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ELC-11-1118Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 161128 Scheduled Inspection Date: June 24, 2011 Inspector: Devaney, Michael Permit Number: ELC -6 -11 -1118 Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue NEW DOORM Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: SUNSHINE STATE ELECTRIC OF FLORDIA INC Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Temp for Construction Phone Number Parcel Number 1121360010160 -37 Phone: (954)565 -1153 Building Department Comments TEMPORARY ELECTRIC FOR BUILDING SITE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments F. P. & L. notified. o( ,re(tc- e_ June 24, 2011 For Inspections please call: (305)762 -4949 Page 14 of 18 Miami Shores Village Building Department i y'a JUN 2 0 2011 J 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BY: INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. Z,� 1\ BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): Address: 11?710 City: c6` Tenant/Lessee Name: Email: 1 State: FL r) Master Permit No. ik — 6A% Phone#: 305- - ` O6 Zip: 33161 Phone#: ig2d '34 ( ..\ kO I AA JOB ADDRESS: 113 d1'' N c City: Miami Shores County: Miami Dade Zip: 31bt Foiio/Parcel #: "' 21/4130 b14° Is the Building Historically Designated: Yes NO 1 Flood Zone: CONTRACTOR: Company Name: jcs,`ci -M e T,9ly 42'zi -71'< <iic 6 ' Phone#: // 3-3 Address: ///,7 rvo• 6:02/ '(: City: C e. ora2ndeUC:�. State: 7-"e- Zip: 3 33 'ex/ Qualifier Name: s /' ✓.9Ja7ael3 j71,Para2 Phone#: vv ' - State Certification or Registration #: 4=---:44.3"74,24V Certificate of Competency #: Contact Phone#: `?Pi 5 //S 3 Email Address: 02l,96151::7Z e e0!*9 DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ %4'19 ` °° Square/Linear Footage of Work: Type of Work: ❑Address ©Alteration t3Niew ORepair/Replace ODemolition Description of Work: i t1a l E-VtAin c.. .k-or t4s.e.r i152.. - et, i t,✓J ions je <7 r e- * * ** * ** * * * * ** * * * * ** * * * * * * * * * * * * * ** Fees************* +**** * * ** * * * * ** * ** *** ** * * **** ** Submittal Fee $ Permit Fee $ / 4",'' CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 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 properly 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 .' r a , pection fee will be charged. Signature Owner or Agent � The foregoing instrument was acknowledged before me this l� The foregoing instrument was acknowledged be day of 711"0-- , 2011_, by .i) , M- .44-4,S day of �1�i. , , 2011 , by who is personally known to me or who has produced who is o: ally_known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PU ; IC: NOTARY PUBLIC: C Signature Contractor re me thish. Sign: Print: CIfig7G 73i -1dam 4( / My Commission * * * * * * * * * * * *** APPROVED BY ' T 1, 11,4eSt14,, Notary Public State of Florida • Cheryl Saida Gerber •My Commis on DD986126 0 AF Expires 05108!2014 Sig f Print& My Commission Ex gel lea 'Ei 1 " Brooke Turpin = Commission #DD795528 • I / E THU ATLANTICSONDING01,ING 2/ 3"e4"- Plans Examiner Zoning Structural Review (Revised 07 /10/07)(Revised 06 /1012009)(Revised 3/15/09) Clerk