ELC-14-1675Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)7564972
Inspection Number: INSP-217075
Scheduled Inspection Date: September 17, 2014
Inspector: Devaney, Michael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Landon Student
Miami Shores, FL 33138-0000
Project: BARRY UNIVERSITY
Permit Number: ELC-7-14-1675
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number
1121360010160-32
Contractor: C DAVIS ELECTRIC COMPANY, INC Phone: (954)4324334
ounarng uepanment comments
INTERIOR GRAB N GO
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed (gyp
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
September 16, 2014 For Inspections please call: (305)762-4949 Page 13 of 45
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING 0 ELECTRIC ❑ ROOFING
j U Lft, 1► i614
//�
F��BC a20' 10
Master Permit No. l�
Sub Permit No. � i
❑ REVISION ❑ EXTENSION QRENEWAL
❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 11300 NE 2 Ave
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Barry University Phone#:
Address: 11300 NW 2 Ave
City: Miami Shores State: Florida Zip: 33161
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: C Davis Electric Co., Inc. Phone#: 954-432-4334
Address: 1701 SW 100 Terrace
City: Miramar State: Florida Zip: 33025
Qualifier Name: Charles E. Davis JR. Phone#: 954-432-4334
State Certification or Registration #: EC0001038 Certificate of Competency #:
DESIGNER: Architect/Engineer: Gallo Herbert Architects Phone#: 954-794-0300
Address:1311 W Newport Center Dr. Suite C City: Deerfield Beach state: FL Zip: 33442
Value of Work for this Permit: $ 3,000.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition M Alteration ❑ New
Description of Work: Interior Grab N Go
❑ Repair/Replace ❑ Demolition
Specify color of collo�ppr�thru tile:
Submittal Fee $� .W Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Rev1sed02/24/2014)
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
V
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
1''�' day of L- 20 t-.1 , by
S sonally known to
me or who has produced
identification and who did take an oath.
fired
Sign
Prins
Signature
—?!��"
CONTRACTOR
The foregoing instrument was acknowledged before me this
24th day of July , 20 14 by
Charles E. Davis JR. who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: C�
Print: Susan J.
as
SUSAN J. BENNETT
Seal: , otic :^r SUSAN J. BENNETT Seal: ;'= Commission # EE 217497
�= Commission # EE 217497 M Expires September 25, 2016
W Expires September 25, 2016
jh;pd ` Bonded Thru Troy Fain Inswance 800.385-7019
•.?„�;,� Bonded Thru Troy Fain Insurence 800.385-7019
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)