EL-11-1970Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
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Inspection Number: INSP - 165832
Permit Number: EL -10 -11 -1970
Scheduled Inspection Date: January 04, 2012
Inspector: Devaney, Michael
Owner: MORALES, YURI
Job Address: 302 NE 92 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: JACQUES ELECTRIC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Pool - Private
Phone Number (305)790 -3849
Parcel Number 1132060136480
Phone: (954)214 -8711
Building Department Comments
ELECTRICAL HOOK UP FOR POOL EQUIPMENT
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
(
January 03, 2012
For Inspections please call: (305)762 -4949
Page 7of31
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
OWNER: Name (Fee Simple Titleholder):
Address: 3c--;)
City: l) ?l4e1)1' t S
Tenant/Lessee Name:
/ /11 4/ t
Permit No.
COQ
Master Permit No.
Phone #: 3 C' 5 7L7 6, `/
State:
Zip: 2,2 3
Phone #:
Email: Yi)) /_>G L t /C...1- (a !p ' 0 S �i a C )-)
JOB ADDRESS: L1A ji t: �% -3-/T
City: Miami Shores County:
Folio/Parcel #: 1) - 3 t °-(. j 3 1/ 5 L
Miami Dade
Zip: . A 3 E'
Is the Building Historically Designated: Yes NO ate'
Flood Zone:
CONTRACTOR: Company Name: 13—e., °fie (` i L ±%f e r Phone #: 62 7/
Address: 7/ G -lid' c I c c i+ S �-
City: ` /fit tttect
�r
Qualifier Nam 6: T 1,
15:1? c' [ Certificate of Competency #: 4 ( C +( / 7
State:
zip: 36 ,, 5/
Phone #: q 4 ') `.i —r ///
State Certification or Registration #:
Contact Phone #: � y-,77) / _ . 7 I / Email Address: ;);. L.:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $_2.5.__LL e' Square/Linear Footage of Work:
Type of Work: ❑Address Alteration URepair/Replace ODemolition
Description of Work: fit 6IC Ly Kr. t ip p )e = a �'
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ ,747v" e
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ ad" 63
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 is issued. In the absence of such posted notice, the
inspection will n be ap ova, and a reinspection fee will be charged.
Signature
Owner or Agen
The fore oing instrument was ackno dged be ore me this 7
day of her , 20 //, by Uct �O %l /e 5
who is perso 11y known to me o who has produced /4;2--
D/'eLP1` . 'Cease As identification and who did take an oath.
NOTARY PUBLIC:
Sign: Zit.k(,Ld L> 4 L.
Print:
My Commission Exp
G ENDOL 6 STEW ART
MY COM4 JSSION # DD9615R6
c c' EXPIRES. April 19, 2014
1- 8®- 34NOTAay t9. Notary Disc Assoc. Co.
�V1fWARiiuwwsa ®» _ _
Signature
Contractor
The foregoing instrument ' ` was acknowledged before me this
day of a%4 , 20 //, by 3b.-, ISegeell
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
GWENDOr_}'N B. STEWART
Sign: �, ,;yl l�r
^OPoIMI„StON N DD961586
Print: e* EXPIRES: April 19, 2014
-Th L Now,. n. &sexy Diumant Max. C.
My Commission Expires:
s:
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APPROVED BY
/q,e9g"/7 /Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk