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EL-12-900Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 177401 Permit Number: EL -5 -12 -900 Scheduled Inspection Date: August 16, 2012 Inspector: Devaney, Michael Owner: DINAR, SHOLMI & REBECCA Job Address: 10110 NE 4 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: ABLE ELECTRIC OF SO FLORIDA INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060135250 Phone: (305)778 -8340 Building Department Comments INTERIOR REMODELING SIX NEW HI HATS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 15, 2012 For Inspections please call: (305)762 -4949 Page 23 of 26 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 1 r� Permit Type: Electrical .i Er \TED► MAY 18 2Q12 1 Permit No. I 00 Master Permit No. 12- 12_9 OWNER: Name (Fee Simple Titleholder): ecce7 ii I" Phone#: 3o5 - 7/0 - 586/ Address: /0 //0 /116 /- y% City: 11 / f'// l % 7/ ores State: . Zip: 33/3 c-19 Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: 10/ 10 ,V. 4117 City: Miami Shores County: Miami Dade Zip: �33/ 3d? Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: e C . ©5 - Co7J"634 CONTRACTOR: Company Name: ,46/ G1+� ?ec PC &A h/l /MPhone#: 3() 5 214' etc668 Address: 623 / ./ c'3 c7' City: kit /974 �/ State: Pi_ Zip: 38/7c0 Qualifier Name: `. Or N5 ryi} IG Phone#: 4 60 7 4'04 State Certification or Registration #: Certificate of Competency #: Contact Phone#: YOM 1 axl X19 u e-: Z Email Address: 0. g . &/ee/, ka./ 5 /e /itlG 4-01 LOI-7 DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 600 . Square/Linear Footage of Work: Type of Work: UAddress UAlteration UNew URepair/Replace UDemolition D e s c r i p t i o n of Work: Z2 7 Oit, 72/ICdei /.O,6 ne**** ****>k***********>%**** ** * * ** * * ** Fees* ***** ******** ********* * * * * *** ***4* ****s **** Submittal Fee $ ��''� - j'ermit Fee $ /:-.1'.:0 (c 45 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Trairring/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, promise in good faith that a copy of the notice of commencement and construction lien whose property is subject to attachment. Also, a certified copy of the recorded notice for the first inspection which occurs seven (7) days after the building permit is is inspection will be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was ac ledged before a this "2_ day of . 4 20 Eby C* whois ,- rsonally known to me or who has produced.. dentiflcatioltdd.3ttake an oath. MY COMMON= OMM 000 0414 Sign Print My Commission Expires: * * *** * * * *** * * *** APPROVED w brochure will be deliv ommence must be p In t ab•nce of suc applicant must to the person at the job site ted notice, the Signature Con''•ctor The foregoing instrument was acknowledged before me this ?+,g_. day of M , 20 tZby who is perso • - . - to me or who has produced ' p tt $n oath. NO ' Y UBL. : • 00980414 28, 2014 5 — _I:. .� �� Sign: tiflcation Print My Commission Expires: A 0/ ireeL Plans Examiner Zoning Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk