EL-12-901'T �
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
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Inspection Number: INSP - 173985 Permit Number: EL -5 -12 -901
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Scheduled Inspection Date: May 24, 2012
Inspector: Devaney, Michael
Owner: RHODES, LISA
Job Address: 1341 NE 103 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: METRO ELECTRIC SERVICE INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132050300140
Phone: 305 - 945 -1991
Building Department Comments
CABLE TV AND PHONE LOW VOLTAGE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
<1 fro /7 /v
May 23, 2012
For Inspections please call: (305)762 -4949
Page 26 of 33
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
BUILDING
PERMIT APPLICATION
FBC 20
SEP 1 5 2011
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): L1p -J '&.5 Phone #:
Address: (34,l NE 193 s+'e.4.4
City: 140Ct S-6 reS State: F(.- Zip: 33 c3 % Name: Phone #:
Email:
JOB ADDRESS: ? 3 L B A t b 3 i e•e.` -
City: Miami Shores County: Miami Dade
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
zip: 33 ► 3 $
CONTRACTOR: Company Name: f tvo �' `'e L�l I C.. Set,/
Address: 1.57)S13 AJE
City: N��,1 gVhV State: FL
Qualifier Name: bb I4 6 cis garr9p/
State Certification or Registration #: E 6'' ®38.5
Contact Phone #: 2t1S° c cat's ®Q 0
Phone #:
Zip: 33 (8
Phone #: or–P 2— ,
Certificate of Competency #:
Email Address: i w h' 0. a I .eC.j-f't G 6 hem u (• ($ tin
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 3, 00
Type of Work: Address Q' ❑AlteratiolIn--
Description of Work: i t j h T'
r j� ► }-�1
Square/Linear Footage of Work:
New affepair/Replace
b�- ) end
1$oosf•
ODemolition
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******** * * * * * * * * * * * * * * * * * * ** * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * ** * * * * * * * **
Submittal Fee $ Permit Fee $ 7.0717;5–& CCF $
Scanning Fee $ Radon Fee $ DBPR $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
CO /CC $
Bond $
TOTAL FEE NOW DUE
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Bonding C mpany'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 MR 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) drays 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 � ' ,A— A°
Owner or Agent
The foregoing instrument was acknowledged before me this 2-� The foregoing instrument was acknowledged before me this 13
day of '201,by
who is ersonally known to me or who has produced w
As identification and who did take an oath.
NOTARY PUBLIC:
, 20 11 , by tO &W(,
r who has produced
'cation and who did take an oath.
`Sign:
P
My �,�v�i " �•mmission Expires: "''• Joubert Pierre
,,;; `Commission #DD783726
\,,,,,„ Expires: APR. 29, 2012
BONDED TIIIW ATLANTIC 1101011+0 6o., INC,,
* * * * * * * * * * * * * * * * * *, -:., * * * * * * * * * * * ** . * *** * *** ** * ** ***** ****** **+ s*** ******* *+ x*************** ** *s<******* ***mix*
APPROVED BY
0/' Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk