EL-11-1729Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 171423 Permit Number: EL -9 -11 -1729
Scheduled Inspection Date: March 26, 2012
Inspector: Devaney, Michael
Owner: NEWMARK, ADAM & JESICCA
Job Address: 355 NE 93 Street
Miami Shores, FL 33138 -2854
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1132060136290
Phone: (786)331 -3967
Building Department Comments
BURGLAR ALARM SYSTEM INSTALLATION
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
please make it your last stop. Home owner will be home after 6:00 p.m
/7-
March 23, 2012
For Inspections please call: (305)762 -4949
Page 26 of 37
Miami Shores Village #62,1—
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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
Address: �%+ g' V3 - City: djA/721 State: Zipj-'
Tenant/Lessee Name: Phone #: •
Email:
1
Permit No.E
Master Permit No.
)U44% Phone#:
JOB ADDRESS: 3537 ✓7 c` /
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: / —6/3 6,2-9O
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
Address: i/D *2 1_5" (a
City: // State: e Zip; 3? 4
Qualifier Name: C/.e,D //z % A Phone # %�. )�� 3�/
State Certificatio or Regi trration #: 4 (0407/fjZ� Certificate of Competency #:
Contact Phone 9J 2p,6 57/ 1 Email Address: aretiaJiQ- a . °
DESIGNER: Architect/Engineer: Phone #:
NO Flood Zone:
Phon #: .S
Value of Work for this Permit: $ /OD ` 4- Square/Linear Footage of Work:
Type of Work: ❑Address OA ration New OR ODe olition
��? ��
Description of Work: ( /) • y - e 40 l C �j� /4-,,,,, /0,14 /2
***** * ** ** * ****** * ***** ****** ***mm** qua:* Feeo************ *o *** ** * ******* * *** **** **** * * **
Submittal Fee $ Permit Fee $ ����� �' 4' CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE
mint
Bonding Company's Name (if applicable)
Bonding Company's Address
City " State Zip
Mortgage Lender Name (if applicable)
Mortgage Lender's Address
City to Zip
Application is hereby made to ob. :'n a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance o permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I unders d 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 reinppection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this p The forego ;. g ins
day o, 20 C
, by c.7:-taGfZvcr_l AL, day of . /.l
who is personally known to me or who has produced l 41
! dr&b czA OAs identification and who did take an oath.
NOTARY PUBLIC: 41 ®�` 4�
Signatu
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•
Si
Print: •••.
My Commission ExpiresyS , fM5�,,,
•
*=k=k=k*nksg9k'knkDk**: ***
APPROVED BY
Contractor .
ent was acknowledged before me this '
,20!►,by
who is personally known to me or who has producedd"O"7
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
. //l !1rgirwr —
�ji7f il:cw� ! ,;
My Commission Ex
1.
20
% Notary Public - State of Florida
My Comm. Expires Jul 26, 2015
Commission # EE 106656
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Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk