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EL-12-1576Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 12--1 93 Inspection Number: INSP- 177614 Permit Number: EL -8 -12 -1576 Scheduled Inspection Date: October 11, 2012 Inspector: Devaney, Michael Owner: GROPPER, ADAM Job Address: 9901 NE 13 Avenue Miami Shores, FL Project: <NONE> Contractor: MOODY ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050090480 Phone: (305)758 -2000 Building Department Comments NEW 40 AMPS CIRCUIT AND 2 120 VOLTS 20 AMPS CIRCUITS FOR DOCK Passed v Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments October 10, 2012 For Inspections please call: (305)762-4949 Page 7 of 22 414-(Liq BUILDING PERMIT APPLICATION FBC 2010 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 AUG G _ i'5 G2 B' Permit No. [ 2 l(.0 Master Permit No.fiDOC4C 1 Z 1 I 110 Permit Type: Electrical OWNER: Name (Fee, Simple Titleholder): Adair) Gr®ff &r Address: /V e /3 /h) cut- s City: 1& 1AM gl o V s State: (L zip: 3g/3 k Tenant/Lessee Name: )1/4)/a Phone #: Email: Phone #: 505- -Qq(iq JOB ADDRESS: 6 Q City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO ' Flood Zone: CONTRACTOR: Company Name: f I £L,Eef JC-. 1 �.i� Phone #: 30s--15g- WOO Address: (O2 Mai Q w I City: (Yl) DM'i(V l 1 - ry� State: Zip: 33/S0 Qualifier Name: ib it A �1 / /(iQ� / Phone #: State Certification or Registration #: G ®tom 11479 Certificate of Competency #: �(�n IY1�r P�P� �c Contact Phone #: i� - %S8 -moo Email Address: e ' f T a c.Gp%v Phone #: DESIGNER: Architect/Engineer: N/A- Value of Work for this Permit: ` cc o Square/Linear Footage of Work: Type of Work: DAddress Description of Work: DAlteration ❑New DRepair/Replace DDemolition cen e- *** * * * * * * * *** * * * * *** * ***************** Fees* *+ a+ x****** ************ ********************** Submittal Fee $ Permit Fee $ If a (to`j CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ b Bonding Company's Name (if applicable) Bonding Company's Address City State 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 properly 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 pproved and a reinspection fee will be charged. • Signature /// AN/, _ A / • wner or Agent The foregoing instrument was acknowledged before me this b. The forego' g instrument was acknowledged before me this 9 day of , 20{ by �[I 1 9r? /ft' , day of who is per nally known to me or who has produced who is personal (9 known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sigua ure Contracto ,20Llby -- c // //I NOTARY PUBLIC: Sign: Pri y Commission Expir ** * ******** * * * **** KARMA GROPPER • 'MY COMMISSION # EE0322713. .*, EXPIRES October 05, 2014 407) 398 -3153 FlofldallorarvServico.aom ********** ** * ******************************* ¢ e C! "v Plans Examiner Zoning Sign: Print: My Commission MARY PAT IRIGGS 14 MY COMMISSI01911DD 1979267 EXPIRES: May 11, 2014 Bonded Thru Notary Public Umienvriters APPROVED BY Structural Review Clerk (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09)