ELC-14-0285Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 207213
Scheduled Inspection Date: February 19, 2014
Inspector: Devaney, Michael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Adrian Hall
Project:
Contractor:
Miami Shores, FL 33138 -0000
BARRY UNIVERSITY
MOODY ELECTRIC INC
Me] viIill il1f
INSTALL 2 DUPLEX
Permit Number: ELC -2 -14 -285
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
1121360010160 -07
Phone: (305)758 -2000
February 18, 2014 For Inspections please call: (305)762 -4949 Page 39 of 53
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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 Titleholder):
Address: l j 366 _ KNE 22 AVE
City: t V1 [ (A 611
Tenant/Lessee Name:
Email:
JOB ADDRESS:
State:
40
City: Miami Shores County:
Folio/Parcel #:
Is the Building Historically Designated: Yes
Permit No.
FEB 13 201
Master Permit No.�%
NO Flood Zone:
-3213 9
CONTRACTOR: Company Name: G Phone #: ® ' 5 &)06
Address: 6(7 IJAJ '76 51-
City: Stater Zip: 33 ('- .1 1
Qualifier Name: 6 h A T M Phone #:
State Certification or Registration #: t%b (,X)U / 14 `9 Certificate of Competency #: _
Contact Phone#: ?b5"1'53-Z060 Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑Address OAlteration ONew ORepair/Replace
Description of Work:
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $
Radon Fee $
DBPR $ Bond $
Notary $ Training/Educadon Fee $ Technology Fee $
Double Fee $ Structural Review $
ODemolition
TOTAL FEE NOW DUE 60
Bonding Company's Name (if applicable) _
Bonding eit*w s_A"( a
City State
Mortgage Lender 's - Name -(If applicable)
Mortgage Lender's Address
City
zip
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 WORD, 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.
Signat4 Signature
Owner 01GO Contractor
The foregoing instrument was acknowledged before me this
day of fgWkly, 20 L�_, by � 15fRZ, U1�A
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission
WY CONIb115LSION # EE36829
EXPIRES: Nwawbw 12, 2D14
The foregoing instrument was acknowledged before me this,
day of , 2q0/ , by /l
who is personally known to me or who has produced
as identification and who did take an oath.
APPROVED BY �, �/Z. /Z/f',e� Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
Sign:
Print:
My Com y "" ireo MARYPATBRIGGS
=* - COMMISSION # DD 979267
flf,t:+�4 Boned rnra Notaq Punnc undlerrmfters
Zoning
Clerk