EL-11-207A
Scheduled Inspection Date: February 23, 2011
Inspector: Devaney, Michael
Owner: BORDOWSKI, MARCELO
Job Address: 9418 N MIAMI Avenue
Miami Shores, FL 33150-
Project: <NONE>
Contractor: RELIABLE ELECTRIC CORP
Building Department Comments
February 22, 2011
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 156233 Permit Number: EL -2 -11 -207
For Inspections please call: (305)762 -4949
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition
Phone Number
Parcel Number 1131010340020
Phone: (305)218 -8653
REPAIR SERIVCE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 26 of 29
BUILDING
PERMIT APPLICATION
FBC 20
CONTRACTOR: Company Name: &ASP h
Address: / �DJ� ,„.cLe
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 I
Permit No. EL• t l ~ 2
Master Permit No.
� _ ' ►�- I '
Permit Type: Electrical
,�, jt
OWNER: Name (Fee Simple Titleholder): 41 > d,�, 9 J�'I✓..S a Phone #:
Address: 2 ® 7 Ce ,FO gr/,j
City: i i4✓JZl 74) /40 1 • State: "V- Zip: A,CP e
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: g , !/0 J . 4 tie- wax.
City: Miami Shores County: f rL • Miami Dade Zip: .3. ����
Folio/Parcel #: 1/ 'r e/ D J 7 2.
Is the Building Historically Designated: Yes NO Flood Zone:
10CMW3n
€s 0 < 2011
BY• .....
PhoneQl) /dv." ,,r
City: �� ' n? �' State: G • Zip: .33 C1 ' S
Qualifier Name: i r L,i - Phone #: (f 2 T)7.- i g j , f 3
State Certification or Registration #: j'j . lie) 04.10/4 Certificate of Competency #: a eC ►1,0 2151 i
Contact Phone#: ( 1-) 2 14 744-13 Email Address:
DESIGNER: Architect/Engineer: Phone#:
/red Value of Work for this Permit: $ `Q / �� Square/Linear Footage of Work:
Type of Work: ❑Address DAlteration New epair/Replace ODemolition
Description of Work: PA/ 2 ■ /11/) G�
*+ x*** ********** ********** ** * * * * ** ****** F * x***** *x:+ x**** ***** ************** ** * **
Submittal Fee $�- k_) . p Permit Fee $ i - Of eV CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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 properly 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.
Signatur
Owner or Agent
The foregoing instrument was acknowledged before me this
day of c , 201, by r / l t loUrci- (1ZL)\ Z ,
who is personally known to me or who has produced I
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
\�P
0%11111
is
NOTAIV DIBl I
Signature
Sign:
Print:
Contractor
The foregoing instrument was acknowledged before me this C a
day of ,20t \, by e tet YNet thV�^(IV ^
who is personally known to me or who has produced 1�' i— 10
as identification and who did take an oath.
NOTARY PUBLIC:
C
Co �, fi ss i on My Commission Expires: = NO T��Y PU�IIG
s �b59 C
�x�x****' Il 441§04 * * * * * * * * * * * * * * * ** : *�x**** * * **x * ***** ** **** e ee *Ao ,* * * **
APPROVED BY d�1!1Y 4 Plans Examiner Zoning
Structural Review Clerk