ELC-12-181Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 169515 Permit Number: ELC -2 -12 -181
Scheduled Inspection Date: April 04, 2012 Permit Type: Electrical - Commercial
Inspection Type: Final
Owner: , SHORES SQUARE INVESTMENTS Work Classification: Sign
Job Address: 9005 BISCAYNE Boulevard
Miami Shores, FL 33138-
Inspector: Devaney, Michael
Project: <NONE>
Contractor: ATLAS SIGNS OF LAKE WORTH INC
Phone Number
Parcel Number 1132060110060
Phone: (561)863 -6659
Building Department Comments
FINAL ELECTRICAL CONNECTION
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
/// /7/z- z/
April 03, 2012
For Inspections please call: (305)762 -4949
Page 6 of 22
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 LES
P ermit No. G1Ls S
BUILDING
PERMIT APPLICATION
FBC 20
U
BY:
Master Permit No. I 412,4
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): Waite fatinn( / /'t1f7?7 "1f GGL Phone#:
Address: ►Q 1P0 3"
City: /Z /AM/ State: FL Zip: •71/PI
T e n a n t / L e s s e e N a m e : T b ° l , t l r 4 l : l � . Phone#: 6 1 5 L - 1 ' ' . 6 / - 3 " - 5 0 4
Email:
JOB ADDRESS: /00l 811 C A PT ALUM
City: Miami Shores County: Miami Dade Zip: 3,? / y�
Folio/Parcel#: 11 ° c.)& - 0 ( 00 &(,
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: Mk! 116/1/ 10 Mif TR/CJ Phone#: SG / `/J'
Address: / 077 k 677 13 Lb 1 I" Weito/ 8110
City: pn/hT y PALA lint,/ state: FL zip: 3,75/07
Qualifier Name: )(P/7 y /t o j4'& F F Phone#: d6) °
State Certification or Registration #: EJ aop° 20y Certificate of Competency #:
Contact Phone#: 5f61- 1.67 - 6 6ry Email Address: ()CNA, n AWAY' (Hi't/f71 /t'l. UJ
DESIGNER: Architect/Engineer. MeV Don C /c ANL,f Phone#: 36 /• 70- Gds
Value of Work for this Permit: $ � t» - Square/Llnear Footage of Work:
Type of Work: DAddress CIAltiration Tew ORepair/Replace ODemolition
Description of Work: Ej CcArs C. F co"
* * ***** ********* * * * ***a * * *a * * ***** * **p *** ******* ** ** say****e,a****+wn*** * * ******a,****
Submittal Fee $ Permit Fee $ / eo ee ®O CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Doable Fee $ Structural Review $
TOTAL FEE NOW DUE $ 5U'(00
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
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.
The
day
who 's personally known to meep who has produced
As identification and who did take an oath.
NO
Si
"'•' SHANDA SUTTON
LAYNE
' *= MY OMMISSION 9 DD 967415
is PIKES: A P ril 4, 2014
• ' `/' . rd Thru N.. •
y Commission Expires:
* * * ** * *** * **** * * **
APPROVED BY
Co actor
The forego in instrument was acknowledged before me this i
day of le"ev-- , 20 (1-,-by ' l jigt C�
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
•
Sign:
Print• --�b
My Commission Expires:
* * *** *** * * ** ** ** *e * * * * *e * * *e * * *eeeee
c5 /2_
Plans Examiner
Structural Review
(Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15109)
DUSTY R. SMITH
STATE OF FLORIDA
Comm# EE063019
giriomm or2Siget8
Zoning
Clerk