EL-12-1632Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 178545 Permit Number: EL -8 -12 -1632
Scheduled Inspection Date: September 17, 2012
Inspector: Devaney, Michael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Wiegand & Annex
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1121360010160 -09
Phone: (305)758 -2000
Building Department Comments
FURNISH AND INSTALL 2 NEW CIRCUITS FOR COOLER
120 VOLT 20 AMP AND 220 VOLT 20 AMP
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
d
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
lee
September 17, 2012
For Inspections please call: (305)762 -4949
Page 30 of 35
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
_ 'S PHONE NUMBER: (305) 762A949
Permit No.
Tel: (305) 795.2204 Fax: (305) 756.8972
✓1"� INSPECT
B I MNi G
PERMIT APPLICATION
FBC20 (c�
Permit Type: Electrical earn/ OWNER: Name (Fee Simple Titleholder): ear (i On) � r / Q Phone#:
Address: IAA 113QD ?J& 2 Aug I MP 6t4kC'
City: IA A I 1 �71C�t. -c-S State: F►- / zip: 3 igg
L - -ICa3Z
Master Permit No.
Tenant/Lessee Name: Phone #: -
Email:
JOB ADDRESS:
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO r Flood Zone:
CONTRACTOR: Company Name: / n00 g�i Z gic% 406 Phone #: 3(C 70'06VO
Address: 69 J) b) 90 f
City: M ) - ii ) py� State: FL' zip: 333/6D
Qualifier Name: '' t14) f 12€ Phone#:
State Certification or Registration #: 6 c .00i // 4 9 Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ Igoe) 6 Square/Linear Fooe of Work:
Type of Work: Address DAlteration New &epair/Replace ODemolitiQ
Description of Work: 12/.
i e? , C
***+x *******ox** ** **** x****** ****x:******* Fees* *** *****x:*********** * * *+x***************+x***
Submittal Fee $ `' 11� Permit Fee $ / h ' ,ff> CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 1 [0 `10
Bonding Company's Name (if applicable)
Bonding Company's Address
City State I !1. 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, BOB ,F,RS, 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 approved a reinspection fee will be charged.
/
Signature
w
Owner or Agent
The foregoing instrument was acknowledged before me this
Contractor °71
, The foregoi _ instrument was acknowledged before me this c;1
day of ��1. �i b gww"OC 0d 7��s , , ,
20 �, y day of l , 20 � � by ,T®MAJ:i
viliwit-pecnown to me or who has produced who is persona 1 known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print:
My Commission E
Sign:
Print:
My Commission
AY ri MARY PAT BRIGGS
MY COMMISSION # DD 979267
W EXPIRES: May 11, 2014
arat a Bonded Thai Notmy Public Underwrtters
********************************** * * * ***** * *** * * * * * * * * * * * * * ** * * **
f6 /A-
P, Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk