EL-08-568 4�����
� ,��,,• Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel: (305)795.2204 Fax:(305)756.8972
BUILDING -S
7APR
Permit No. ��
PERMIT APPLICATIOZ000 Master Permit No._c3 08 -53L
FBC 2004 /__ _9____
Permit Type: Electrical
YP
Owner's Name(Fee Simple Titleholder) DDC_Wfij- (!:�b '61t S24-WL Phone#. 30f-- 7.rq-Z.?jV
Owner's Address l 3yf AAJ SoV. �t
City 2State A(-
zip
Tenant/Lessee Name Phone#
E-MAIL:-WO 440CTOX1'5/+AP 1Z-1'614nOL 0VL!
Job Address(where the work is being done)
City Miami Shores Villase County Miami-Dade Zip ?310
FOLIO/PARCEL#
Is Building Historically Designated YES NO
�P a �F'c Iii i e-A l S J
Contractor's Company Name Phone#, 3 06 d lB C
Contractor's Address 341 S 7-
City State ,=/d Zip 3 2�8/
Qualifier Name 141 V V -Pe0gF-z- Phone# 30 5-j'7 - d/cl 9 ,?
State Certificate or Registration No. F Q % ®19 5 d Cert
E-MAIL: ificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
Value of Work For this Permit$ 3��� Square/Linear.Footag�Of:Work:
Type of Work: []Addition ❑Alteration ❑New
❑ Repair/Replace ❑ Demolition
Describe Work: 1 57 `��C� —f��
x+rdraYsYsSrsYdraYaYdrY4r3r4aYa44rarda3e4eoYxn�rir4rdr&sYdntoYdadr4radoF drekdraYS a4sirdrxsr 3e 4sk4txebdea4e�rt&iadrdrdrYsSxPrYdrdna�e
Submittal Fee$ Permit Fee$ / $ CO/CC
Notary$ Training/Education Fee$ ethnology Fee$
Scanning$ Radon$ DPBR$ Zoning$
Bond$ Code Enforcement$ Double Fee$
Structural Review.$ Total Fee Now Due$
See Reverse side-�
ilk
Bonding Company's Name(if applicable)
Bonding Company's Address CV
City State Zip L(C
�
Mortgage Lender's Name(if applicable) RUM
Mortgage Lender's Address �� / �a • j
City State
Zi
p
Application is hereb made to obtain a permit to do the w r and installations
y pe k ,as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and thiratt 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 and a reinspection fee will be charged
r
Signature Signature
O ner or Agent Contractor
The foregoing instrument was acknowledged before me this/— The foregoing instrument was acknowledged beforejne this 31
day of ,�,�,20 Com,b day of iia 20� ,by
who is personally known to me or who produced who is known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY P LIC: Its K FARM NOTARY PUBLIC:
W MISSION#DD SW
EXPIF'ES:April 10,2008
Tluut�yvab@oun�w�e 40"4=881&
� ES
Sign: Sign: 4 AM4A881&ODL766
EXPIRES:S&26,2010
BE" ist ho
Print Print:
My Commission Expires: My Commission xprres:
20
APPLICATION APPROVED BY: Pi's- ®�Plans Examiner
Engineer
Zoning
(Revised 02/08/06)
-
ts� Inspection Worksheet
` Miami Shores Village
y s:te fin�1
(4 . 10050 N.E. 2nd Avenue Miami Shores, F
Phone: (305)795-2204 Fax: (305)756-897
....:.....::..:..:::......
Inspection Date: 05/16/2008 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael Inspection Type: Final
Owner: , CHARTER SCHOOL Work Classification: Addition/Alteration
Job Address: 113015 Avenue NW
Miami Shores Village, FL 33138- PhoneNumber
Project: <NONE>
el Number 112136000060
Block: Lot:
Contractor: DD&D ELECTRICAL SERVICE INC Phone: (305)839-2986
Building Department Comments
P®'
Inspector Comments
Passed
FailedEl
Correction
Needed �Z: Yy�'�
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid .
Thursday, May 15, 2008 Page 2 of 2
� R Inspection Worksheet
Miami Shores Village
k`
10050 N.E.2nd Avenue Miami Shores, FL
X Phone: (305)795-2204 Fax: (305)756-8972
Inspection Date: 04/15/2008 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael Inspection Type: Underground Rough
Owner: , CHARTER SCHOOL Work Classification: Addition/Alteration
Job Address: 113015 Avenue NW
Miami Shores Village,FL 33138- Phone Number
Parcel Number 112136000060
Project: <NONE>
Block: Lot:
Contractor: DD&D ELECTRICAL SERVICE INC Phone: (305)839-2986
Building Department Comments
Inspector Comments
Passed cc
Failed
Correction ��� � �
Needed / j//
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid .
Monday,April 14, 2008 Page 2 of 2