EL-18-3240Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Ave, Miami Shores, Florida 33138
Tel: 305-795-2204 Fax: 305-756-8972
Inspection Number: INSP-001070-2018 Permit Number: EL-10-18-3240
Scheduled Inspection Date: October 25, 2018
Inspector: DeVaney, Michael
Owner: BRYON J THOMAS
Address:
Project:
136 NE 101ST ST
Miami Shores, FL 33138
Contractor: MOODY ELECTRIC INC
JOHN MOODY
Permit Type: Electrical - Residential
Inspection Type: Electrical Final
Work Classification: Service Change
Phone Number:
Parcel Number: 1132060132000
Phone Number: 3057582000
Building Department Comments
CHANGE OUT 100 AMP ZINSCO PANEL
Checklist Item
General Comments
Passed
False
Comments
Inspector Comments
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 24, 2018 For Inspections please call: 305-762-4949
Page 3 of 30
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date: 10/24/2018
Permit Na: EL-1 O-18-3240
Permit Type: Electrical - Residential
Work Classification: Service Change
Permit Status: Approved
Expiration: 04/22/2019
Parcel Number
136 NE 101ST ST, Miami Shores, FL 33138
Contacts
BRYON THOMAS
136 NE 101 ST, MIAMI SHORES, FL 331382321
Owner
Description: CHANGE OUT 100 AMP ZINSCO PANEL
Fees
Amount
Application Fee - Other
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
$50.00
$1.20
$2.00
$2.00
$0.40
$50.00
$3.00
$2.50
MOODY ELECTRIC INC
JOHN MOODY
669 N W 90 Street, Miami, FL 33150
Business: 3057582000
Contractor
Inspection Requests:
305-762-4949
Payments
Total Fees
Credit Card
Credit Card
Amount Due:
Date Paid
10/24/2018
10/23/2018
Amt Paid
$111.10
$61.10
$50.00
$0.00
Building Department Copy
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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulatin... nstyiiction and zoning. Futhprmore, I authorize the above named contractor to do the work stated.
izeij ignature: Owner
Applicant / Contractor / Agent Date
October 24, 2018
Page 2 of 2
City:
Phone#:
State: Zip:
Square/Linear Footage of Work:
Type of Work: ❑ Addition Ir—1t Alteration ❑ New
❑ Repair/Replace
Description of Work: Cha,, ,a_ �cf.,/- /00' or
Specify color.of color thru tile! �=
Submittal Fee $ c� , Permit Fee $,^•/OCP, OVCJ
/ 6 //'/ 5A
City: d_'1I7/ sAn/`t' S
0)0
v•
Miami Shores Village
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
BUILDING
PERMIT APPLICATION
BUILDING ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: //30 ✓E /0/ 5/
Master Permit No.
Sub Permit No.
RECEIVED
OCT 2 3 1018esL
FBC 20 j)
EL► - 3240
❑ REVISION ❑ EXTENSION RENEWAL
❑ CHANGE OF
CONTRACTOR
CANCELLATION
City: Miami Shores County: Miami Dade Zip:
SHOP
DRAWINGS
Folio/Parcel#: Is the Building Historically Designated: Yes x NO
Occupancy Type: Load:
OWNER: Name (Fee Simple Titleholder):
Address:
Tenant/Lessee Name:
Email:
Address:
CONTRACTOR: Company Name:
3 $/a
City:
Qualifier Name:
WOO
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address:
Construction Type:
M / - 1Di a
State:
Flood Zone:
e-
(?
c
��J State:: �%ko/�!a/ Zip: 13 0
Vt7 " T zficioG4' Phone#: 30S—/ 51� 000
Certificate of Competency #: f%/4
00G//,'
Value of Work for this Permit: $ p (X) s 0 O
BFE: FFE:
Phone#: 3 3 = a06 fig
Zip:
Phone#:
Phone#: j— a('QD
❑ Demolition
CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 2- • 03 DBPR $ 2 C7z), Notar
y ',
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ 6 I to
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 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.
tr/Al
"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 tol 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. ,
OWNER or AGE T
The foregoing instrument was acknowledged before me this,
ZZ •day of Or }Q\O't Y' , 20 1 C , by
i3 1 0 rne) , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
********* *
Mu'
r Notary PubUc State of Florida
Rebeca Munoz
.f MY Commission FF 916344
ExFires 09/06/2019
APPROVED BY
(Revised02/24/2014)
The foregoing instrument was acknowledged before me this
22. day of 0ctob-e ( ,20 i ,by
,1 Qh f ,) _ O0dk1 , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
73. e Plans Examiner
"MN, Notary Public State of Florida
, Rebeca Munoz
MY
rxp
Zoning
Structural Review Clerk