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EL-10-187 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 141184 Permit Number: EL -2 -10 -187 Scheduled Inspection Date: April 22, 2010 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: LEONE, DEBORAH Work Classification: Alteration Job Address: 5 NW 105 Street Miami Shores, FL Phone Number Parcel Number 112136005032 Project: <NONE> Contractor: P&M ELECTRIC INC Phone: (305)949 -6373 Building Department Comments INSTALLATION OF ALL NEW THHN WIRING THROUGHOUT HOUSE TO REPLACE CLOTH COVERED CONDUCTORS INSTALLATION OF 4 NEW SMOKE DETECTORS Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 21, 2010 For Inspections please call: (305)762 -4949 Page 23 of 26 Y Miami Shores Village �lift 10050 N.E. 2nd Avenue �O Miami Shores, FL 33138 -0000 a ` Phone: (305)795 - 2204 ..� �f �N �� �. Expiration: 081091201 Project Address Parcel Number Applicant 5 105 Street 1121360050320 DEBORAH LEONE Miami Shores, FL Block: Lot: Owner Information Address Phone Cell DEBORAH LEONE 5 NW 105 ST MIAMI FL 33150 -1241 Contractor(s) Phone Cell Phone Valuation: $ 2, 400.00 P&M ELECTRIC INC (305)949 -6373 (305)588 -9724 _, Total Sq Feet: 0 Type of Work: ELECTRICAL Available Inspections: Additional Info: SERVICE UPGRADE Inspection Type: Classification: Residential Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice # EL -2 -10 -36995 Education Surcharge $0.60 04115/2010 Check #: 9331 $ 237.80 $ 0.00 Notary Fee $5.00 Permit Fee - Additions/Alterations $225.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $237.80 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 zoning. Futhermore, I authorize the above -named contractor to do the work stated. April 15, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy April 15, 2010 1 ��\40 Miami Shores Village s a sy sl Building Department FED 0 4 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ��r� •.,•....••••••" INSPECTION'S PHONE NUMBER: (305). 762.4949 BUILDING Permit NOE. 10 — ) PERMIT APPLICATION Master Permit No. FBC 20 Permit Type ELECTRICAL Owner's Name (Fee Simple Titleholder) )-b 8,64 e- Phone # Owner's Address City *,,,,: State m Zip Tenant/Lessee Name Phone # Email Job Address (where the work is being done) _�� A/A/ /0-5— S,T City Miami Shores Villaee County Miami-Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO X1, Flood Zone Contractor's Company Name Z lec–,Zr6 Phone # Contractor's Address _/ �"� / / 9e 5,7" city r ,��,, .° State o Qualifier Name Phone # State Certificate or Registration No. /, ?UPS j ,? 7S Certificate of Competency No. Contact Phone E-mail , Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: Addition „®`Alteration E]New Repair/Replace El Demolition Describe Work: -- �, ,� d,- gk � ;,t Submittal Fee $ Permit Fee $ �' �j�P ®® CCF $ CO /CC $ Notary $_ 5 - 0 Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Q Structural Review. $ Total Fee Now Due $ C <L*) p® See Reverse side 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 of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certed 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 re- inspection fee will be charged. Signature e 40 Signature Owner or Agent ��f Contractor The foregoing instrument was ackno !edged efore me this (9 � The foregoing instrument was Y acknowledged ore e day o � day 2 b � —, of #��onally � U Y , wh personally known tome as produced who ' known to me o has produced As i ation and who did take an oath. as identifi d wl� f4take an oath. NOTARY PUBLIC: ' t ele °° °io NOTARY PUBLIC: e � @.E ; AVILg tr °r ° °1 ��� / t AA "a �,�; ®•° g1pN E,1p� °• s, r ao � ov �� 21, 20 "N '. Sign: Sign: NY a r • ' O g2g4fl 1 •�. Print: ' o a® ;ate Print: ° 7�6 � � �o ° aadea My Commission Expires: COQ e; My Commission Expires: ®/ �9 • °• r�oYFan�• °° O�C®�� naiai + + +����� APPROVED BY Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06110/2009) Mo i. "� .. P'" •1 �8' ;.i.7" 3 ;.: . >. : "i. • .�7. - ' :7 *4 . iV:. @ ',[I.1 i''. A: :1" &•N eM "':4 "0". - 9 - n: 9i:'.7° i;a2. .9'° f :,' ► x1j.1 Ev :aa i 1 IS' si A+ 4'