EL-09-618v
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 111531 Permit Number: EL -4 -09 -618
Scheduled Inspection Date: July 11, 2011
Inspector: Devaney, Michael
Owner: COOK, MARIANNE
Job Address: 360 NE 105 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: EFJ ELECTRICAL CONTRACTOR
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360130020
Phone: (305)793 -3263
Building Department Comments
ELECTRICAL WORK FOR A BATHROOM REMODELING
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
I/
ee,//
July 08, 2011
For Inspections please call: (305)762 -4949
Page 2 of 32
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
APR 15 2009
BY: �--�
Permit No. fJ 09 -Ce l 0
Master Permit No. O 0 -' /02 V
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder) in R (J ALN) E Cco
3(,G NE !CS' 31'
Owner's Address
Phone # 3j0 5 -7S 7- S (G F
City (VI IA MI Sgok E S State 1 L
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done)
Zip 33(7
Phone #
3Co ,1e I05 51
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL # 1, -AO 6 -013- o� �G.G�" Pz /6- `f' 7 B1'1 ! 7
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address
City
Qualifier Name
7/44 Or,) 4 6-9"
State
rindC fir 3,e .t
305 °143 -3263
Zip
Phone #
33/ 3 -
400. �T j� ra —,52 4.3
No. eta
State Certificatteeyo -r. Registration No.ER .13 Q/ J/ �°' Certificate of Competency see)
E -MAIL: 61:„7 'clear ,e �Jjt4;ld`//.% ar
Architect /Engineer's Name (if applicable)
Value of Work For this Permit $
Type of Work:
Describe Work:
Phone #
Square / Linear Footage Of Work:
❑Addditioonn Iteration ['New ❑ Repair /Replace
1. I ,r+�d * 1 Z7'j4 /.�'i�2 +iris
Z oo S4\�-I,
0 Demolition
* * * * * * * * **xxxx x * * * * *** * * * * *xxxxx xxx* xxr. Fees xxx xxxxxxx*** * * *** *** * * * ** ** * *** * * * * * * * ** * **
Submittal Fee $ Permit Fee $ 2Z ••,!-`
Notary $ Training /Education Fee $ (.J Technology Fee $
Scanning 0 •� Radon $ 1 -SO DPBR $ (- �7V
Bond $ Code Enforcement $ Double Fee $
CCF$44QO
coicc
Zoning $
Structural Review. $ Total Fee Now Due $ c24410
See Reverse side -a
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
COM MENCEMENT."
Notice to Applicant: , 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 s section which occurs seven (7) days after the building permit is issued. In the absence of such osted notice, the
inspection will of be approved and a reinspeetion fee will be charged.
Signatu
Owner or Agent
Signa ell Js•crf
tractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 , by Mat t' "Q COOL_ , day of , 20 , by
who is personally known to me or who has produced Qj i..Fnrs who is personally known to me or who has produced br
( As identification and who did take an oath. L IestA&c as identification and who did take an oath.
NOT • ' Y PUBLIC:
Si
e,0RALLY
My Commission Expires: [l J l0
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires: llut�
L
s 'VP 4"
OF it
(007) 396.0153
DE. NNA I, 01,014
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APPLICATION APPROVED BY
(Revised 02 /08/06)
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Plans Examiner
Engineer
Zoning