EL-11-804Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 163811
Scheduled Inspection Date: September 14, 2011
Inspector: Devaney, Michael
Permit Number: EL -5 -11 -804
Owner: , CK PROPERTY SOLUTIONS, LLC
Job Address: 10618 NE 11 Avenue
Miami Shores, FL 33138-
Project: <NONE>
Contractor: WATTS ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1122320280630
Phone: 305 - 8244722
Building Department Comments
ELECTRICAL WORK FOR INTERIOR REMODEL
//°,1-
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 159423. Label panels & mains.
A.C.C.U. onthe north side raise disconnect and add 120 volt G,F.I.
receptacle.
A.C.C.U. on so. side check breaker size.
Out side receptacles to be G. F. I. protected and in use covered.
Garage receptacles to be G. F. I. protected.
Need access to all panels .
l�/
)7-'
September 13, 2011
For Inspections please call: (305)762 -4949
Page 10 of 30
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical
MAY062011 Li
YJ6
Permit No.
Master Permit No. gip
OWNER: Name (Fee tSiimpleTitleholder) & .7 'a" t.) J o 7T UN6"IL /!ii) Phone #: �s��?%J'`D 3T2
Address: A9 �W� 150,4-4(6 7
h^yrd?.eJ A� State:
/Y/fr
City:
Tenant/Lessee Name:
Phone #:
Email: ti// 1 W, lG 9P410,f c 5. GO0-7
JOB ADDRESS: / elf / 0 >le7.7 it 4-V-
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: I/U i 77-6 EGE -7'/e' c Phone #: w6 /ate - 3 7 2 2-
Address:� 476 w 3 APL
City: / sQ GE rift State: FG. Zip: 33 V / Z
Qualifier Name: %.)1,10,n) ost L8 Z- Phone #: 784 /oI 9<9 G6'/
State Certification or Registration #: £e. 00 /0 2-/ Z Certificate of Competency #: D 60 0 /6 & 0 e
Contact Phone #: Email Address: W A' 17 -5 4-t.e'c7',e4 C, C &Ei L . se; O7 . flier
DESIGNER: Architect/ Engineer: MoVitf -alir2A a6 IV= ' ,4rJtrf 5 Phone #: 05-41-33-4-0 g
Value of Work for this Permit: $ g00 0 0 Square/Linear Footage of Work:
Type of Work: Address Alteration UNew URepair/Replace ❑Demolition
Description of Work: T Na?'s4LI — #.9- -- S e vFW 6 FCC'
o.Ua-- s w�rcff r1':- °�
spa ,e ..s tafpv? 441.•: ; 'dtA9
* * * * * * * m***** * *m *** *:x*u:x:** **** *** * * *Fe Vie`
Submittal Fee $ Permit Fee $ /.4-2, : OP CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 11(01$0
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 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 i • sued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Owner or Agent
The foregoing instrument was acknowledged before me this 7Z
day of r. 1 , 2011 , by V fi4 k aofl
who i
to me or who has produced
Signat
The foregoing i
day of
Contractor
strument was acknowledged before me this
Oa[., by
h s personally kn•' to me or who has
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: .600 rye
My Commission Expires:
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69
GEORGE ORTIZ
Notary Public - Mate of Raids
My Comm. Expires Feb 3.2014
Commission * 00 987983
**** *** * ***** *** * * ***
APPROVED BY
as identification ands 1I9t
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NOTARY PUBLIC:
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Print: 0` 'e 1t /1/ ,/; i
My Commission Expires: it— pa / y
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************* ******* * * * * * * * ** * * ** * * ** * * * * * * * * ** ****
Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk