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EL-11-1150Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 162456 Permit Number: EL -6 -11 -1150 Scheduled Inspection Date: July 26, 2011 Inspector: Devaney, Michael Owner: WALSH, PETER & FRANCES Job Address: 504 NE 101 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MV ELECTRICAL SERVICES Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060171190 Phone: (305)216 -0677 Building Department Comments INSTALL 12 NEW RECESED LIGHTS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Commen 2E 7--6czy• z� /r July 25, 2011 For Inspections please call: (305)762 -4949 Page 20 of 24 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 Type: Electrical OWNER: Name (Fee Simple Titleholder): VEr4Z. tkr h Address: 5M �t�� 161 51-R61- City: Ml 14.0 I `S t eiR4. State: F L Tenant/Lessee Name: Phone #: Permit No. 77:7f 7 77 JUN '4 4 2°11 BY: .Y...:77:77:777 Master Permit No./# 1/ — /12 7 Phone #: Zip: 33 l c�Z1 Email: JOB ADDRESS: 5-0M 10 I City: Miami Shores County: Miami Dade Zip: 3 -6 LY8' Folio/Parcel #: 1 1— c ? a — 01 / `° a ct C° Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: k.'" V A 3 1•00e-8 Phone #: — r4.7b�� Address: ki S it 'ANA CO- c--°N City: \---kC-1 J State: Qualifier Name: \ .C.11) \i iNk' 5 Certificate of Competency #• State Certification or Registration #: �. 4 - `a � Contact Phone #:I , 2-Mcs-"kip -Wt ° • Email Address: l i (N DESIGNER: Architect/Engineer: Phone #: Zip: '`b®xS.- Phone #: Value of Work for this Permit: $ 4 CK1 C:S) Square/Linear Foot ge of Work: Type of Work: DAddress DAlteration ONew i air/Replace Description of Work: . �� \Z .-> \`‘5\x- ODemolition 9 .pd • S 0 IBM .11111r,71 'PM PK some no YY ***************** ************ Submittal Fee $ Permit Fee $ /-' /-6-0,e*4,. CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 15 1 10 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 t ' person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at t 'ob site for the first inspection which occurs seven (7) days after the building permit is is < e ' . In the ° bsence of such posted n ce, the inspection will not be approved and a reinspection fee will be charged. tore Yrz(L(('' � /c'-- � Signature i t 3— 111 Owner or Agent re l The foregoing instrument was acknowledged before me this AJ dayof :J;ine ,201! ,b who is p onally 12/Rvi. 1)(rveb NOTARY PUB Sign: Print: My Commission Expires: VAL Contractor The foreg .. g i trument was acknowl day of ls�� 2011 , byC ed who is personally known d n to me or who has produce At pp i cation and who did take an oath. N TAR PUBLIC: ged before ipe this ZrP 1cc' own to me or who has produced identi cation and who did take an oath. IC: i * * * * * * * * * * * * * * * * * * * * * *.. APPROVED B My Commission Expires: 'C �� op t _)be 'ro �Ow...y,, Codes p'� * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *t po Zoning Clerk Z5 c74 Plans Examiner Structural Review (Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)