EL-13-1118Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 210254
Scheduled Inspection Date: April 07, 2014
Inspector: Devaney, Michael
Owner: "ILA, REGINA
Job Address: 161 NW 107 Street
Miami Shores, FL 33168 -4308
Project: <NONE>
Contractor: ADT LLC
suilding uepartment comments
ALARM SYSTEM INSTALLATION
Permit Number: EL -5 -13 -1118
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1121360100110
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP- 210137. No one home 4:45
p.m..
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
April 04, 2014 For Inspections please call: (305)762 -4949 Page 7 of 17
•�I ' d �l
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fag: (305) 756.8972
INSPECTION'S PHONE NUMBER: (3055) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
F-IIVFID
MAY 212013
Permit No. 15 — l 11 L
Master Permit No.
JOB ADDRESS: i (4 1 l 7 sjr
City: Miami Shores County: Miami Dade Zip: l �D
Folio/Parcel #: a I- 'A 1S�p" 0 1 Q— Ci t( 00
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple
A-
NO Flood Zone:
Mc)'' D k
309--778 — 07.E %
City: M' ji2m ; 5 h & t" G $ State: rr— L— Zip: „ � to
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Y07 ZY,
Address:
City: '01;- alnow' State: Zip: c5Z02.5—
Qualifier Name:
State Certification or Registration #:
of Competency #:
Contact Phone#: Email Address: G2i► ���- ��'�
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $ .690 Square/Linear Footage of Work:
Type of Work: ❑Address Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: Q09 419j- -111 -
Submittal Fee $ Permit Fee $ A'4% CCF $ CO /CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
Cr V
TOTAL FEE NOW DUE $ f
d
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
inspection will not b oved and a reinspection fee will be charged.
Signature Signature
wner or gent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this / 7
day of 20 & by ad i4 ubXP .(.I day of J , 20 1\3, by
who is personall own to me or who has produced 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 PUB C:
r/,
Sign:
Print: '
My Commission Expires: a k my comet SSt 1 AEE /W43
EXPIRES Apra 02, 20iS
asao�+
APPROVED BY �`YG� Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06/ 10/2009)(Revised 3115/09)
NOTARY PUBLIC:
Zoning
Clerk