EL-12-835Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 193866 Permit Number: EL -5 -12 -835
Scheduled Inspection Date: June 20, 2013
Inspector: Devaney, Michael
Owner: RICH, RENE
Job Address: 10515 NE 3 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: VIVINT, INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1122310130380
Phone: (877)479 -1667
Building Department Comments
INSTALLATION OF LOW- VOLTAGE WIRELESS BURGLAR
ALARM SYSTEM
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
June 20, 2013
For Inspections please call: (305)762 -4949
Page 29 of 40
5\ t't1,, -V\
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical
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. �1 I + 4�
Master Permit No.
MIZMEW'ffii
la MAY i0212
BY: - - - - -- � - - -e
OWNER: Narne (Fee Simple Titleholder): .Do,ry( Ecrwcards Phone#: ('505)151 5-6'7?
Address: 10515 ')E 3rrA Av,e
City: Mi Ar, i % < State: Fi Zip: "5315V
Tenant/Lessee Name: '�a�yl CAw t
Email: I
Phone#: (3o5)1S1 -CW`6
JOB ADDRESS: 1 cs S (5 ?Qr. �, �{ Q+v�
City: Miami Shores County: Miami Dade
F o l i o / P a r c e l # : II 223 (a 13 o ?$
Is the Building Historically Designated: Yes NO Flood Zone:
Zip:
CONTRACTOR: Company Name:
Address: 213( NI a 7SO®
City: Trost o
Qualifier Name: Y r t -11 t t
State Certification or Registration #:
Contact Phone#: $ii- X171- 111,1
DESIGNER: Architect/Engineer
YiViv1 17, \,c
1+JQs
Phone #: `t� 11- �i l �t - (Lo Lo
State: LiT
Zip:
Phone#:
G1 �oa� C� Certificate of Competency #: r
Ct1s a r r jt-s Qv ,-- -1cow
Phone#:
4X1.1(oo t(
Email Address:
Value of Work for this Permit: $ j I Square/Linear Footage of Work:
Type of Work: DAddress DAlteration
Description of Work: �, t� E x : s: • t'
DNew DRepair/Replace
DDemolition
Submittal Fee $ Permit Fee $ /42 '4'4" 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
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
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 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
inspectio,_ ill not be approved and a reinspection fee will be charged
Signature
The forego
day of
who is perso
Owner or Agent
tzumentfias ac ' wled
20 }",`by P/L
before me this IO
Signature
Contractor
The foregoing instrument was acknowledged before me this2f
/ylel. , , 20 La by Li7 S44 .fit,
nally known to me or who has produced V A
day of
who is
me or who
and who did take an oath.
as identification and who did take an oa
NOTA
Sign:
Print:
My Commission Expires:
NOTARY P
Sign:
Print:
My Commission
RAMEEZ ABBAS
Notary Public
Commonwealth of Virginia
711
C' i ssion Expires ' c
Aires: O &t obe'U 314- 15
*********************************************************+******************* * * * **** * * *** * * * * * * * * * * * * * * * ** **
/' /eterY Plans Examiner Zoning
APPROVED BY
Structural Review
(Revised 07/10/07XRevised 06/10t2009XRevised 3/15/09)
Clerk
DBPR - EVERS, LARRY S; Doing Business As: VIVINT, INC., Certified Alarm System... Page 1 of 1
11:24 :41 AM 5/15/2012
Licensee Details
Licensee Information
Name:
Main Address:
County:
License Mailing:
LicenseLocation:
License Information
License Type:
Rank:
License Number:
Status:
Licensure Date:
Expires:
Special Qualifications
EVERS, LARRY S (Primary Name)
VIVINT, INC. (DBA Name)
4931 N 300 W
PROVO Utah 84604
OUT OF STATE
Certified Alarm System Contractor II
Cert Alarm II
EG13000290
Current,Active
07/25/2006
08/31/2012
Qualification Effective
View Related License Information
View License Complaint
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