EL-10-319 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 144249 Permit Number: EL -3 -10 -319
Scheduled Inspection Date: May 25, 2010 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: CHAMORRO, CARLOS Work Classification: Alteration
Job Address: 439 NW 111 Terrace
Miami Shores, FL 33168 -3327 Phone Number
Parcel Number 1121360010460
Project: <NONE>
Contractor: AUSTEN ELECTRICS Phone: (305)805 -8166
Building Department Comments
Inspector Comments
Passed
E�f
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 24, 2010 For Ins1pections please call: (305)762 -4949 Page 20 of 22
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10050 N.E. 2nd Avenue! ' Wor*GlaxS 1t8
Miami Shores, FL 33138 -0000 y3 g
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Project Address Parcel Number Applicant
439 111 Terrace 1121360010460
Miami Shores, FL 33168 -3327 Block: Lot CURRENT OWNER OR OCCUPA
Owner Information Address Phone cell
CURRENT OWNER OR OCCUPANT 439 111 Terrace
MIAMI SHORES FL 33168 -3327
Contractor(s) Phone Cell Phone Valuation: $ 2,775.00
AUSTEN ELECTRICS (305)805 -8166
. _ _ ..._..... _..__:_ _.__ Total Sq Feet: 0
Type of Work: CHANGE TO 200 AMP For Inspections please call:
Additional Info: ELECTRICAL (305)762.4949
Classification: Residential Available Inspections:
Inspection Type:
Fees Due Amount Invoice # Invoice Total Amt Paid Amt Due
CCF $1.80
Education Surcharge $0.80 EL -3 -10 -37159
.-_Permit Fee - Additions/Alterations $225.00 $232.80 $232.80 $0.00
Winning Fee $3.00
%b, nittal Fee $50.00
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Snb ittal Reversal Fee ($50.00)
Technology Fee $2.40
Utal: $232.80
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ftilding Department Copy
March 15, 2010
2
Miami Shores Village ► MAR o��o,o
Building Department �� ®eO
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 °®
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. C,� 1 ® 1
PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type Electrical Ll dm CJ p ,,,, b p
Owner's Name (Fee Simple Titleholder) A& #)/ftl 2ko ag Phone #
Owner's Address 4G 4 /y(eU `/ / a/?2 M/ 6-m * t -!�- t�b gC l sz / 4 P
City 6�1 e`3d'�'lll S S State F� Zip 33 1& C P
Tenant/Lessee Name Phone #
E -MAIL
Job Address (where the work is being done) 5G A/ 1k)
City Miami Shores Vill a County Miami -Dade Zip P
FOLIO / PARCEL # 11 0 ®kj (0 - 0
Is Building Historically Designated YES NO
Contractor's Company Name 4j S (C P /�'G /L -G-V — ,Phone # . 91Dr 0 C 16
Contractor's Address '7P s'f
City / 14 G State FY Zip 3 0
Qualifier Name Phone # ' ��S — (?/6 4
State Certificate or Registration No. Certificate of Competency No.
E-MAIL: U/GUW ► HUS - l�i C° a »'1
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit Oo Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration New [I Repa ❑ Demolition
Describe Work: 0 fi) ®a V'e' 1 '
C Lm
�9 Submittal Fee $ -0b Permit Fee $ �S �� CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $ c�(
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
See Reverse side
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) /Ul
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of su h posted notice, the
inspection will not be appro nd a reinspection fee will be charged.
.s
x Signature Signature
Owne r Vgent Contractor
The foregoing instrument was acknowledged before me this The forep*n instrument was acknowledged before me this Z�
day of _ ,20 /b, by 0. day of 20 by 5A4-W� (194 a
who is p on y rno to me or who has produced who is pe 1a y kno o me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY P UBLI E m 3 NOTARY PUBL :
Sign: �1 0 Sign: �$ ®E ®RO
Print: r� Print• l
LUIS
r 3 MY COMMISSION # DD937464
My C b "JR X � s Q Z My Commission Expire EXPIRES November 02 2013
=�4AUMMIS ION # DD937454 , '' OF1 �`�
" ftV VemVer U2,2013
( 407 )38&0153 ft6dallotaryeervice.com -
APPLICATION APPROVED BY: y Plans Examiner
Engineer
Zoning
(Revised 02/08/06)