EL-16-3063 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL C I b—
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-271259 PermitNumber: EL-11-16-3063
Scheduled Inspection Date: November 21,2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: FACCIDOMO,JUDE&FRANCES Work Classification: Low Voltage
Job Address:30 NE 93 Street
Miami Shores, FL 33138- Phone Number (305)374-5730
Parcel Number 1132060130200
Project: <NONE>
Contractor: B.L.F ELECTRICAL INC Phone: (786)380-2509
Building Department Comments
LOW VOLTAGE Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed [Z] ��
ry
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
2016 For Inspections please call: (305)762-4949 Page 32 of 45
3063
Miami Shores Village ` � � le 1w� d erdial
10050 N.E.2nd Avenue NE
tf3tCJf � t ,
x"' Miami Shores,FL 33138-0000
Petfti! I AQ.FP { �/L ;.
h � Phone: (305)795-2204OR
-`
-1 ,u ante: 111 6/204 Expiration: 05/1562017
3.
Project Address Parcel Number Applicant
30 NE 93 Street 1132060130200
JUDE&FRANCES FACCIDOMO
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Celt
JUDE&FRANCES FACCIDOMO 30 NE 93 Street (305)374-5730
MIAMI SHORES FL 33138-
30 NE 93 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 300.00
B L F ELECTRICAL INC (786)380-2509 Total Sq Feet: 0
Type of Work:LOW VOLTAGE Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Review Electrical
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# EL-11-16-62002
DBPR Fee $2.00 11/16/2016 Credit Card $ 108.60 $0.00
DCA Fee $2.00
Education Surcharge $0.20
Permit Fee-Additions/Alterations $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFI 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 an zoning. RuWermore,I authorize the above-named contractor to do the work stated.
November 16,2016
ze �gna re: wner / Applicant / Contractor / Agent Date
Buildin Department Copy
November 16,2016 1
Miami Shores Village RECEIVED
Building Department " ' '
10050 N.E.2nd Avenue,Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 L _
FBC 201
BUILDING Master Permit No-]�(_) l 6 — I
PERMIT APP KATION Sub Permit No.n_ (�o-
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
l ,1 cam, CONTRACTOR DRAWINGS
JOB ADDRESS: �� 1y/ ! 8 r-/
City: Miami Shores County: Miami Dade Zip: i9113r
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):JI� IW 4 4✓i�.t-0i T�LG[ l.�c� Phone#: � 964Y C111681
Address: 30 ntic— Q3 .97L
City: d inh State: Zip: 3313K
Tenant/Lessee Name: Phone#:
Email: t,41;4 I bo KA Q P 6md -f(, , Go%4,
CONTRACTOR:Company Name: L�-PPC /Lt [�,�,z[ _ Phone#: 8'6 WO 7S-0 1
Address: 987073: l/ 0:3 d t
City: )46�G,49eC4 / /4_S_tatee: Zip: 3 ?r
Qualifier Name:N&ae�-s'Key— C 6wx-A Phone#:
State Certification or Registration#: CL wOb S Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 3C70 Square/Linear Footage of Work: Cl =C/
Type of Work: ❑ Addition ❑ Alteration ❑ Newy— / [l/Repair/Replace ❑ Demolition
Desai tion of Work: %p0Ltn 7P,LGGn��
nvj Vdf4LSg
Specify color of color thru tile: ��nn
Submittal Fee$ Permit Fee$ ®� " ®� CCF$ Q • 60 CO/CC$ (�
Scanning Fee$ 3- GO Radon Fee$ Z' DBPR$ 2-OJ Notary$
Technology Fee$ eo Training/Education Fee$ 0. 20 Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 6Q
(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
s
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS,HEATERS,TANKS,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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
I _day of NOW-14fv ,20 IL , by `r t day of IV 0\1f—VA ,20 I6 by
T-rua S VQ CCI dQVl4V,who is personally known to V JD&IW11V L4bYC1dA ,who is personally known to
me or who has produced�DY Q�V u 11EQ,UlfC' as me or who has produced [)r 1\J?_V LICeWe as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: J0 01- �V `1 VQf Sign: LuLt l •e.!
Ym
Print: l.li'y�` d Print: le U 11 U ,e
Seal: Jorge L.Cifuentes M. Seal: .�`'�:¢;/ Jorge L. Cifuentes M.
?` `!<Rt Commission#FF985416 --
�`• , , Expires: April 25, 2020 `'sCommission FF985416
1 Expires: April 25,2020
Bonded thru Aaron Notary
APPROVED BY P4W/GPlans.Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)