RD-14-1274 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-216546 Permit Number: EL-6-14-1278
Inspection Date: July 25, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: BENTON, THOMAS AND LAUREN Work Classification: Alteration
Job Address: 230 NE 100 Street
Miami Shores, FL Phone Number (305)795-2207
Project: <NONE> Parcel Number 1132060134480
Contractor: ATLANTIS ELECTRICAL CORP Phone: (305) 551-4043
Building Department Comments
BATHROOM RENOVATION Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
July 25,2014 Page 1 of 1
Miami Shores Village FBY:/,,-2
IVED
Building Department 7 2014
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20)0
BUILDING Master Permit No.q? / I-/— /C �
PERMIT APPLICATION Sub Permit No.t/
❑BUILDING Oj ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
p CONTRACTOR DRAWINGS
JOB ADDRESS: G�O QE � e 'k
City: Miami Shores County: Miami Dade zip: 33\38
Folio/Parcel#: 11- SW(O - C d-6-''-11'1%0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):�oy-rxaa-'.) Phone#:
Address: GSc� UE tc�U
City: PCLyvj j S1�cs�`es State: zip: 33(3g
Tenant/Lessee Name: Phone#:
Email: r�
CONTRACTOR:Company Name: A_k-kcx \'\iS Ikea�wj'CaQ Qc rp. Phone#:
Address: kZ9,03 %W 20
City: i \(Ol(Y1i 1 State: korlA Zip: 3 �5
Qualifier Name: i::fCt(WA'&'Q6 'qlcff2- Phone#:
State Certification or Registration#:f,C. 1306 RP4 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
s
Value of Work for this Permit:$600f Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: tK#-�Lu'�.e� (SyAJC C •L L'7 t
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ _ ����6'49 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$_ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ C
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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 oj'commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a c•ertijied 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 ap roved and a reinspection fee will be charged.
Signature / Signature
Owner or Agent Contractor
The foregoing instrument was acknowledgedbeforee this�� The foregoing instrument was acknowledged before me this
day of �U 20 by ( VI
(I VA �� D day of ,20 LLt,by:;FW&-6W
who is ersonally known me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. eO VA 7i le- as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sig .
Print: Vr Print:
My CommissioJExpires: ,.t BARBWhEVEP My Commission Expires: +�` REBECA M.PASTRANA
MY COMMISSION#FF 073975 MY COMMISSION M EEE72624
EXPIRES:March 29,2016 EXPIRES:Fcbnuuy 07,2017
ti Bonded Thru Notary Pudic Underwriers °P
****x********************************m**s***************
APPROVED B Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)