ELC-11-1919Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FIL
Phone: (305)795 -2204 Fax: (305)756 -8972 i
Inspection Number: INSP- 193932 Permit Number: ELC -10 -11 -1919
Scheduled Inspection Date: June 20, 2013 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael Inspection Type: R�h
Owner: EDELMAN, ALEX Work Classification: Addition/Alteration
Job Address: 9999 NE 2 Avenue
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060134490
Project: <NONE>
Contractor: LS CURTIS INC Phone: 305 -892 -0115
is
comments
3 NEW OUTLETS ELIMINATE ONE SWITCH AND
RELOCATE 1 SWITCH INSPECTOR COMMENTS False
Inspector Comments
Passed r
Failed
Correction ev l
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- Inspection fee is paid.
June 20, 2013 For Inspections please call: (305)762 -4949 Page 39 of 40
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Project Address Parcel Number Applicant
9999 NE 2 Avenue 1132060134490 SHOREVIEW CENTER
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
SHOREVIEW CENTER P.O. BOX 476 ()__ (516)551 -3806
LAWRENCE NY 11559-
Contractor(s) Phone Cell Phone
LS CURTIS INC 305 -892 -0115
Valuation: $ 600.00
Total Sq Feet: 0
Fees Due
Amount
CCF
$0.60
DBPR Fee
$3.37
DCA Fee
$3.37
Education Surcharge
$0.20
Permit Fee
$225.00
Scanning Fee
$3.00
Technology Fee
$0.80
Work without Permit Fee
$225.00
Total:
$461.34
Pay Date Pay Type Amt Paid Amt Due
Invoice # ELC -10 -11 -42320
05/20/2013 Check* 1396 $ 461.34 $ 0.00
Avaname
Inspection Type:
Final
IFire Alarm
Service Chanqe
1�i�Ar
Applicant Copy
For Inspections, Call (306) 762 -4949 or Log on at https : / /bidg.miamishoresvillage.com /cap/.
Requests must be received by 3 pm for following day inspections.
NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
additional restrictions applicable to this property that may be found in GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
the public records of this county. DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
20, 2013 2
BUILDING
Miami Shores Village4Crv]D
Building Department 'OCT 18 2011
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ,
Tel: (305) 795.2204 Fax: (305) 756.8972 3 i
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. fit t
PERMIT APPLICATION Master Permit No. " /0—//—/g qg
FBC 20
Permit Type: Electrical
OWNER: Name (Fee
City: 1Mt�n �4_
Tenantd,essee Name:
Email:
State: Zip: xg1i---r-
JOB ADDRESS: Q'q ��2 " i # pall
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
Address: vJ
City:
Qualifier Name:
NO Flood Zone:
Phone #:
46 , . �i ��
State Certification or Registration #: � �� tb Z,,?�Certificate of Competency #: e i, 0 d ® er�5
Contact Phone #: 2 Z4 `/ C 96^I Email Address: d �v�
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit $�2® c� _ 1 Square/Linear;.Faotage. of Work:
u wy
T -of Wb rk. ' CIA&drgss Alter tion ONew URepair/Replace.
ODemolition
Submittal Fee Permit Fee $ 2 CCF $ CO /CC $
Scanning Fee $
Radon Fee $
Notary Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
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
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 co to f the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to a Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection whic occueven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appro nd a rein ection fee will be charged.
Signature Signature
/'q °` or Agent Contractor
The foregoing instrument as aco ledg befo me this The foregoing instrument was acknowledge before me this /0
day of, 20 0 , b}� �' ` day o , 20 !i , by ,
who is personally known 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 PIJBLIC: NOTARY UBLIC:
4e n!'kc IMARIAMESAGNM
* * MY COMMISSION # EE 091851
S g EXPIRES: May 9, 2015 Sign , MELINDA K. CU]10sl 1191" P0116 2#20-
t. /� 7 � S v Print �,• Q My Comm. Expires Ma,t' Bon -11110 My Commission Expires: 9 av�J My Co ugh National N
APPROVED BY �l '�%—/ Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
CURTTSC, LEWIS STEVEN
20341 NE 30TH AVE FL 3.3180
jittNT RA
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w6 this ocanse you becom 011-14 ! wr p alai i PiorESSSO� .
�toridians licensed by tits pepartment of Susrness and rofessional Reputation. /Q�t {lta. 08 724
Ouc professionats.and tzustnesses range ftk m a orida`s #ecanomY strong. ftom EC.tt 0031
box+ars to barbeque restaurz�rttst and they eep
to yyam+
Every day we work ttt improve the way we do business in order��sdtt�€�fi�� ou �titt9er
cr in #or► aeon abr�uut twr serviees,.p�ese tiig t iRf.irjtt Cti'.Y
There' can find more irrfarmati<sn about our divisions and the regulations that CiJt .
imp you, subscribe to
department newsletters and seam more about the
Department's irtitie Ives. t
Our mission .at the Department is: License Efficiently b4 cumomeres. as �s�'��� ��z c�x�a3 ;�� �s ���
constantly strive to serve- ycsw bbetisr sa wf you
m Florida, and congratulations on your new iicenset s,sY ��;,:AVQ 3ti,
Thank you far doing isusinas�
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