EL-05-1413Inspection Date: 08/30/2007
Inspector: Devaney, Michael
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL On c 140
Phone: (305)795 -2204 Fax: (305)756 -8972 NL, •
Owner: LUDICKE, ROBERT & ALLISON
Job Address: 999913 Avenue NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: RUSSELL THOMAS ELECTRIC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)754 -2903
Parcel Number 1132050090460
Lot:
Phone: 954 -894 -2900
Building Department Comments
ADDITION
11°°
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Inspector Comments
g:// 0 / \e 1-ex
6)/2 tit e
Wednesday, August 29, 2007
Page 2 of 2
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
`:it�i~S�i13r:
Inspection Date: 08/30/2007
Inspector: Devaney, Michael
Owner: LUDICKE, ROBERT & ALLISON
Job Address: 999913 Avenue NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: RUSSELL THOMAS ELECTRIC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)754 -2903
rce mber 1132050090460
Phone: 954- 894 -2900
Buildin . De • artment Comments
ADDITION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING MCA MEVIE1M Permit No. 106 1 toe)
PERMI
FBC 2004
Y: ..... S
Permit Type (circle): Building Electrica Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder)
Owner's Address 9S
City 2SState
Tenant/Lessee Name
•
Phone # (c,--.599 �O
Job Address (where the work is being done)
Zip R
Phone #
9'9c 9 N E. t1 e.
City Miami Shores Village County Miami -Dade Zip 33132
FOLIO / PARCEL #
Is Building Historically Designated YES NO g
Contractor's Company Name k" V1.0 ry Phone # 95''{— 87(-1—,7-9 00
Contractor's Address ,s- t-
City Ha ar woad State f Zip .33 0
Qualifier Name i ci.SsG j c la 1 tA.S¢ay".._ Phone # 9147(1-. 414.—. -9 `O
State Certificate or Registration No. Certificate of Competency No. ,. C. —0C O `3 t '7
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ � 6 Square / Linear Footage Of Work:
Type of Work:
Describe Work:
Addition
❑Alteration
❑New
r.d
❑ Repair/Replace
"Pa irve.
❑ Demolition
******** ** *** * ** * * * * * ** *** * * * * * * * ** * * ** Fees************** * *** ** *** ** * * ** ** * *,* * **** * * * **
Submittal Fee $ Permit Fee $ CCF $ G' CO /CC
Notary $ Training/Education Fee $ igM Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 4l -05
See Reverse side
SEP14PID
CX 6(
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 reins section fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
e
day of { (A- , 20Ot, by P\,\ %son Lut,J �cL
who is personall y known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Signature
Contractor
The foregoing instrument was acknowledged before me this911
day of ff Ay , 20 04:4 by
who is personally known to me or who has produced
as identification and who did take an oath.
• A . L
NOTARY PUBLIC:
Sign:
Print:
elk
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY.
(Revised 02/08/06)
MY COMMISSION # DD 431489
• EXPIRES: November 12, 2007
My Commission Expir
* * * * * * * * * * * * * ** * * * * **
JANET L BAKER
•ta4 MY COMMISSION # DO 431489
*fAIAI t20,r
esteem Way Public Undonvrirers
Plans Examiner
Engineer
Zoning