ELC-12-1220Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 175372 Permit Number: ELC -7 -12 -1220
Scheduled Inspection Date: September 12, 2012
Inspector: Bruhn, Norman
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Andreas Buildin
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: LONGMAN ELECTRIC INC
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -21
Phone: (305)758 -1211
Building Department Comments
ELECTRICAL WORK TO RELOCATE TWO LIGHT
FIXTURES
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
September 11, 2012
For Inspections please call: (305)762 -4949
Page 8 of 31
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: 1130 0 11/41E--- 14 2 hc)
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Permit No. 12--
Master Permit No C-
, /) 92-2—
City: Miami Shores County: Miami Dade Zip: 3 3111
Folio/Parcel #: 11- 2,136 • (1 0 0 - O 050
Is the Building Historically Designated: Yes
NO k Flood Zone:
OWNER: Name (Fee Simple Titleholder): 60kc1 Ur the r3 I k-1/47 Phone#:
Address: 11 300 fie 9.,,,,J- A v L
City: tk ke rn 1 S %,o re_ S State: FL zip: 3 311 1
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: !-42/YU074.+/ I Calk Phone#: 3 — 75,0— %Z 1/
Address: V!/ /1/ t 9 07k
City: /f2d /9"/ I State: f Zip: 53 / . ' $
Qualifier Name: /'e -' �f,1 fO4.6-/144.-- Phone#: — ?OAr - %oi //
State Certification or Registration #: E C 13c'3 7 / 3 Certificate of Competency #:
Contact Phone#: — 7 5 $— ow Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 2.00 a 00 Square/Linear Footage of Work: <ETC
Type of Work: ❑Address *iteration t 1 / ❑New ❑Repair/Replace Demolition
/�
Description of Work: " 0 McS0r■ t 1" J relocn. e- two ‘3\N
Submittal Fee $ Permit Fee $ P v CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 0 4 • la J
Bonliing 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 einspection fee will be charged
Signature Signature g714(117-2...----
Owner or Agent
Contractor
The foregoing instrument was acknowledged before me this aR The foregoing instrument was acknowledged before me this 2 7
1c1. s.45 day of , 20 it, by 01 ac-L�v 1 InA ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
day of , 20/ 21 by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expire
4r** ***** * ** 4; ** * * **
APPROVED BY
Nee, Notary Public State of Florida
Cheryl Baida Gerber
; My Commiss on DD966126
p04. Expires 05/08/2014
Examiner
' ,•
Structural Review
(Revised 3 /12t2012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09)
Sign:
Print:
My Co
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II n
ROA, ePffNoiary Public State of Florida
44 A' •chelle Perez
c. b My Commission EE002609
bed' Expires 04/09/2013
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Zoning
Clerk