EL-11-1702Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 168113 Permit Number: EL -9 -11 -1702
Scheduled Inspection Date: December 22, 2011
Inspector: Devaney, Michael
Owner: GRATEROL, RAFAEL
Job Address: 240 NE 99 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1132060134330
Phone: (786)331 -3967
Building Department Comments
BURGLAR ALARM INSTALLATION
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
December 21, 2011
For Inspections please call: (305)762 -4949
Page 21 of 25
VR1(817
BUILDING
PERMIT APPLICATION
FBC 2004
Miami Shores Village
Building Department
>0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
sEP 1 9 2011
Permit No. 6 11-11(9dN
Master Permit No.
Permit Type: Electrical ^�
Owner's Name (Fee Simple Titleholder) ove C- S � � �� <_ Phone # St 1 — 1 7"" 5 ■ 37
Owner's Address Q(it) N17
City 1WI1►a,:— State �L
Tenant/Lessee Name
Zip 33136
Phone #
E -MAIL: Q
Job Address (where the work is being done) c2�o N G ' q
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # 1 ' 3 a 6 { -6_13:433 0
Is Building Historically Designated YES NO
Contractor's Company Name
17.E
Contractor's Address
City
Qualifier Name
1111 A _
State Zip -5c�--S
Zip 1
Phone # (4 — 4.Q (Q 5b6 1
State Certificate or Registration No. (....„"FeD
Phone #
Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit c279
Type of Work: ❑Addition
Describe Work:
1•lteration
Square / Linear Footage Of Work:
0 Repair /Replace ❑ Demolition
['New
4cx xxxxxxxx**
Submittal Fee $
xxxxxxxxxxxxxxxa '�Fee$xxxxxxxxxx xxu xxxxxxxxx** ****�4xxxxxxx�cxxxxxx
Permit Fee $
CCF$
Notary $ Training /Education Fee $
Scanning $ Radon $ DPBR $
Bond $ Code Enforcement $
Structural Review. $
CO /CC
Technology Fee $
Zoning $
Double Fee $
Total Fee Now Due $
See Reverse side -+
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: 1 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 eondition 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 he approved and a reinspection•fee will be charged.
Owner or Agent
The foregoing instrument was acknowledged before me this 15 The foregoing instrument was acknowledged 4edged before me this 1
day of 5 eQ� , 20 11 , by 0 , day of ��:.,/ , 20 if, by Oeo Q J4AQ L v .I
who is . o me or who has produced
Signature
C ntractor
who is personally known to me or who has produced
As identifi a io
NOTARY PUBLIC:
d'd
a
e
■Mtv°04, Notary Public State of Florida
Mark A Rosengarten
4+� 1 My Commission EE093461
"Io a Expires 05/12/2015
ersonally known
as ide
NOTARY PUBLI
Sign: g Sign:
Print: Print:
My Commission Expires:
,; IADAM M. RAMREZ
• �: tit MY COMMISSION 9 EE 091724
/ I• EXPIRES: May 92018 •
• ,fir Bonded Thu Notary Public Underwriters
4 L_ . 'ff'
My Commission Expires:
xxxxxxx xxxxWWWWWXXWXXY. xxxxlXY. Y. Y. xxxxr.xrxx xxrxxxxxx WRxxxxxxx3xxxx*** isxxx: Ficxiexxxxie4rwicicak zicxxxxxxxxxxxxxxx>Fxxxxx
APPLICATION APPROVED BY:
(Revised 02/08/06)
/9 S &'/ e711' //
Plans Examiner
Engineer
Zoning