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ELC-12-967Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NSP- 174145 Scheduled Inspection Date: June 11, 2012 Inspector: Devaney, Michael Permit Number: ELC -5 -12 -967 Owner: Job Address: 9031 -65 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: JW BERRY SIGNS Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)779 -8040 Parcel Number 1132060110051 -31 Phone: (352)728 -1119 Building Department Comments CHANNEL LETTER HOOK TO EXISTING ELECTRICAL Passed m Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 08, 2012 For Inspections please call: (305)762 -4949 Page 16 of 28 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. . (2_ Master Permit No.S N3 BUILDING PERMIT APPLICATION FBC 20 :RECEIVED MAY 5 12 Permit Type: Electrical OWNER: Name /.� (Fee Simple Titleholder): ��' C!�% /� /bflSL`P�ione#: ,'&— 3 7- f te: - zip: 3 3 t (a / >'°_ //t //I y - L a�� ew Phone#: 3 S -5 Address: City: Tenant/Lessee Name: /i2(' /4 "a - Email: I'm Aleal c2S4a9a TT /1, 7 4 JOB ADDRESS: " (b L0q " [ 0 e [ (3 t 5C 2 tJ. f► e el Lj ct City: Miami Shores County: Miami Dade Zip: 33t3$' Folio/Parcel #: / / - i , O - f7 // - o a 77) Is the Building Historically Designated: Yes NO e/ Flood Zone: CONTRACTOR: Company Name:J/J rr y 5! U $ Address: q file4, ,0 EJC 9Q j 0 6 City: 1,. tS44.r,e a State: i Qualifier Name: i,./ oc_r State Certification or Registration #: ES / abto 36 7 Contact Phone#: ; - ?c 5— / /1 Email Address: DESIGNER: Architect/Engineer: Phone#: 31'.2-7,;/ "/9 Zip: , iL7 S1q Phone#:,352- 2 2 /// Certificate of Competency #: Phone#: Value of Work for this Permit: $ ©. ed Square/Linear Footage of Work: Type of Work: ❑Address Description of Work: e1ee7(e_1 Cr DAlteration atNEw ORepair/Replace ❑Demolition *************************************** F************* * *** * ** ** * ** ** ****w**** * * * ** * ** Submittal Fee $ Permit Fee $ 7I ®P'2 Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ DBPR $ Technology Fee $ CO /CC $ Bond $ TOTAL FEE NOW DUE $ I / d Bonding Company's Name (if applicable) NIA 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 broc - "w l be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of com r cement ust be at the job site -'' for the first inspection which occ -'s seven (7) days after the building permit is issued. r� the abs ce s 'such p.' ted no, •e, the inspection will not be a and a reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this 2. day of NUJ l 20 II, by aliam lahcANI- who impersonally known 10 me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: actLa L„ of+17, My Commission Expires: * * * * * * * * * * * * * * * * * * ** APPROVED BY Notary Public State of Florida Jacqueline Ortiz ar p tires 04/16/2010 for The forego' _ ,:'strument was knowledged before me this f day of .,1: [ , 21 > by 0 /e,f , J who e �, • +me or who has produced P as identification and who did take an oath. NOTARY P IC: Sign: Print: My Commission Expires: 0 ajf eg,l2. Zoning RA (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Plans Examiner Structural Review VALERIE A. TEICHMANN NOTARY PUBLIC STATE OF FLORIDA galligiAAMMO Expires 1/27/2018 Clerk