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EL-12-2223 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: I NS P- 187197 Permit Number: EL -11 -12 -2223 Inspection Date: March 12, 2013 Inspector: Devaney, Michael Owner: GLINN, MacDAM & DENISE Job Address: 1201 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ENERGIZER ELECTRIC LLC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132050250160 Phone: (305)308 -5061 Building Department Comments ELECTRICAL FOR INTERIOR ALTERATION Infractio Passed Comments INSPECTOR COMMENTS True Passed Inspector Comments ry://,,,,,,y /2- iL "--V-,,,--- 2 e" .°, Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 March 21, 2013 Page 1 of 1 Miami 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 JOB ADDRESS: I s . FBC 20 Permit No. /� --A)'- c©75 Master Permit No. City: Miami Shores County: Miami Dade Zip: 33 1 3 Folio/Parcel #: Is the Building Historically Designated: Yes NO ✓ Flood Zone: OWNER: Name (Fee Simple Titleholder): it/Lc I lo_ G.\ Address: k ci c7 l % \ 0 City: A , Sd �o e State: FC- Tenant/Lessee Name: av i Phone #C l a-� $ $ ' g 0 6 C� Phone #: Zip: 331/W Email: CONTRACTOR: Company Name: :--..e —c ■ Ze — ,i (e ,.i ; C_ Phone #:C3u zJ 3 S - TO 6 Address: 7 go g , e1 L S-1, . City: IA'% r Ct. to". c — State: P L _ Zip: 3 3 0 a. ) Qualifier Name: C � a...s. e j Or `r A A/ Phone #: QO5) C) x- CO 4 I State Certification or Registration #: Certificate of Competency #: 0 l' • D CO ' Co Contact Phone #: Email Address: i%vfO �.✓e�� e� ��c� c - a� DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 700 Square/Linear Footage of Work: Type of Work: ❑Address la teration ONew Description of Work: �„ v o4- c°.�c t S kel, c e ` ®�''� \ G4 c r - 10,,,o HRepair/Replace a ( 0k 'r' aotri� fro D molition • ********************** * * * * * * * * * * ** * * * * *Feesx * * * * * * * ** * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ *' v ilk ,(. , r Permit Fee $ 4/4 t�� CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 2/- 1. • 5(0 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 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. Signature The fore day of . r is personally kn om Owner or Agent Signature S_e_co Contractor trument was acknowledged before me this) The foregoing instrument was acknowledged before me this -- 1 J 20 j Z, by r(Vlac i4 (1CAAA (1 ° e‘.r. , day of N 0 i , 20112_, by l) e c G, cd. Re d c 4f- o me or who has produced who is personally known to me or who has produced 1:"--'vw,, i' w As identification and who did take an oath. NOTARY PUBLIC: My Commission Expires: as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commissio KELLY YARDS • MY COMMISSION 9 DD 868069 EXPIRES: April 11, 2014 • BondedTh+u Notary Pare Undenweers 2 )° EGG 2c' Plans Examiner Zoning Structural Review Clerk (Revised 3 /12 /2012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)