EL-13-929Miami 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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical
OWNER: Name (Fee Simple
City: I It 1(j, in
Tenant/Lessee Name:
Email:
JOB ADDRESS:
6Yo aoeoo®POO®OPP00060PP
Permit No.Ej _
! ✓ qjq
Master Permit No -UT _ 1+
F Zip:
State: C --
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes
Company Name:
Address:
City:
W
NO Flood Zone:
Qualifier Name: --r—A Phone#:
State Certification or Registration #: EF Certificate of Competency #: _
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ I S) Square/Linear Footage of Work:
Type of Work: OAddress Alteration ONew ORepair/Replace ODemolition
Descriptio of Work--,.,
Submittal Fee $ Permit Fee $�,/,�p . ®0 CCF $ CO/CC $
Scanning Fee $
Radon Fee $
DBPR $ Bond $
Notary $---L-- Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ , t�
Bonding Company's Name (if applicable)
Bonding, Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lerlder'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 apprpawd and a reinspection fee will be charged
Signature Signature
Owner or Agent, Contractor
The foregoing instrument was acknowledged before me this ��,U' " The foregoi instru ent was acknowledged before me this
day of -q�u" , 2013 , by Cf CIO "M , day of , 20 by
who is personally known to me or who has produced who is personally known to me or who has produced
L
As identification and who did take an oath.
NOTARY PUBLIC:
n
- �17om
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: 114114
Print:
My Commission Expires: `a'%
My Commi "sir
1%2014
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APPROVED BYkkkkA s
-2 &a Plans Examiner
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Structural Review Clerk
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL s�
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-190511 Permit Number: ELC-5-13-929
Scheduled Inspection Date: September 10, 2013 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael
Inspection Type: Final
Owner: , BARRY UNIVERSITY Work Classification: Addition/Alteration
Job Address: 320 NW 115 Street
Miami Shores, FL 33138-0000
Phone Number
Parcel Number 11213600000600
Project: BARRY UNIVERSITY MEDICAL SCIENCE
ON nr±
Contractor: MOODY ELECTRIC INC Phone: (305)758-2000
Building Department Comments
INSTALL ELECTRIC FOR CONSTRUCTION TRAILER IFal Passed comments
INSPECTOR COMMENTS False °
Inspector Co
Passed 1
Failed
Correction a
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
September 09, 2013 For Inspections please call: (305)762-4949 Page 1 of 31