EL-13-1703Miami 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
Permit Type: Electrical
FBC 20 r
Permit No. ZY � 0-703
Master Permit No ®"
JOB ADDRESS:
&W q Nt
&LAv
City: Miami
Shores
County!
Miami Dade
Folio/Parcel#: II — A'L. II U
Is the Building Historically Designated: Yes
OWNER: Name
Zone: N 0
City: A State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company
Address: M—'i 6 M U
City: IV
Qualifier
!:F1—UMj Zip: �!N `31 z 17 `�
_ Phone#kp2 ? 97 ° :I �4
State Certification or Registration #: U l -- Certificate of Competency #!y is ®0 '7 ' —I
Contact Phone#: I Email Address ' n C� Chi ° Eo ,
DESIGNER: Architect/Engineer. Phone#:
Value of Work for this Permit: $ 115 0 0 . A D Square/Linear Footage of Work:
Type of Work: DAddress
Description of Work: PIQ
ONew
Submittal Fee $ Permit Fee $ /S ® If C-;- CCF $ CO/CC $
Scanning Fee $
Radon Fee $
DBPR $ Bond $
ODemolition
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $ 1(0(0---10 �
TOTAL FEE NOW DUE $ + � •^ b
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
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
MPROVEMENTS 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
day ofin O� , 20 ? by 9N N t 0�12. L '66X L
who is personally known to me or who has produced V�:U1C>
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires:
The foregoing instrument was acknowledged before me this
day of 20///,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
; MARIBELBREfON
Print:
0 ' Y -r "' EXPIRES: October 19, 2016
My Cr�►
2 ep /Y
APPROVED BY ye>P yevb y Plans Examiner Zomig
Structural Review
(Revised 3/12/2012)(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 toz -WWI , 0 c 4'�.
inspection Number: INSP-196143 Permit Number: EL -7-13-1703 I
Inspection Date: September 10, 2013
Inspector: Devaney, Michael
Owner: WEBER, JENNIFER
Job Address: 849 NE 92 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: FOSTER $ SON ELECTRICAL CONTRACTORS, INC.
Buildina Department Comments
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number
1132060050050
Phone: (305)644-5869
BATHROOM REMODEL
Infractio Passed Comments
INSPECTOR COMMENTS False
Passed
21
Inspector Comments
Failed
%
l
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
For Inspections please call: (305)762-4949
September 10, 2013 Page 1 of 1