ELC-13-2663Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 203587
Scheduled Inspection Date: December 02, 2013
Inspector: Devaney, Michael
Owner: ,
Job Address: 9823 NE 4 Avenue
Miami Shores, FL
Project: <NONE>
Permit Number: ELC-11 -13 -2663
Permit Type: Electrical - Commercial,
Inspection Type: Final
Work Classification: Sign
Phone Number
Parcel Number 1132060170330
Contractor: MOODY ELECTRIC INC Phone: (305)758 -2000
comments
INSTALL SIGNLIGHTER FIXTURE
INSPECTOR COMMENTS False
Inspector Comments
Passed n
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 27, 2013
For Inspections please call: (305)762 -4949
Page 11 of 24
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3
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical
OWNER: Name (Fee Simple 7
Arhirne- q 62-3 M F_
Permit No.
Master Permit Noj_4-11� j 3 - 2.X6 3
City: f ! ( apm 05 State: F� Zip:
Tenant/Lessee Name: AJ 1A Phone #:
Email:
JOB ADDRESS: 5 d4m 6
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: &�� IG Inc, Phone #:
Address: 661 A) iW 7
City: All C e State: �L. zip: �iSC9
Qualifier Name: _�_1 01) 0 _j /11
State Certification or Registration #: e G
Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ i H ®1® ® Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ONew Ol epair/Replace ODemolition
Description of Work:
Submittal Fee $ SP - 61 i) Permit Fee $ IX-014-4o' CCF $ CO /CC $
Scanning Fee $
Notary
Radon Fee $
DBPR $ Bond $
Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $�
Bo ding C ,.amp4ny s Natn `(if applicable)
AZ I
Bonding Company's Address
Cit}., State Zip
Mortgage Lender's Name (if applicable) D J
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 approved and a reinspection fee will be charged.
Signature
4wner or Agent
The foregoing instrument was acknowledged before me this
day of ® V , 20 43 , by �� r�� 10kV 446 ,
who is personally known to me or who has produced
Signature
Contract
The foregoing instrument was acknowledged before me this/
day of AID V —,200, by j
who is personally 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:
a
Sign: Sign: pct�
Print: Print: Ou
My Commission Expires: ,"A' ° YPBB
MARY PAT BRIGGS My CommissioifEXpire
=* MY COMMISSION # DD 979267 R MARY PAT BRIGGS
e
A
K. EXPIRES: May 11, 2014 r:;. ` �Iy COMMISSION # DD 979267
Rf° Bonded Thru Notary Public Underwriters ;, - t iP1RES: May 11, 2014
APPROVED BY O Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)