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EL-11-975Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 161580 Permit Number: EL -5 -11 -975 Scheduled Inspection Date: July 06, 2011 Inspector: Devaney, Michael Owner: HUNDERVADT, ROBIN Job Address: 9100 N BAYSHORE Drive Miami Shores, FL 33138- Project: <NONE> Contractor: ADT SECURITY SERVICES, INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alarm Phone Number (305)751 -7624 Parcel Number 1132050010560 Phone: (786)331 -3967 Building Department Comments ALARM Inspector Comments Passed • Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. July 05, 2011 For Inspections please call: (305)762 -4949 Page 18 of 21 Miami Shores Village Building Departmen 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305). 762.4949 0,gy 2 Permit No. EL I I `I �ly9/f� BUILDING 05 -25 -201 ■ A07:34 PERMIT APPLICATION FBC 20 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) J�'` (�l( 'Z! l� Phone 526- DiO1 P ) �� ne #— Owner's Address 0 b ,,(1 ST k j :-t 7 f w - City Ca.//v14_ ! �S State [� Ft- Zip . Master Permit No. Tenant/Lessee Name Email Phone # Job Address (where the work is being done) 9/00 o &IIS i r City Miami Shores Village County Miami -Dade Zip ` '3 i 3 8 FOLIO / PARCEL # 1 3 2-o_s 001 054.0 Is Building Historically Designated YES Contractor's Company Name Contractor's Address NO Flood Zone • 4ne # (9150- —J% /s' /a9 Xi- (- 1/J t City L.r'U./_�,'..,1 State (= Zip Qualifier Name "'� T .� �� / . Phone # 9.Sy »»n �..S�l,j' State Certificate or Registration Th6. ei4o 2/ Certificate of Competency No. P Y Contact Phone /A% E -mail Qa e„,e, Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Q ( Square ./ Linear Footage Of Type of Work: ❑Addition ❑Alteration ❑New . ❑ Repair+ ' ..lace ❑ Demolition Describe Work: * * ** * ** * * * ** * * * * * * * * ** * * * * * ** * ** * * ** *Fees * * * * * * ** * ** ** Submittal Fee $ Notary $ Scanning $ Double Fee $ Permit Fee $ /-1 e'vt.06? CCF $ Training/Education Fee $ Radon $ DPBR $ Violation date: * * * * * * * * * * * * * * * * * * * * * ** CO /CC $ Technology Fee $ Bond $ Structural Review. $ Total Fee Now Due $ See Reverse side --> Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if ap cable) 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 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 re- inspection fee will be charged. Owner or Agent j Con u ctor The foregoing instrument was acknowledged before me this g The fore• instrument was acknowled day of d—� —, 20 11_, by r"-A'h CA k(vi tV 14— day of u , 20 1/, by who is perso lly known to me or who has produced identification and who did take an oath. Print: My Commission Expires: who is personal 'y known to me or who has produced as identification and who did takeath. c. • Notary Public State of Fiotil 13rnara -o2G My Commission 0D775417 i cnifss0410612012 My Commission Expires: * * * * * * * * * * * * * * * * * * * * * ** *************************************** * *** * ** ** * **** * * * *** * * ** * * * * * ** *,ter * * *** APPROVED BY Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009)