EL-4-13-682Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972�
Inspection Number: INSP-192785
Scheduled Inspection Date: June 05, 2013
Inspector: Rodriguez, Jorge
Owner: CLARK, JENIFER
Job Address: 8953 NE 4 Avenue Road
Miami Shores, FL
Project: <NONE>
Contractor: WIREMASTERS ELECTRIC INC
5uiiaing Department comments
ELECTRIC FOR KITCHEN REMODEL
Permit Number: EL-4-13-682
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)767-3734
Parcel Number 1132060460420
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Phone: (305)378-4011
June 05, 2013 For Inspections please call: (305)762-4949 Page 39 of 47
Miami Shores Village
Building Department APR 0 8 013
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20 h
BUILDING Permit No. Eu 13 y
PERMIT APPLICATION Master Permit No.�C. - -3l f -3
Permit Type: Electrical
JOB ADDRESS: V 5-3 NE A4� A e_n uP__:R d a A
City: Miami Shores County: Miami Dade Zip: 3&j 1:3 y
Folio/Parcel#: I t - 3,2()k - 04(p - b�2
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): T-elan ifcr �. % k) n d Phone#: (CM) 4,39- C)��
Address: q We 44k }�1 �1 zAQ . p (�--
City: ftjyl1 Shut'-zs State: r L Zip: 531
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: wi Elee tn'c i i"l C Phone#: f2 137g -qo I I
Address: I ��O S l?� (3 g C.J� r Lt +,e_ O t
City: 1V19 O�kY'' //1 I State: EL— Zip.�`-
Qualifier Name: Phone#:
State Certification or Registration #: CC k 50u4{D-1 -9 Certificate of Competency #:
Contact Phone#: 6n=)�5-78 - 4c) i I Email Address:
J
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 1-3
W • Z) Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: d C C 71C" �Y L i +zk4 n r'I tr::j nA e I
***** *********************Fees**********************************�*�x**** x**
Submittal Fee $
Scanning Fee $
Permit Fee $ 1-4� '1' V CCF $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CO/CC $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $ 1 co 0 1 CJ
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
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 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 reinspection fee will be charged. �)
Signature z� - Signature 7t--C�Crt
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this �l_irl The foregoing instrument was acknowledged before me this,
day of 2h , 20 1-3, by c I day of d 1 , 20 �3 , by &-,.nL � .
who is personally known to me or who has produced -5&fo/is personally known to me or who has produced
9As identification and who did take an oath. as identific QW who 1kA%##Aa10ARMER
e••I
NOTARY PUBLIC: ' . 4tATRINA FARMER NOTARY PUBLIC:
MY COMMISSION # EE206M
EXPIRES July 09, 2016
Sign: Sign:
Print: 1 Print:
My Commission Expires: / j My Commission Expires:
MY COMMISSION 11 EE206640
EXPIRES July 09, 2016
q /ocl /.D U k l�
APPROVED BY i'%z Plans Examiner Zoning
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Clerk