EL-07-2507Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 01/02/2008
Inspector: Devaney, Michael
Owner: LANE, CRISTAL
Job Address: 1200 91 Terrace NE
Miami Shores Village, FL
Project: <NONE>
Contractor: PULSAR ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Underground Rough
Work Classification: Addition /Alteration
Block:
Phone Number (305)498 -9822
Parcel Number 1132050010490
Lot:
Phone: (954)394 -5827
Building Department Comments
KITCHEN REPAIR 6 PLUGS AND 1 WALL OVEN.
Ai 03 2000
Passed
Inspector Comments
CC
/61/2--
� °k
--P
L/ f�
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Friday, December 28, 2007
Page 2 of 2
vt \\ \ tiioi.
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
Permit Type: " Electrical
Owner's Name (Fee Simple Titleholder)
Owner's Address 1 O
City l tl I/ tate
Tenant/Lessee Name
E -MAIL:
pL'
Pr-fmc
.
Permit No. EL Th1. 1
aster Permit No.
Phone # 305 itex 7$22
Zip
Phone #
Job Address where the rk i being done) 12-0 0 N !i Ir7
City Miami Shores Village County Miami -Dadee Zip
FOLIO / PARCEL #
is
Is Building Historically Designated YES
•
Contractor's Company Name ,fAl2 :r tiP� Ci Phone # q�✓i f- 9 6•j$-
Contractors Address ,S
City SJ1AK State,, Zip 1,1!�
Qualifier Name al®'-10k1J ,� 1.30( 01.1 Phone #
154 306 6/0
State Certificate or Registration No. EIS, 0,,C6 rD23 Certif cat of Qpmpetency No..
E -MA[L:
Architect/Engineer's Name (if applicable)
Phone #
Value of Work For this Permit $ 7' " Square / Linear Footage Of Work:
Type of Work: ['Addition ['Alteration ❑New Repair/Replace
❑Demolition
Describe Work:
W Q G.L c&11_.
* x*** * * * * * * * * * * *xxxxxxxxx * * * * * * * * * ** **Fee$*****xt`:***** xrxxx 9exxaYxxxxxxxxxxx* aY*********
Submittal Fee $ Permit Fee $ /r'e'f
Notary $ 5-00 Training /Education Fee $ 0- (/
Scanning $ 5'c0
Radon $
DPBR $
CCF $ 040 CO /CC
Technology Fee $ a ,s
Zoning $
Bond $ Co for ement $ Double Fee $
Structural Review. $
DEC 272007
MIAMI SHORES VIL1Ar,
Total Fee Now Due $ k&7' SS
See Reverse side -*
01
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. 1 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: 1 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: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of e notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to #ttachnt. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspec on .. ch oci � s seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will n ' be R o oved 3 d a reinspection, fee will be charged.
Signature
0 'er or Agent
Contractor
The foregoing instrument was ackn ledged before me this The foregoing instrument was acknowledged before me this / 7-
day of 5e ; 20 pY aez÷{4
personally known to me or who has produced a who is personally known to me or who has produced DL. 0 Z 563
-1 S`c O1-/�As identification and who did take an nth. /q3-3f—/‘/-as identification and who did take an oath.
`p .q.6* gry�'ti NOT ' UBLIC:
p� 44 #,v$v im
4. * 41,..* �
• yo-_ o 4)
day of !. €1C , 20(a, byO
who i
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
rr. %xx.**** Yxr.*xx9eak****xakxxxxxxxx XX xxaYxxi,
APPLICATION APPROVED BY:
(Revised 02/08/06)
Sign:
Print:
My Commission Expires: ; 499
* xxx xxxxxxxxa: **xx* xxxxxx x x7Yxx ,**•******* ****** ***x*****
Mans Examiner
Engineer
Zoning