ELC-13-2318Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 201028 Permit Number: ELC -10 -13 -2318
Scheduled Inspection Date: November 05, 2013 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael
Inspection Type: Final
Owner: , BARRY UNIVERSITY Work Classification: New
Job Address: 11300 NE 2 Avenue Dalton Hall
Miami Shores, FL 33138 -0000 Phone Number
Parcel Number 1121360010160 -17
Project: BARRY UNIVERSITY
Contractor: MOODY ELECTRIC INC Phone: (305)758 -2000
comments
NEW 20AMP Circus FOR PROJECTOR AMPLIFIER AND 2 ' -- - -- --
INSPECTOR COMMENTS False
TV UNITS
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 04, 2013 For Inspections please call: (305)762 -4949 Page 13 of 40
Miami Shores Village
Building Department OCT 2013
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 BY. c
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit No. f
Master Permit No./ / y
Permit Type: Electrical ,, A
JOB ADDRESS: x ® fie/= � '4zle
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple
City: Z �Y State: Zip: 3:�r%
Tenant/Lessee Name: Phone #:
Email:
Address:
City. _
Company Name: /�� ®l �'-�_ G/ll� Phone #:
9 -9 A-; �
Qualifier Name: 'Y' A .4
State Certification or Registration #:
Contact Phonek C
DESIGNER: Architeet/Engineer:
M
of Competency #:
Value of Work for this Permit: $ �o ®� Square/Linear Footage of Work:
Type of Work: DAddress DAlteration kNew ORepair/Replace ODemolition
Description oaf Work: _Z14W e G N-A _
Submittal Fee $ Permit Fee $ �v ®P� ® 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
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
inspection will not be ap oved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this
day of ' , 20 L3 , by ._�lN
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged befor meetthiiss®/
day of 20 a by
who is ersonally known me or who has produced
' S `% JEFFRY L YAO 3
as identification and who did take an oath.
NOTARY PUBLIC:
AN
1iraCOMMISSION # DD 979267
EXPIRES: May 11, 2014
Bonded Thru Notary Public Unde %'911ers
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APPROVED BY l/ ���' Plans Examiner Zoning
Structural Review
(Revised 3 /12/2012 )(Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
Clerk