ELC-14-750Miami 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) 762.494
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS:
City: Miami Shores
Folio/Parcel #:
9;/ A/E
County:
PA
Miami Dade
FBC 20
Permit No.
Master Permit No.� // l9 7S-6
Aa
Is the Building Historically Designated: Yes NO
Zip:
OWNER: Name (Fee Simple Titleholder):
Address: /73-00 /OE c51.2.)-e
City : 11,44/int i
Tenant/Lessee Name:
State:
Flood Zone:
Phone #: C, f5
Email:
CONTRACTOR: Com/ p�.ny Name:
Address: L1'
City:
Qualifier Name: 0.4.4)
State Certification or egistratioonn #:
Contact Phone #: /
DESIGNER: Architect/Engineer:
.4? - /i)
State:
41Z Phone#: le5WZIe,60
Zip:
cate of Competency #:
' Email Address:
� Phone #:
Value of Work for this Permit: $ �0D " O C Square/Linear Footage of Work:
Type of Work: Address
Description of Work:
❑Alteration
New DRepair/Replace
ODemolition
yr �� /� i Z r r
********* * * * * **** * * * ** * * ****** * * * * * * * * *F ********* *** *** * ** * * *** *** * ** * * * ** * ** * * ** *
Submittal Fee $ d C) Permit Fee $ 1. -�'®0 CCF $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ I 472- SO
CO /CC $
DBPR $ Bond $
Bonding Company's Nance (if applicable)
Bonding Company's Address
City State
it) /1- zip
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 Al4FIAAVIT: 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 Signa •
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this Ai* The forego',- .1 ' i s ent was acknowledged before me this
day of AfR,1 L , 20 i� , by WEAN QiEiS6 L day of �'tJ . 20 p�; by f�A
who is personally known to me or who has produced who is perso _ • • , to 11 a or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires: 11
as identification and who did take an oath.
NOTARY PUBLIC:
MARY PAT BRIGGS
COMMISSION # DD 979267
PIREES: May 11, 2014
Bonded
Notary Public Underwriters
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APPROVED BY
00/y
2 >" 9.2 - Plans Examiner
Structural Review
(Revised 3 /12/2012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
Zoning
Clerk
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 210867
Permit Number: ELC -4 -14 -750
Scheduled Inspection Date: June 16, 2014
Inspector: Devaney, Michael
Owner: , BARRY UNIVERSITY
Job Address: 9701 NE 5 Avenue Road
Miami Shores, FL
Project: BARRY UNIVERSITY
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Repair
Phone Number
Parcel Number 1132060171450
Phone: (305)758 -2000
Building Department Comments
REPAIR ELECTRICAL 200 AMP SERVICE. SERVICE IS
EXISTING AND TO CODE WATER DAMAGE
Infractio
Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
gagi z
June 13, 2014
For Inspections please call: (305)762-4949
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