EL-12-640Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
I '--(,0(3 �
Inspection Number: INSP- 178681 Permit Number: EL -4 -12 -640
Scheduled Inspection Date: September 26, 2012
Inspector: Devaney, Michael
Owner: FRYER, ANITA
Job Address: 758 NE 95 Street
Miami Shores, FL
Project: <NONE>
Contractor: ELECTRAK LTD INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132060141890
Phone: (786)286 -7515
Building Department Comments
ADDING TWO SWITCHES 3 HIGH HATS & 2 GFI
OUTLETS.
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
CREATED AS REIN
ION FOR INSP- 178622.
5\)(0-
September 25, 2012
For Inspections please call: (305)762 -4949
Page 28 of 41
BUILDING
PERMITOPPLICATION
FBC 2
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 No. al 240 4 0
Master Permit No.
Permit Type.
40S)11 //� �y /' OWNER: Name (Fee Simple Titleholder): IS 'v 1 eT11- L L Phone l� 1 7G�
state: . '_ct., Zip. 13
•
APR 12 2012
ROOFfNG t-er%1 -4 GA•t_,
prg_er-irr
Address: 152 toe qs T
City: 1410 M1
Tenant/Lessee Name:
10/Pr
Email: t rnrnc 1'; I a) do &, @ g,Y t i1 Morn
JOB ADDRESS: 5 q 5. SF
City: iami Shoress ^ /� County: Miami Dade Zip:
Folio/Parcel #: +32- ` 0d``(r Ificta
Is the Building Historically Designated: Yes NO Flood Zone:
Phone #: )1.
CONTRACTOR: Company Name: CI t a.k. GT P in • Phone#: 4323-4513
I Address: t 1) 41 W • q 0 S-/-
City: 14 1 a L a State: C 1. Zip: 33 0
Qualifier Name: CO C./WO/VI I �'� 0 V%A VL. Phone#:
State Certificatio or Re 'stration #: o00 6 / 4 to 3 Certificate of Competency #:
Contact Phone# 3°5)3(0.3 5 / 3 Email Address:
DESIGNER: Architect/Engineer: Phone#:
sC.)v acd
Value of Work for this Permit: $
Type of Work: UAddition�
Description of Work: Add)
rD 3 PI
Alteration
IW0
Square/Linear Footage of Work: Pr
ONew ORepair/Replace ODemolition
ak, u--g
Submittal Fee $ ' w - Permit Fee $ /5' ''" CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
4.
TOTAL FEE NOW DUE $ UV .
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
NYA-
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 FT.RCTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S A1414 'DAVIT: 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] me 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 whic occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection :. will not be apps d end a reinspection fee will be charged.
Owner or Agent
The foregoing
instrument was acknowledged before me this .1%.1 day of H , 20 I (., , by. If IJEt__ AtibAgE ,
who i ersonally kno to me or who has produced
As identi
NOTARY PUBLI
Signature
Contractor
The foregoing instrument was acknowledged before me thiYQ
day of ,vex /1 , 20 / 2 , by e tri9-ii.%r 6 elirl 6. z,
who is ersonall known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: mt—
Print:
My Commission Expires: C I 10—i 1 act c
.01.101104_ Notary Public State of Florida
lCrIstiane C Leon
'i My Commission EE119033
ov Expires 08/04/2015
Sign:
Print:
My Conunissi
MY COMMISSION # DD 792104
es: EXPIRES: July 1B, 2012
Banded Thai Budget Notary Services
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APPROVED BY 9 t l64-FJ' Z '2 Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk