EL-12-1609Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
RC- 12 -P488
Inspection Number: INSP- 180106 Permit Number: EL -8 -12 -1609
Scheduled Inspection Date: October 17, 2012
Inspector: Devaney, Michael
Owner: MCFADDEN, DANIEL
Job Address: 9280 NE 12 Avenue
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)762 -6519
Parcel Number 1132050070172
Phone: (305) 551 -4043
Building Department Comments
REMOVE AND REPLACE TWO FRONT LIGHT FIXTURES.
Reinstall OUTLET AND LOW VOLTAGE DOOR BELL.
Infractilo Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
October 16, 2012
For Inspections please call: (305)762 -4949
Page 17 of 18
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
Permit Type: Electrical
JOB ADDRESS: 6 � Pe D.—�
City: Miami hores County:
Folio/Parcel #: 2-QS-
Is the Building Historically Designated: Yes NO Flood Zone:
RECEIVED-
AUG 2 317..
FBC 20,E
Permit No. EL-12 — i ( 061
Master Permit No. 2I I LI V°
Miami Dade
Zip: s3I3�
OWNER: Name (Fe
Address: C.
Simple Titleholde ): 1-\4•3(6-1.— .. t1 " `c.(4O Phone#:
3 j 3
City: State: Zip:
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name:
Address: C d" 2-€)
City: 0 State:
Qualifier Name: ■ckSCO __ Phone #:
State Certification or Registration #: EC- /30017/11' 5706 YC) Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
S CLEr-v-1L
Phone #:
Zip:
Value of Work for this hermit: $� t Square/Linear Footage of Work: - "l� 45 M /`
Type of Work: OAddress OAlteration ONew ORepair/Replace UDemolition
Description of Work: 1,. f'i V� ( ? 14 C 'j— W ()_(_:r( A i Its 5 k F ) ' b 1hr ✓f 5 I`e "'1p U .
Ct. dt,� rtivt,sfej Co IA.Vevta CACe- C, of t �,1" 1 Q$ k W 11'x.. A) Cwl s to cc-a) t c
cl,vvCt (e-Pikce 4>d li i �'5 t' 1000r ge.l! , y�e r'& vC, .Xcstiv.5 /ow Vv [ift.St tvt av
Src��cer�LJco>t1-e4c ,-- to Cruse ve kcte_hyot s.
* * * * * * * *, * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees ******** * * * ***** **** ***** * *�•:x�x *x�x�x��x�u** *****
Submittal Fee $ _ . . / F . ; Fee $ �� a"‘'' J CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ S - 10
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 thc 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 AI killAVIT: 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 ftot be apprfaved rnd a reinspection ;e e charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
20 (Irby N i tic/7-
dayo
who is personally known to me or who has produced iL ! (7
As identification and N11Hrdt,» oath.
,
NOTARY PUBLIC:
.ai'_
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * *,- * **
APPROVED BY
* * * * * * * * * * * * * * * * * * * * * * * * **
Contractor
The foregoing instrument was acknowledged before me this"
day of C� , 20 ) Z by fil#S) (0 P iz'L
who is personall known to me or who has produced D. 4
yi' ?1 as identification and who did take an oath.
NOTARY PUBLIC:
******** *************** *** * ***** * * * ** ***** ** * * ** ******
, i(
Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk