DEMO-15-1329 (2) Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
nspection Number: INSP-235932 Permit Number: DEMO-6-15-1329
Inspection Date: August 18, 2015 Permit Type: Demolition
Inspector: Devaney, Michael
Inspection Type: Final
Owner: , Work Classification: Electric
Job Address: 1151 NE 99 Street
Miami Shores, FL 33138- Phone Number (786)253-2869
Parcel Number 1132050180070
Project: <NONE>
Contractor: SOUTH DOM ELECTRIC INC Phone: (305)626-5904
Building Department Comments
DEMO SHUT MAIN DISCONNECT AND INSPECT Infractio Passed Comments
INSPECTOR COMMENTS True
Inspector Comments
Passed =
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
August 18, 2015 Page 1 of 1
GCTR IC
Miami Shores Village
EMO
Building Department P F-A sr coN,r-AC_r
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 "C'>ti( QV C-- Ope lO u IS
Tel:(305)795-2204 Fax: (305)756-8972 / 'SSU Ef
INSPECTION LINE PHONE NUMBER:(305)762-4949 W! 4/u y
FBC 20 7k-�-253 i G
�b M
/
305- 7q ,_ .yg2G
BUILDING Master Permit No. 24W = L32F
PERMIT APPLICATION Sub Permit No.D?mQ b✓� 13,2,
❑BUILDING jK]ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip: 3
Folio/Parcel#: // 36v S J / ? L'U•7 U Is the Building Historically Designated:Yes NO t-'
Occupancy Type: Load: Construction Type: �-f�_� Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): LLCPhone#: �
Address:
City: ^dyl/�' "f State: Zip:
Tenant/Lessee Name: _Phone#:
Email: 4 t/ 7—.2�
CONTRACTOR:Company Name:��� /t�{ J'}L/_ ��C�/� /G Phone#:`: CS
Address: 6 2 Car-) rV 4) l��
City: Al 1A /° r State: - / Zip:
Qualifier Name: � ��'� MAl 03 Phone#:.t�
State Certification or Registration#: > 4500 1 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace jtfDemolition
Description of Work: '
Specify color of color thru tile:
Submittal Fee$ Permit Fee$$"l�G'i d ` CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 4
(Revised02/24/2014)
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 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 - goodf aith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose pro rty 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 s after the building permit is issued. In the absence of such posted notice, the
inspection 'll t e approved and a rei sp tionlee will be charged.
Signatur Signature
WNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of r'Y► �`� 20 1:5-- by day of 12J,::�Zc—/ 20 , by
who is personally known to who is personally known to
me or who has produced /�� � —� as me or who has produced �� • as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print: = n: o ; J= nt. 01 Florida
-
�, ..,�M ... •,,P'`, = ''� �4; NJEmasu NlsFab
Nhcie
bO0FO1s3L4 m Seal: o Seal:
Ole
************************************************************************************************************
APPROVED BY �� 2,?2�.� jy Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)