EL-13-1984 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-204461 Permit Number: EL-8-13-1984
Scheduled Inspection Date: December 13,2013 Permit Type: - Residential
Inspector: Devaney, Michael .Inspection Type: Final
Owner: RODIER,ALEXANDRE&EMILIE Work Classification Alarm
Job Address: 1009 NE 104 Street
Miami Shores, FL 33138-2655 Phone Number
Parcel Number 1122320290140
Project: <NONE>
Contractor: MESA BROTHERS INC Phone: (305)345-1974
Building Department Comments
BURGLAR ALARM infractio Passed Comments
INSPECTOR COMMENTS True
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
December 13,2013 For Inspections please call: (305)762-4949 Page 23 of 26
Miami Shores Village IV�D AUG 3 0 2013
Building Department jalf:
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No 13 f N 67
Permit Type:Electrical
JOB ADDRESS: 1009 NE 104 STREET
City: Miami Shores County. Miami Dade Zip: 33138
Folio/Parcel#: 11— 22SZ —029'— O1Y0
Is the Building Historically Designated:Yes NO Flood Zone: A F
OWNER:Name(Fee Simple Titleholder): Alexpndm Rout's" Phone#:
Address: /#Of AF 10115'.
City: om1 Wi t' slims State:-'/o ro k& zip.. 33131
Tenant/Lessee Name: Phone#: TSY-11Z u—t#)
Email:
CONTRACTOR:Company Name: A9 'P'V Phone#:.3
Address: S�l J®� ��- •
W417 City: d'C?��e' ,, �/ State: , 4,. zip: .
Qualifier Name: ze� /-- ��
State Certification or Registration#: 1870 Certificate of Competency#:
Contact Phone#:3995 3 r/ l Z V Email Address: h7ey dt, ^*0-
DESIGNER:Architect/Engineer.. Phone#:
Value of Work for this Permit:$ � ' SquareAAnear Footage of Work:
Type of Work: UAddress ClAlteration 2New ORepair/Replaee_ ODemolition
Descriptientoi:'�Vork�
��a�+���a���*+�«��a«a��������������es�����Fees��ax����•������*����a�a��+x*�e��*x��a•�������$�
Submittal Fee$ Permit Fee$ ��� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE 9
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 u building permit with an estimated value exceeding-$2500, the applicant must
promise in good faith that a copy of the notice of commencement and+onlstruction lien law brochure will be delivered to the pervon
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.,flrst inspection which'occurs seven (7) days after the building permit is issued. In nce of such posted notice, the
inspection will not be approved and a reinspec•tion fee will be charged.
Signature' Signature
or'
4,
',Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 97 The foregoing instrument was acknowledged before me this NCO
day of ,20 4,by [7ltXandw RoXer day of ,20 13,byt� lPSO _,
who• known to me r who has produced who is onally known to me o ho has produced
As identification and who did take an oath_ emi ication and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
/Ala-
Print: Print:
My Commission Expires: My Commissi n
se 2%2W LEONOR ROSARIO
MY COMMISSION#EEISM41
IMMES April 24,2016
APPROVED BY 70 / lans Examiner Zoning
Structural Review Clerk
(Revised 3/1=012)(Revised 07/10/07)(Revised 06/10fL009)(Revised 3115/99)