EL-12-268Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 170972
Permit Number: EL -2 -12 -268
Scheduled Inspection Date: March 12, 2012
Inspector: Devaney, Michael
Owner: ZAINAB, AHMED
Job Address: 335 NE 101 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: SAFE STREETS USA
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number (305)906 -0668
Parcel Number 1132060135211
Phone: (813)514 -2693
Building Department Comments
BURGLAR ALARM
Passed
E'
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
iteiti--A-2/
March 09, 2012
For Inspections please call: (305)762 -4949
Page 24 of 31
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FBC
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
Permit No. u 2-2
Master Permit No.
PPLICATION
Permit Type: Electrical
FEB 15 2012
OWNER: Name (Fee Simple Titleholder): A \ertGA ZO��rAb
Address: 33S N'E. \O \*
City: \Z■0.144_ C c c. S State:
Tenant/Lessee Name:
Email:
Phone #: 30S • R'O • Valo%
33\35•
Phone#: SOS • QOto • Ototo%
JOB ADDRESS: •S NE \Sr
City:. Miami Shores County: Miami Dade Zip: 33 \3S•
Folio/Parcel #: \ 1-0 to O \3'S a \ \
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: S0.R2 ce s. vS4:\ Phone #: S\3 • AO • C'l`t5
Address: \lo V3S t•\ • F\ O-.c O
City: State: S,SLia
Qualifier Name: VJh \ \\QMA. OAK- rea cCOCY Phone #: 9A3• SRO • al'VL5
State Certification or Registration #: 3000yDy Certificate of Competency #: ` -
ContactPhone #: cb\3.14t0 •crISS Email Address: `'�c`c10�\'�e \a( sk-gl •cowl.
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ \3IA .00
Type of Work: Address tEilteration
Description of Work: LOW NkOoAo.t
�'3 • Mollhor 1k • .• 4'ob 3 • I«. ;-`
• CAA tiv■. -Ir •fie•{ •
Square/Linear Footage of Work:
❑New ❑Repair/Replace
'$4.1cnl\cZ4 �A\aus Y\ t Q = �►e•►
❑Demolition
* * * ** ********* * * * * * * ** ************ * ***F * ********** ** *** ** **** x*** ******** * * ** x****
Submittal Fee $`� J Permit Fee $ /C " " f CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ _ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ U' ( )
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 FT ECTRICAL 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 ' reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 4P
day of '& , 201? -, by AV_
vv ,
who is personally known to me or who has produced
cc'S7 As identification and who did take an oath.
NOTARY PUBLIC:
Sign: `
Print: 'P-. ci�r�,tCc VhQ/C:"
My Commission Expires: \'N‘p\ZONS
RICHARD RIVERA
NOTARY PUBLIC
STATE OF FLORIDA
Comm# EE147031
Expires 11/1612015
* * * * * * * * * * * * * * **
APPROVED BY
Signature \ILL BLL L
The foregoing instrument wass acknowled before , ye thi
day of r69 , 21:11; by a nn
who is personally known to me or who has produced
as identificalqato wwiI ath.
NOTARY P
Sign
Print:
TARY PUBLIC
TE • FLORID
i 7298
v ,
My Commission Expires:
**********+x *** six *** **+ ************ ******+ x*********** ****• x****+ x******** ***************
e. z -
r�� Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk