EL-16-498Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number:INSP-253461 Permit Number: EL-2-16-498
Scheduled Inspection Date: February 25, 2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: PERIKLES, JOHN & MARIE Work Classification: Temp for Test
Job Address: 9730 NE 5 Avenue Road
Miami Shores. FL
Project: <NONE>
Contractor: BULLARD ELECTRICAL INC
Building Department Comments
TEMP FOR TEST
Phone Number (786)236-0254
Parcel Number 1132060171470
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction D
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Phone: (786)487-9505
February 24, 2016 For Inspections please call: (305)762-4949 Page 19 of 29
Permit No. EL-2-16-498
Miami Shores Village t Permit Type: Electrical - Residential
s �� 10050 N.E. 2nd Avenue NE
M- Miami Shores, FL 33138-0000 Pwo% r ' Work Classification: Temp for Test
"
y4FN Phone: (305)795-2204 Permit Status: APPROVED
F�ORiDp'
Issue Date: 2/24/2016 Fxpiration: 08/22/2016
Project Address Parcel Number Applicant
9730 NE 5 Avenue Road 1132060171470
Miami Shores, FL Block: Lot: JOHN & MARIE PERIKLES
Owner Information Address Phone Cell
JOHN & MARIE PERIKLES 9730 NE 5 Avenue Road (786)236-0254
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
BULLARD ELECTRICAL INC (786)487-9505
ype of Work:
dditional Info:
lassification: Residential
canning: 1
Fees Due
Amount
CCF
$0.60
DBPR Fee
$2.00
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
Valuation: $ 500.00
Total Sq Feet: 00
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-2-16-58788
02/24/2016 Credit Card $ 58.60 $ 50.00
02/23/2016 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Electrical
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 regulating
construction and zonog. Ff, rFmore-MUtKonze the above -named contractor to do the work stated.
February 24, 2016
Authorized Signature`: Owner / Applicant / Contractor / Agent
Building Department Copy
February 24, 2016
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 20TELECTRIC ❑ ROOFING
FEB Z S 2016
F,B�C" 20
v Master Permit No. `r % -(I
Sub Permit No. a i h -- ��o
❑ REVISION ❑ EXTENSION [—]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: -1 l
Citv: Miami
IN e J'C� 0--
. r
Occupancy Type: Load
OWNER: Name (Fee Simple Titleholder):
Address: 3 ti j�:)
City: ,
Tenant/Lessee Name:
Email:
County: Miami Dade Zip:
hD Is the Building Historically Designated: Yes NO
Construction Type: Flood Zone: BFE: FFE:
Phone 34-
State: Zip:
CONTRACTOR: Company Name: W t `(4,IE .PCS-41 Phone#:
Address: N-7 1�k (,✓ �� �i
City: At C-% I State: Zip: D (( q
Qualifier Name: .1C't d I
rr fi Phone#:
State Certification or Registration #: 00 ` Certificate of Competency #: '\
DESIGNER: Architect/Engineer: uL Phone#:
Address: City: State: j;� Zip:
Value of Work for this Permit: $ Y quare/linear Footage of Work: "Dl 5
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: i / ,
r .r- e- s"10--
Specify color of color thru tile:
Submittal Fee $ � Permit Fee $ /Ott CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ J
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City '
State
WE
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 wi of be ap oved and_�j7 fee will be charged.
Signatu
OWNER or
.The f iregoing instrument was acknowledged before m this
day of 20 by
wh is personally know o
me or who has produced as
identifi io and who did take an oath.
NOTA Y PU LIC:
Signature
CONTRACTOR
ThJinstrument was acknowledged before me this
yj o 20, by
lIDUA who i ersonally know_., o
I r
me or who has produced as
identifica ' and who did take an oath.
NOTAR PUB IC:
Sign
Prinr L./V"'t % \- 1V� NrintN--,/ J—,-1 %,.It—k t ffww—
LORETfA COMES
Seal: ,r+Y►o Seal:
W COMMISSION #ff1810 LORETfA COMES
E )SRES: MAR 21, 2016
^� Bonded through 1 St State Insurance my COMMISSION #ff181658
°F ORRES: MAR 21, 2016
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204 0
Fax: (305) 756.8972
AFFIDAVIT FOR 30 DAY TEMPORARY -ELECTRIC SERVICE
NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY
TERMINATION UNLESS APPLICATION IS RENEWED.
It is understood that the temporary -electrical approval by the Miami Shores Village, Building Department given
in connection with the building being constructed under:
Building Permit N: S `� Electrical Permit N:
At Address: Miami Shores, FL
For Owners p�� c� i �J , and is being given only for
construction pur se or for esting the followin equipment in said
structure: o�1 J �,c�-1� r' Cc�
The owner does herby agree to assume t e responsibility of maintaining the installation in such manner that
there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said
structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further
inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of
Occupancy or Completion is obtained.
The undersigned also understands that the temporary electric approval is subject to rescission and
:ancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of
le building concerned is occupied before final inspections are approved and/or obtained a Certificate of
Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will result in your
being unable off future Temporary for Test permits.
I, P� �'`l , being first duly sworn, depose and that I am the owner of the
above described prope ,and that !)agree that the structure covered in this g ; ement shall not be occupied
until the building cont ctor has o ined approval of final inspections and/ r obtained a Certificate of
Occupancy of Compl tion. N : Failure to comply with the provisions fithis affiidavit wAresult in your
being unable to obtain Tutu; — -
-Signat a of Owner
11 a.,
LORE TA COMES
WCOMWAOIN001311658 n ure of Notary
EXPIRES: MAR 21, 2018
1 _ . ` B4)r*d through let State Insurance
I'
%V , beirig Zwy swo. n, dean say th I m the Electrical Contractor for
the above -described Proaerfond that the electrical installations as now a is ng w' I not cre a safety hazard
if zft)�T�
d.
-
r�ar►� LORETTA COMES
Signature of Electrica Contractor' MY COMMISSION#�EE181
g 9 EXPIRES: MAR 21, 2018 I u re Of Notary
l "� Bonded through let
State Insurance
I, �q%� TC1ti�(� , being Irs y d say that I am the Building Contractor
of the above described property and that I will not permit occupancy of this build' until final inspections have
been called for by the contractors and sub -contractors concerned and final ap o I by the inspection division
obtained and that I have the authority insofar as the owner of said property is o erneq to prohibit occupancy
unt' h 'n inspe btained and/or ef QGGR 1pa or pleti is issue
1 7aa
ORETTA COMES
MMISSION #�EE181
RES: MAR 21,201
f Building C tractor roughIstSta Ineur�d ature of Notary
Signature)Qf Inspector Signature of Notary
e �If �13 3
Charles C. Mitchell, P.E.
924 N. Federal Hwy.
.Hollywood, Fla. 33023
Civil/Structural # 11127
305-336-5069
"Welding Certificate"
Feb. 16, 2016
Building Official
Building & Zoning Dept.
City of Miami Shores
Miami Shores, Fla.
Re: Welding
766 NE 96 h St
Miami Shores, Fla.
Dear Building Official,
In reference to the field welds for the steel column and steel beam connections, an inspection
was done to verify the welding. It was determined that the field welds done at jobsite were
structurally sound. The welds were observed at all steel to beam connections, steel angle to beam
connections and beam to beam connections. The methodology used was to visually observe the
welding at all connections to verify work done to FBC 2010 and per the approved set of plans.
Sincerely, _
C < •*
Charles C. Mitchell, P.E.