DEMO-14-189�J
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 209593 Permit Number: DEMO -1 -14 -189
Scheduled Inspection Date: March 25, 2014 Permit Type: Demolition
Inspector: Devaney, Michael Inspection Type: Final
Owner: BROWDER, EDWIN Work Classification: Electric
Job Address: 500 NE 96 Street
Miami Shores, FL 33138 Phone Number
Parcel Number 1132060140700
Project: <NONE>
Contractor: AUTOMATION AMERICA CORP Phone: (786 )417 -9161
tiu
comments
KITCHEN AND MASTER BATH DEMO
INSPECTOR COMMENTS False
Inspector Comments
Passed
CJ'
Failed
Correction
Needed ❑ pelf", / ��
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 24, 2014 For Inspections please call: (305)762 -4949 Page 32 of 35
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
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BUILDING
PERMIT APPLICATION
Permit Type: Electrical
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Permit No. O I `l '-( ��
Master Permit No. f Y —(W
JOB ADDRESS:
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City: Miami Shores County: Miami Dade
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
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OWNER: Name (Fee Simple Titleholder): - -�-°�� Phone#:
Address: N'- 9 (o -
City:
Tenant
Email:
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CONTRACTOR: Company Name: A tJA 0W dA% 0iA A * C f t ctA CG rO , Phone #: q 8 (s` 4
Address: (<,-4 �5 Z 5vi , r 2--O) e. -'
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City: l d State:
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Qualifier Name: ��► t � Phone#:
State Certification or Registration #: 10 rc Dot co-3 4 Certificate of Competency #:
Contact Phone#: quo o ° 4! 1 `i�l Email Address: tits L%t Sit) o-As-6 y xW x, r e-s
DESIGNER: Architect/Engineer: n Phone#: ^
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Value of Work for this Permit: $ '*ID C� . Square/Linear Footage of Work:
Type of Work: DAddress OAlteration ONew ORepair/Replace Mdemolition
Description of Work: KA ilr-4n
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Submittal Fee $ Permit Fee $ 1`5' 1�"""
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $_
Technology Fee $
TOTAL FEE NOW DUE $
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'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 IN TEND 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 ccurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be a ov g $nd a reinspection fee will be charged. A IN
or gent / Uottractor
The foreg ing instrumen as ac owlledged before this �` The fore ing instrum nt w acknowled edgbefo MIS this
day of Q A , 20 , by I q �1 day of , 20 by - ,
o is personally known or who has produced o is person y wn to me
a nd who did take an oath. as identific i h Be! a 29, 2017
NOTARY P C: NOTA�IC: _ e � � tie N Nft womb y
Sign IP W. Q___V Sign:
Print: Print:
My Commissi :�y Motary Public - State 01 Florida
r� My Commission Expires
•F �yCommission # EE 17175/18
r Notary ab�•
.• mro�+Natronal
APPROVED Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /12J2012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3115/09)