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EL-11-277Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 156145 Permit Number: EL -2 -11 -277 Scheduled Inspection Date: January 10, 2012 Inspector: Devaney, Michael Owner: KNIGHT, TRACY Job Address: 910 NE 91 Terrace Miami Shores, FL Project: <NONE> Contractor: JERUSALEM ELECTRICAL INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060000020 Phone: (305)206 -5564 Building Department Comments REPLACE PANEL CIRCUIT BREAKER 150 AMP 12 CIRCUITS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments January 09, 2012 For Inspections please call: (305)762 -4949 Page 1 of 25 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 K4 'EIVED I JAN 0 9 2012 Permit Not( — t c'1' Master Permit No. Permit Type: Electrical NA OWNER: Name (Fee Simple Titleholder): �tZ,9 -C-7 /c''�ai ('r/V 7 ' Phone#: Address: 9 / 0 4j. �f% 7 K — City: /7 Qi7 i ` 5A4; e_ S — State: Zip: 3 3 / 3er Tenant/Lessee Name: Phone #: Email: "1 . JOB ADDRESS: /O /l/ # F 9/7 -- City: Miami Shores County: Miami Dade Zip: 5 W3 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: Ac CONTRACTOR: Company Name: J E e u 5.9© err E /Qe,' z, e czP, In ed Phone #: (30,$),P.06 3-5 '. 9 Address: 5 30 A ° t 17 a City: fV ' 1/ //47-7/ State: r� Qualifier Name: //ZZIE- .� / 2 e Phone #: �®.r) v-01 Sr SF' State Certification or Registration #: Z / 3 9/ / Q, Certificate of Competency #: Contact Phone#: (3©J) 070 ic, 53 A Email Address: _ 6 r a 2gyr DESIGNER: Architect/Engineer: Phone #: zip: 33/G o2. Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: Address DAlteration ONew DRepair/Replace ODemolition Description of Work: ii- e,,ta! l ( (2_J\) ) ********+x+ + x******* ** ***+x***********+ *** Fees**** *** ******* ******** ***+x**•x*+x*+xm********** Submittal Fee $ Permit Fee $ I - O 1' CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ \OO . W 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 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 Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 _, by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: ****** *** **** * ** ** APPROVED BY The foregoing instrument as acknowledged before me this 9 day of —5A , 20 1( , by DJBE_ 4-EUt3 7 who is personally known to me or who has produced ' •_ ( D as identification and `wkgv1 W l 8* NOTARY PUBLIC: �,C1°..-' St A s �ti' .. '% Sign: —41a\ Print: ti C ®016 (' ®� / /i2i V ......... '••• . .\•., T4TE0' \ \`,. ��/// 'i�iiitnl1 �`�` My Commission Expires: ******* ***** ** ********************************* *******w* *** **** ** ***** ** * * * *** - 474 1e �'' /.7 Plans Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk Miami Shores Village Building Department ZCZTVE FEB 1820 BY:..:..,.,........ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. i I --I BUILDING PERMIT APPLICATION FBC 20 Master Permit No. Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): 101 Cr %G k N )i T Phone #: 3a5-75F-75C7 Address:: Ito Ark" tit liirctcf- City: I V i;am; .5464 5 State: PG-- Tenant/Lessee Name: N I ,l- Email: iR 4/ i ( frti 7A-5 tri )3 e ! L SUS ii . (a JOB ADDRESS: 51Y )-(,E 45 A-6 GUS Zip: 33 13 S' Phone #: City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: 1-li4bes Cleei- ���a1 9u16-- Phone#:305.- 2 06-5 541f. CONTRACTOR: Company Name: a15 ci) 6. in Address: 530 Al •c /),Ji- city: N • if/ *7/ � �. State: di Qualifier Name: 'et .t.a. ,3-z zip: 331 Phone#: 6114...f./.2.04 £ 6 f• State Certification or Registration #: i le 13 DI ' ' 9/ Certificate of Competency #: Contact Phone #: (303 jai-494654,4 Email Address: �� 6 DESIGNER: Architect/Engineer: Phon Value of Work for this Permit: $ / - Type of Work: Address ❑Alteration Description of Work: g O D Square/Linear Footage of Work: ❑New 3ittepair/Replace C. a e44- C Byre t e guy , /aim?. .Q. ❑Demolition ***************************************Fees******************* * * * * * ** * ** * * ** * * * * * * ** ** Submittal Fee $ Permit Fee $ /'0'0 P a'' C% CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Conipariy'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 AFIi'II)AVIT: 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 ap! v:d and a reinspection fee will be charged. Signature Owner or Agent The foregoing � intr instrument was acknowledged before me this ng day of . , 20 11 by Frac b K \1 k who is personally known to me or who has produced %� NbeY S `I CC -If _ As identification and who did take an oath. NOTARY PUBLIC: Signature The f, : , day of Cwho is • • instrument w ac , 20 1 , by e sona y known to me or who has produced 20ils identification and who did take an oath. NOTA' 'P,UBLIC• , *A v £ , P I I r �� ti �eb1 Sign: .1.1JAA. ,. ,�1L•,SiiC`i ?`, `1 e. sprint : ��� N1.• O, i\ < �, My Commission Expires0 .•• , ,G�4v'6' G,e • NOua� ***************** *******Irk**sk+k*** & *********** My Commission Expires: Irv/ P02_, Plans Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) Clerk