EL-11-925Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 166974
Permit Number: EL -5 -11 -925
Scheduled Inspection Date: April 17, 2012
Inspector: Devaney, Michael
Owner: SOTELO, JULIA
Job Address: 114 NE 108 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number (305)308 -6031
Parcel Number 1121360090070
Phone: (786)331 -3967
Building Department Comments
INSTALLATION OF BURGLAR ALARM 1 USTR AND 15
DEVICES
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 163489. CREATED AS
REINSPECTION FOR INSP- 163315. No one home .
No one home at 3:36 P. M..
April 16, 2012
For Inspections please call: (305)762 -4949
Page 2 of 21
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. LI
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical
l coRria575
MAY 2011
Master Permit No.
Phone#: - 120 2-14 LIZCI
Zip: Za ILO /
OWNER: 4
Name (Fee Simple Titleholder): rr‘k-,\ � v
Address: 114
� � 9,
City: t l P� u)t rj State:
Tenant/Lessee Name:
Email: . FYi �j ��� (� tft
1 -
Phone#:
JOB ADDRESS: I Q'4
City:
Miami Shores
Folio/Parcel #: ((- 2(3(0 —OCCI - 007O
County: Miami Dade
Zip: C
Is the Building Historically Designated: Yes NO
\4.
CONTRACTOR: Company Name: ADT SECURITY SERVICES
Address: 10785 MARKS WAY
MIRAMAR, FL 33025
City: // State:
Qualifier Name: G -c.rce
State Certification or Registration #: t— 00011-1
Contact Phone#: A-rac e. t i S Email Address:
DESIGNER: Architect/Engineer: Phone#:
Flood Zone: i-10
Phone#: q .q -5057
Zip:
Phone #: QSq •a-G242 - 56(04 Certificate of Competency #:
Value of Work for this Permit: $ Z 55. 00/ Square/Linear Footage of Work:
Type of Work: ❑Address Erkteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: t ''' sf 4 (c t lP Y)ta- 9 to 1- o -(a4r-en I L.I5VV- (5 d w
+ s* ******* ** ************w*n•**** ********* Fees** * * ** * ** ********* * ***** * ********x *** *a+s****
Submittal Fee $ Permit Fee $ re G' # e."°
Ss nine Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
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
Signature
or Agent C6ntractor
The foregoing instrument was acknowledged before me this UP The fo 'mg instrument was acknowledged before me this l
day of , 20 , _, by _ L_ =� n
= - - day of Y'I4 , 20 IL, by &'1 - ' 0)
who is personally known
NOTARY PUBLIC:
My Commission Expires:
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:-'��" l"
Print: 13 o-1100-e0- Cerv-
My Commission Expires"--..
es/ Notary Public State of Floes
1,4 r; Harbara orzo
e lUty r: �m +fission DD775417
* * *** ************* *** ** x****** * *** **** ***** **** * * **** ******s• **** * *** x***********+>< *WWW D ***
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APPROVED BY , � �e AraV Plans Examiner Zoning
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk