EL-12-84Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 168930 Permit Number: EL- 1 -12 -84
Scheduled Inspection Date: April 17, 2012
Inspector: Devaney, Michael
Owner: ALVAREZ, LAZARO
Job Address: 372 NE 98 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060135680
Phone: (786)331 -3967
Building Department Comments
BURGLAR ALARM SYSTEM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
April 16, 2012
For Inspections please call: (305)762 -4949
Page 4 of 21
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
44 %1 Tel: (305) 795.2204 Fax: (305) 756.8972
X33 .7, INSPECTION'S PHONE NUMBER: (305). 762.4949
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 20
JAN 1 {=;;::2
11 1
B Y:
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) O' v'k C WWI On Phone # �j 3(1 41551 4'
Owner's Address J
City�61Y►�1`1 ,\N(21-&S State C-L
Zip 1? 1346
Tenant/Lessee Name Phone #
Email C\i\L' s eex 1� aI -e_ & yotkoo . ccoll
Job Address (where the work is being done) %A /() e g iz,
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # 1 I 1 3.. 6 1_,S
Zip `3313e
Is Building Historically Designated YES NO ✓
Contractor's Company Name 1414.51 Sec, Sef ✓1 Ced
Contractor's Address `'1 6 PY\a' K. S t,.1
City Mt r&nnor State Z i p 1N' 25 -
Q u a l i fi e r Name el - N j l r) ,e1 L ; Phone #
State Certificate or Registration No. t "Ca It, t I
LC
Contact Phone LUL-1 01 E -mail LLCc .r4er' a a —4- . CL
i ,
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 1 °I oi
Type of Work: ❑Addition QA teration :New
❑ Repair/Replace
Describe Work: But reel' Ci A farm 664,5 444n
Flood Zone
Phone # Q'Stoj 24.0 /141" A
Certificate of Competency No.
Square / Linear Footage Of Work:
❑ Demolition
* *,, * * * ** * * * * * * * * * * * * * * *** * * *** * *** * ** Fees** * * * *** * * * * * * * * * * * * * * ** * * *** * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $
Notary $
Training/Education Fee $
CCF $ CO /CC $
Scanning $ Radon $ DPBR $
Double Fee $ Violation date:
Structural Review. $
Technology Fee $
Bond $
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: 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 of %e app oved n ' a r -- inspection fee will be charged.
Signature
1 1 ( �
1 . .. . .
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 / (, by C/( 1 6' ( 'OF2 44/
who is personally known to me or who has produced
A ; (t;y� k : + ,r; }: —�� • th as identification and who did take an oath.
NOTARY ' IC: �•y , • X44' ,,,
9 2o4i,\'A ��.
viC�O
BOD �? 6 •
p ig THRNDEOUW4 (n 0
NOTARY PUBLIC ; R'
t.UNDERWRITER.. O:
. A ••FE 13961•
d •
Signature
The foregoing instrument was acknowledged before me this
day of De C , 201_1, by _ G € 11 of
who is kno�n to me or who has produced
Sign:
Print:
My Commission Expires:
APPROVED BY
Sign:
Print:
(ATHA
My Commission Expires:
Plans Examiner Zoning
Engineer Clerk checked
(Revised 07 /10 /07)(Revised 06/10/2009)