EL-12-1064Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 174698 Permit Number: EL -6 -12 -1064
Scheduled Inspection Date: June 28, 2012
Inspector: Devaney, Michael
Owner: PERRY, ROXANNE
Job Address: 868 NE 100 Street
Miami Shores, FL
Project: <NONE>
Contractor: WIREMASTERS ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Repair
Phone Number
Parcel Number 1132060340020
Phone: (305)378 -4011
Building Department Comments
METER REPAIR
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
7,/,'„/L --z.c97-
June 27, 2012
For Inspections please call: (305)762 -4949
Page 13 of 24
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
6\ ,31.111z,,_ o ���1 INSPECTION'S PHONE NUMBER: (305) 762.4949
BUIL ING
PERMIT APPLICATION
FBC20
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): Ok..eu- r ep,r -rt Phone #: (3()) \
1 S 1- a 9 1
Address: (c N1 r---, I dT Sky-,0 -Q j
City: i C1011 j State: f= L Zip: 5 .51�
Tenant/Lessee Name: Phone #:
RECEIVED
JUN 112012
BY: ZSA
Permit No. -`"" 1
Master Permit No. 1
Email: rrNe_ai- \ r-F' Y ()Lt. I - c 17111
JOB ADDRESS: i.pc'0 Me lb n
City: Miami Shores County: Miami Dade Zip: 53 1 3g
Folio/Parcel #: 11 — ,-.1',Dl,9 -6,3L1-- Or)...-C)
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: l..016"-.2-4-Y-111 £ e_c_t i C., I nC. Phone #: COS")3. g ` 4- b 1 1
Address: t 1 0 t S u. 1 gr C_61.1 ►— D SL& i 1 (D :
City: Li( State: lv ;.._ Zip: ° . 3 3'r
Qualifier Name: jC rk Ca TIM tL Phone#: (30S) 3D.1 —T0? ca"-
State Certification or Registration #: l 30b (-1-L, 9 J Certificate of Competency #:
Contact Phone #: � ) 3°`�g— 4-1 t Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ if 7 VS' ell' Square/Linear Footage of Work:
Type of Work: Address ❑Alteration ❑New 1epair/Replace ❑Demolition
Description of Work: A14346, /ern f.
*****m**** a:**** **+x**+x**************a *** Fees: ** ***************** * *** x * *****+x*****+x******
Submittal Fee $ t i Permit Fee $ f� '!a G CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Owner or Agent
The foregoing instrument was acknowledged before me this 31
day of 20 , by Plbxa -r,np . arn ,
who is person y known to me or who has produced
(� o lob o
4'I� .Mr1 J� -a" As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
/_ 11 a#
. P 7f.k
r4i3;,lt::; ,
(40 398-015 FbridallolaryService.coni
Dot•.
XPIRES July 09, 2012
Signature
Contractor
The foregoing instrument was acknowledged before me this 31
20 9, by T L,.
to me or who has produced
as identification and who did take an oath.
day of
who is p
NOTARY PUBLIC:
Sign:
Print:
My Commission Expire
rdeli
•
(407) 398-0153
ER
ISSION # DD804790
EXPIRES July 09, 2012
FloridallotarySer ice.conr
********* ************ BsR+ k******* ********** ******* ****** *+N***** **********shah ** ** ******** ** *** *shah* ***$*
APPROVED BY
1 /7 reeeP Flans ans
Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk