MultipleMiami 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 i�
JOB ADDRESS: t. G s- " `o ff OA t
FBC 20 (b
Permit No. 12 �� S
Master Permit No. CC, 1 I j 1 —2,06 0
City: Miami Shores County:
Folio/Parcel #: 1. ��2 ® 4c, 0 I " 1 35D
Z)
Is the Building Historically Designated: Yes
Miami Dade
zip: 32438>
NO 'r/ Flood Zone:
�
t �
OWNER: Name (Fee Simple Titleholder): J/t 1 � L L �' ° Phone#:
Address: (0f W i �) 0 '&e3 Y = - .
City: liV) Gift State: C-L- d Zip: 3314 I
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Va /7 kc A Phone#:
Address: 40
City: ' fkgi Ttf2 State: FL Zip: 32,75 6
Qualifier Name: JcIti a, iUleah 4 /au Phone #: s,,,,,e
State Certification or Registration #: fC °' 00C9/60 $ Ce cate of Competency #:
Contact Phone#: 1 °` Jsi ve Email Address: ( 09 U /% e, £ tk e)-
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑AddreyCsss ❑Alteration ❑New t°3
Description of Work: 1Q. 1 "v`
cQLe4 . 1
ORepair/Replace ❑Demolition
Submittal Fee Permit Fee $ J >=13-e-- S cCO/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 PT.RCTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S Ab'1NII)AVIT: 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 rei ection� ill be charged
Signature
Owner or Agent
The foregoin_ instrument was acknowledged befor me this
day of ,�2U
lat
by I Q t�i0
who is personally known to me or who has produced
As identification and who did : , e an oath.
NOTARY PUBLIC:
Sign: _
Print:
4
My Commission I
.•4 * ft- Sylvia A Perry
�.1 My Qommission EE027516
s: f or r►a Expires 10/15/2014
Signature el, / il.a
Contractor
The fore oin iinstrrument was acknowledged ledged before me this /JJL
day of Z�/� ; 20 a, by ( n @ !i
who is personally known to me or o has produced
as identification and who did take an oath.
NOTARY PUBLIC:
4 /-
Sign: �a�J'���i9N-�►�, s.. a ir, %�
Print: 17: '_.
My Commi
My Commission EE027516
o i sl es£xpires 10/15/2014
**** ********** **** ***** *****+ x******+ x***** *aaw* ******a******************** ****a+ r+ a*s ***************** *********
/9 P Plans Examiner
APPROVED BY
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk
compressor
NEW
ELECTRICAL
ROOM
lasers 5)
o - do s
RADIATION
VAULT
AHU and associated
Compressor
CLOSET
HDR
STATION
ower distribution
unit and linear
accelerator
Mini split AC & 3 240v 1 ph receptacles for computers
Temp location of power conditioner
SUBJECT ►'O CCMPLIANCE WITH ALL FEDERAL
STATE AND e Iglu "le RULES AND REGULATIONS
V
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
II- 2o(Qo
Inspection Number: INSP - 172910
Permit Number: ELC -4 -12 -763
Scheduled Inspection Date: December 17, 2012
Inspector: Devaney, Michael
Owner: LLC, DEVINELLA
Job Address: 9165 PARK Drive
Miami Shores, FL
Project: <NONE>
Contractor: 50 STATE SECURITY SERVICE INC
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)785 -8990
Parcel Number 1132060141350
Phone: 305- 893 -7766
Building Department Comments
FIRE ALARM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
December 14, 2012
For Inspections please call: (305)762 -4949
Page 7 of 41
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 179261
Permit Number: ELC -9 -12 -1745
Scheduled Inspection Date: December 17, 2012
Inspector: Devaney, Michael
Owner: LLC, DEVINELLA
Job Address: 9165 PARK Drive
Miami Shores, FL
Project: <NONE>
Contractor: VOLT -TECH
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Temp for Test
Phone Number (305)785 -8990
Parcel Number 1132060141350
Phone: (321)268-4348
Building Department Comments
ELECTRICAL TEMP WIRING FOR TEMP MEDICAL
MACHINE, TEMP LIGHT AND POWER FOR TESTING
Infractio
Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 178679.
'e C
December 14, 2012
For Inspections please call: (305)7624949
Page 11 of 41