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ELC-12-2137Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 181458 Permit Number: ELC -11 -12 -2137 Scheduled Inspection Date: November 28, 2012 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Landon Student 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 -32 Phone: (305)758 -2000 Building Department Comments INSTALLA QUAD RECEPTACLE WITH FLOOR TRACK FOR COUNTER Infractio 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 November 27, 2012 For Inspections please call: (305)762 -4949 Page 19 of 32 UILDING 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 PERMIT APPLICATION FBC 20 @LJLWa -i tiiGV 0 5 2U12 B Y: Permit No. tiC) 12 -Z13 -1 Master Permit No. Permit Type: Electrical �/ Q OWNER: Name (Fee Simple Titleholder): � � /A Phone #: 9©% eft 0y:.5 Address: i/Se3 Zip: 3o-tar City: State: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: //2 CN. ,4.te ° City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: ✓�/ !A /ice, Address: X16 q drs City: �/4 ^!/V State: Qualifier Name: /4 County: Miami Zip: ' '/ NO Flood Zone: 1 Phone#: State Certification or Registration #: Contact Phone#: 77'S ®e9 DESIGNER: Architect/Engineer: /GA 4(1,04010 Phone #: 9.6'758 �;P: visa Certificate of Competency #: Phone#: 110 —70 Value of Work for this Permit: $ /901-6; ° Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration Description of Work: 19/44fre-Z,/, e,he-e/ 11.4" V701) New epair/Replace ❑Demolition ** * * * * * ** u*** *+x********+r** ***** ******** Fees************ x: *********** ** *+x**********+x*+x*** Submittal Fee $ Permit Fee $ /-' ' ' B CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 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 approve . d a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of 10161W1.- , 20 by by ROAC.K (a1r1412 V� whoss personally known to me gr who has produced As identification and who did take an oath. NOTARY PUBLIC: My Commission * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Contractor The foregoing instrument was acknowj g s bef m day of N ©V , 20 /09—, 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 E 14 MY COMMISSION # DD 979267 b� EXPIRES: May 11, 2014 , �Af,R+• Bonded Thm Notarq Public Underwriters ********** ****** *+ x***** ** ********* **+a****** * * ** *+ x****** **+x*****+x+x:e******* *** /�rt /�v �CrtZ Plans Examiner Zoning (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Structural Review Clerk