ELC-12-1923Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 179963 Permit Number: ELC -10 -12 -1923
Scheduled Inspection Date: October 31, 2012
Inspector: Devaney, Michael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Fine Arts Quad
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -06
Phone: (305)758 -2000
Building Department Comments
ADD ONE RECEPTACLE
Infractlo 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 30, 2012
For Inspections please call: (305)762 -4949
Page 25 of 44
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
FBC 20 C0
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): V.q
ijiMCMETZIAI
OCT 1 �� 2ii2
BY: __ae._.__..000000000
Permit No. ) ) l °2
Master Permit No.
Address: 7lZ
//�T , •' #/, IUS l?
a Y� /li� f�
City: �/' / ve State: /I- Zip: t/ g
PrTenant/Lessee Name: AV Phone* Email.
JOB ADDRESS:
City:
Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
NO Flood Zone:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name: OP-el E GTI JC • (/06 Phone #: 0.5-' 75
Address: &q / )) q() it
2
City: l yy��)�� State: PZi Zip: 3. /56
Qualifier Name: Ot'I� / l% Phone #: .5'" 7SW-
State Certification or Registration #: OnC) // 9 9 Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: N/k Phone #:
Value of Work for this Permit: $ [ loo £2 Square/Linear Footage of Work:
Type of Work: UAddress DAlteration ❑New epair/Replace
Description of Work:
A-Do oNe- eii:fir-acc.E,
(]Demolition
m * * * * *****cep**** * * ** v***m******** ***** ** Fees***** **** * * ******************* * *** x****a•** **
Submittal Fee $ Permit Fee $ / CY 0 r 0'0" CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ I tO •
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
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 CONDMONERS, 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 ap r. p - �� and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of �� �� �. 20 by IV 4A 630120-.1
who l rsn»ally kn�o om to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Contractor
The foregoi g instrument was acknowledged before me this
day of , 200, by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: /141�i'
Print:
My Commission Exp
:*e MY COMMISSION # DD 979267
y EXPIRES: May 11, 2014
Banded Thru Notary Pullfc Underwriters
******************* ****** *a:+ x******* u: ************** ** * * ***x:m**+x****** *** qua: **tba: **** ** * ******+xx:***** *******x ***
APPROVED BY .017/4 Y"-- Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)