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EL-12-925Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number. INSP- 173933 Permit Number: EL -5 -12 -925 Scheduled Inspection Date: May 31, 2012 Permit Type: Electrical - Residential Inspector. Devaney, Michael Owner: SFARA, VERONIQUE Job Address: 1080 NE 105 Street Miami Shores, FL 33138- Project: <NONE> Contractor: PARDIME ELECTRIC INC Building Department Comments INSTALL TEMPORARY SERVICE FOR CONSTRUCTION Inspection Type: Final Work Classification: Temp for Construction Phone Number (305)799 -2006 Parcel Number 1122320280090 Inspector Comments Passed Failed Correction Needed a% B CV� Re- Inspection ❑ - � ��- �- W e_` Fe Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 30, 2012 For Inspections please call: (305)762 -4949 Page 17 of 26 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 �3iu_ BUILDIN PERMIT APPLICATION FBC 20 L® MAY 2 2 2012 Permit No. r L 12_92 S Master Permit Nov Permit Type: Electrical JOB ADDRESS: I D ! Y City: Miami Shores County: Miami Dade Zip:�� Foho/Parcel #: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple / Titleholder): Address: %® ,97D Al. • E, NO Flood Zone: City: A14 . �I State: Zip: Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Address: Name: ��/ C—e—) ( ,?- EeC �—/( J Z Phon �� �(�~ City: ' -f 04C 6 S = State: C�3 2— Qualifier Name: , Phone #: 9 "Q State Certification or Registration #: '�- ��C Certificate of Competency #65cMI -0?3 - Contact Phone #: Email Address: ©� r-� �'% �� ©U, a ►� °��' DESIGNER: Architect/Engineer.. Phone #: Value of Work for this Permit: $ % Type of Work: ©Address DAlteration to t® Dial) . - Description of Work: Submittal Fee $ Permit Fee $ 16Vg,,'P � &G CCF $ CO /CC $ Scanning Fee $ Notary $ Radon Fee $ Training/Education Fee $ DBPR $ Bond $ Technology Fee $ ODemolition 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 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 Signature Owner or Age4 f Contractor The foregoing instrument was acknowledged before me this /� The foregoing instrument was acknowledged before me this Zz- day of , 20 lC Z by t/�%'c c� - >� day of 20l Z, by (`� Se- c►�1�� �r who is personally known yy a or who has produced Lam. �/ who is personally known to me or who has produced J! �G J ;D—ss^ ��is ifentiPbatonpd who did take an oath. as identification and who did take an oath. NOT 0 Ove 2G� /Z APPROVED BY 7 k/(eW Plans Examiner Structural Review (Revised 07 /10 /07MRevised 06 /10/2009)(Revised 3/15/09) NOTARY PUBLIC: Sign: Print: My Commission 7,i �vpV : c Zoning Clerk