ELC-12-1222Inspection 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- 175389 Permit Number: ELC -7 -12 -1222
Scheduled Inspection Date: September 12, 2012
Inspector: Devaney, Michael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Thompson Hall
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 -02
Phone: (305)758 -1211
Building Department Comments
ELECTRICAL RECEPTACLES UPDATE
Passed
Failed
Inspector Comments
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Py /
September 11, 2012
For Inspections please call: (305)762 -4949
Page 10 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: 11300 `v r r cf G t �l2
City: Miami Shores County:
Folio/Parcel #: M=1:104) H I ° 213 6. 0(50 • (>06-0
ill JUL 0 r6 i2
BY: ____________000__o_o
FBC 2010
Permit No. El e/12.7 12L7,
Master Permit No.CC 11° 92]
Miami Dade
Zip: 33161
Is the Building Historically Designated: Yes
NO X'
Flood Zone:
OWNER: Name (Fee Simple
Titleholder): aac- f
Phone#:
Address: 11300 Ale- 2,,01- '1 tee_
City: M a S ' %
¢Y' S State: Fl-- Zip: 3 S 1 d I
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address:
City: Ali ■9,7,, ) State: ft-- Qualifier Name: Mi4 4c / �y iiv
L o,i6/4,4 ,
Phone#: 3 - 75A— 21/
zip: 33/3J
Phone#: 3 - 700— foal/
State Certification or Registration #: G 13 ob 37 / 3 Certificate of Competency #:
Contact Phone#: 3 -75e, /At/ Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 1 o 0 SA*— Square/Linear Footage of Work:
Type of Work: OAddress Alteration
Description of Work: A rAcect s [4c L (
UNew IiiiRepairfitepiace
Li a\-e_ Jed-At-v.(11
vo GFI (L a& etvNete8exlc `� 1 �,1 .
366
ODemolition
A, ►e1, ce cool; tc` es
Submittal Fee $ Permit Fee $ /-1-0 c' e'
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ 1 , 40
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 • a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of —111.17 , 20 ®', by b, ati- Q'S,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY ' UBLIC:
Sign:
Print:
My Commission
to CM/18e1de Gerber Florida
'
.� My Commies on D0966128
d� Expires 0610812014
*air * * * *a * * * *** **
""Go /L
APPROVED BY Plans Examiner
Contractor
The foregoing instrument was acknowledged before me this 1-7
day of J h4e._ , 20 LL by
who irsonally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009XRevised 3/15/09)
My Co
II 11 1
jatd'" Not Notary Public State of Florida
Michelle Perez
o; My Commission EE002609
Zoning
Clerk