ELC-12-1429Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
SG W -- 12 -- i L425
Inspection Number: INSP- 176487 Permit Number: ELC -7 -12 -1429
Scheduled Inspection Date: October 18, 2012
Inspector: Devaney, Michael
Owner:
Job Address: 9820 NE 2 Avenue
Miami Shores, FL 33138-
Project: <NONE>
Contractor: KLEAN POWER ELECTRIC INC
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Sign
Phone Number
Parcel Number 1132060132240
Building Department Comments
ELECTRIC FOR NEW SIGN 9802 NE 2 AVE MIAMI THE
PLAYGROUND THEATER.
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
5N)/2_
/g(9-c/-
October 17, 2012
For Inspections please call: (305)762 -4949
Page 6 of 23
Miami Shores Village
Building Department
10030 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305; 795.2204 Fax: 005) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
3011 ADDRESS: j202, kir 2'11 Nve
City: ,MiAmi Shores
Folio/Parcel*
Is the Building Historically Designated: Yes
RECEIVED
JUL 2 7 2012
FBC 20 I'D
Permit Ne !Eli() 2- ILIL1
Master Permit No
County: Miami Zip: 33/ 38
OWNER: Name (Fee Simple Tittleholderlicel
Address: 2. 10 _11 3 5
City. 15 co...0^ State: _
Tenant/Leisee Name: 11,42 kvvro *ha; •
Flood Zone:
C13141-Orrnell:aea_c_.L6.6.5 sses-
Phone#: 3 nS -?-51 c5.0
CONTRACTOR: Company Name: K. lefitr‘ ?owe- fIL4 Phone#: 30S - 6C1 -ei5Y
Address- 46o$ 80 3 t 9.14e. iVri
Cm?: .Scw;Ms. istA ot.wo State: P-L. zip: 51 4 3
Qualifier Narrie: le4n) ti Phnne#:
State Certification or Registration #: 3002.06
Certificate of Competency #:
Conlact Pitorte#. `4QS -46i - a ($4 Entail Address: CA YVcJe 4h,5 0@ LICA ri_L.1-914ALSS:' 61#'
DESIGNER: Architect/Engineer: 7i-40A) t„refi-vnilt-tu,r, 11C Phone*: 30S - 312 - 759?
_ o to
Value of Work for this Permit: S 4 woo— Square/I.Inear Footage of Work: 6/ ..-5441"
Type of Work: °Address °Alteration OSIew ORepair/Replace °Demolition
Description of Work: -I itki rot■I‘elkeJ.. 3-ktitc.svg- __.ci‘vInu 111---4--11-)---
e pA 6.calithi\ 1 80‘ P 6 2-'4 kva.C1.4.11_, NIk
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Submittal Fee $ (-70 Permit Fee $_ /0".k.„ CCF COICC S
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee S Structural Review
Technology Fee $
TOTAL FEE NOW DUE--$-T-'
er
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applivable)
Mortgage Lender's Address
City state
Zip
Application is hereby made to obtain a permit to do the work and installations as indited. I certify that no work or installation has
commenced prior to the issuance of a permit and that all wori, will be performed to meet the standards of all laws regulating
construction in this jtuisdiction. 1 understand that a separate permit must be secured for ELECDUCAL WORK, PLUMBING, SIGNS,
WELLS, POOLS. FURNACES. BOILERS, HEATERS. TANKS and AIR CONDMONERS,
OWNER'S AFFIDAVIT: I certify that all the foregoing information is acetone 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 ropy 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 reinspection ee will he charged.
Signature
Owner or Agent
The fore 'oing instrume t was acknowledged befoie inc this The for oing instrument was anknowkdg d before me thisf
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who is
Signature
Contactor
o to me or who has produced__
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Prim:
My Commission Exp
APPROVED BY
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, I i 'fication and who did take an oath,
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Plans Examiner 7 -2" -2Zoning
Structural Review
(Revised 3112/20120W h4J 07;101074Revised 06i ittelt 3/ ;09)
Clerk