33138- Date 03/10/2011 03/10/2011 03/10/2011 03/10/2011 03/10/2011 03/10/2011 03/10/2011 Fee Name CCF Technology Fee Education Surcharge DBPR Fee Permit Fee - Additions /Alterations DCA Fee Scanning Fee Invoice Number: EL -3 -11 -40333 Invoice Date: March 10, 2011 Permit Number: EL- 3- 11-431 Bond Number: [Comments: J Fee Type Calculated Calculated Calculated Calculated Percentage Calculated Calculated Fee Amount $2.40 $3.20 $0.80 $2.25 $150.00 $2.25 $3.00 Total Fees Due: $163.90 Payments Date Pay Type 03/10/2011 Credit Card Check Number Amount Paid Change $50.00 $0.00 Total Paid: $50.00 Total Due: $113.90 1 Thursday, March 10, 2011