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EL-12-1123Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 MC- 12-- 1122- Inspection Number: INSP - 174973 Permit Number: EL -6 -12 -1123 Scheduled Inspection Date: June 27, 2012 Inspector: Devaney, Michael Owner: MONTERO, ANGELICA Job Address: 9338 NW 2 Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: DONE WRIGHT A/C & ELECTRIC SERVICE INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010150280 Phone: (305)986 -5506 Building Department Comments INSTALL POWER SUPPLY FOR NEW CENTRAL A/C SYSTEM Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Z ‘,/C`. 2 /2- June 26, 2012 For Inspections please call: (305)762 -4949 Page 21 of 36 BUILDING 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 FBC20 J Jtd Permit No. � t 2. )1Z'6 PERMIT APPLICATION Master Permit No. Permit Type: Electrical JOB ADDRESS: Ct 33 4 City: Miami Shores Folio/Parcel#: County: Miami Dade Zip: Is the Building Historically Designated: Yes NO Flood Zone: OWNER :. Name (Fee Simple Titleholder): " i_Phone#:I � -5-6 ' Address: 13 I aLu> DAid _ City: Ii At-kr SkAoce SAO g State: Zip: -) j liS C Tenant/Lessee Name: Phone#: Email: ( irdiv (04o 4l . c ow CONTRACTOR: Company Name: D b'rv:_ W1Q�-4 / C- 1 s.`e- SP-4=#: 305..27 e ° �X a I ' Address: °, '1l R S 5 a-- g.tA 9. L� P 111 �� City: U�b: ct l/vt. i State: ri Zip: 33 / ? % Qualifier Name: 4 u ■ i d Wrri0 L• ,— Phone#: 2 OS- ?2,4,, 5s C 4e State Certification or Registration #: a G / 3OC) ti 3 / Certificate of Competency #: Contact Phone#: 30s. l8C4 • s"6- Email Address:�W.r + Jk- 5'_-4 ". 1 1j &fr DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 1, 0 ®CD Sf� ear Footage of Work: Type of Work: OAddress DAlteration eCi1V ORepair/Replace []Demolition Descri do of Work: � II s°tl c /( � t' e•,,r .� 6 t.®® e,0 l �0 �� ry s *********** ***: x*** *** * *****************F *** ************** ** * ********************+x*** Submittal Fee $ Permit Fee $ /i �/ ®� CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ t Lv 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, WET IS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S A}kIDAVIT: 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 '}' Owner or Agent The fore ring instrument was acknowledged before me this q` day of Jl try , 20 ) l , by kity,lt CA I AttiVi -e rr6 , who is personally known to me or who has produced I) Craeel identification and who did take an oath. NOTARY PUBLIC: Sign: 1 /l4,44?,i, _ Print: Pr1S C t (la IN V, 6417)398:0153, Fb1dallotarySevice.com My Commission Expires: `i -1 b ' 2., Contract The foregoing instrument was acknowledged before me this i 1AFL day of Gts°t _ , 2012 , by who is rsonally knowito me or who has produced as identEicaORci VFISeLhe x.gXAN©ER NOTARY PUBLIC:;*: : *c MY COMMISSION # DD823070 EXPIR ; eptember 15, 2012 Flo '•d; NotaryService.com (407) . j . Sign: 1 � %% Print: te.1sc !Ld/ ;:r th(Atr My Commission Expires: c1-15 -,2611, **> k. x*********** *>x**** ***** * ***** k> x**> x**• x*> k> x********> r: **>x>x>k*>x********** **** x****> k*> k***=x******* * *** * ******* **** APPROVED BY - ' - 074" 12 Plans Examiner Zoning Structural Review (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk