EL-12-1007Miami Shores Village I°c -
Building Department JUN ° 1 012
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC20VC)
Permit No. 12- C0
Master Permit No. C-- 1 �' I c01--i
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): f-\,JQ().) (0/14. MICA gG in'hone4 ?O, (o • g
Address: ��' NE lceer
City: lA-S'M s ik,L
1�
Tenant/Lessee Name:
State:
Zip: i
Phone#:
Email:
JOB ADDRESS:
City: Miami Shores
Folio/Parcel #: ( ° V.DC, ° 0 13 °
County:
Miami Dade Zip:
Is the Building Historically Designated: Yes NO
Flood Zone:
CONTRACTOR: Company Name: (\--Tirik r T I S C.-Lk-C(12-(C— Phone #:
Address: p-& 3 5 _C4). ` za Te(2.g-
City: 04,.( ' (� State: Fl--- Zip: 1I'
Qualifier Name: FL A- GI SCO P 0-- Phone #: On) r 67 f f
State Certification or Registration #: Certificate of Competency #:
Contact Phone#:
DESIGNE
Email Address:
Me- C bort A aL t✓c_
Value of Work for this Permit: $ I L (PO
Type of Work: OAddre .< OAlteration
Descrip on of Work:
Phone#: 34S 57- • ° S
Square/Linear Footage of Work: tc •5KLYZ_
ONew
Repair " eplaceF„ 'ODemolition
*************************************** g************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ 5..9 ev Permit Fee $ -5-2 I `--O CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 514-
Bonding Company's Name (if applicable)
Bonding Company's Address
City State 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 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 awl a reinspection fee will be charged.
Signature?(
Owner or Agent
The foregoing instrument was acknowledged before me this
day of Atli / , 20 a, by Andrew,
who is personally known to me or who has produced -wangles_
Tt " I' S It eel) Jc S As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Co I u ' sion Expires: O 23,, ® - 2.0
Signature
Contractor
The foregoing instrument was acknowledged before me this29-
day of (L,f L, , 20 j'-by Ca-ANSI C 0 '1° WL/2 -
who 's personally known to me or who has produced
c)(J l as identification and who did take an oath.
NOTARY PUBLIC:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
/2-
APPROVED BY � � �/� ZG/ ' ' Y Plans Examiner
Zoning
Structural Review
(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3 /15/09)
Clerk
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
- 1 007
Inspection Number: I NSP- 192853
Permit Number: EL -6 -12 -1007
Scheduled Inspection Date: June 06, 2013
Inspector: Devaney, Michael
Owner: MORGAN, MARY
Job Address: 307 NE 95 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: ORONI INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)606 -2098
Parcel Number 1132060136000
Phone: (305)685 -0412
Building Department Comments
REPLACE METER, PANELS, EXISTING WIRING AND ADD
NEW OUTLETS AND SWITCHES AS PER PLANS
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 Co
41", -
or
i
F
June 06, 2013
For Inspections please call: (305)762 -4949
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