EL-12-2Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 170259 Permit Number: EL- 1 -12 -2
Scheduled Inspection Date: February 27, 2012
Inspector: Devaney, Michael
Owner: RUBEN MARANGONE, GERARDO
gal Address: 9140 NE 8 Avenue 3H
Miami Shores, FL
Project: <NONE>
Contractor: VERES ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132060440340
Phone: 786- 229 -8294
Building Department Comments
CHANGE PANEL RELOCATE FROM KITCHEN TO
HALLWAY.
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
February 24, 2012
For Inspections please call: (305)762 -4949
Page 35 of 43
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UILDING
PERMIT APPLICATION
FBC 20
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
Permit No. EL Z �2
RECEIVED
JAN 03 201
Master Permit No.
Permit Type: Electrical ®®
OWNER: Name (Fee Simple Titleholder): �G44 �P.a r Phone #: 7494 f G
Address: "In) Wu- /27 Jr /1"
•
City: /U - el�i��L State:
Tenant/Lessee Name:
Phone #: 710 reg :423
Email:
JOB ADDRESS: 9/ /O Vi a A-Ke 3
City: Miami Shores County: Miami Dade Zip: 35-4
Folio/Parcel #:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
NO Flood Zone:
Very'''. � 1'c.�
Address: 00109 St,�
City: �l d‘'+go 1 State: r/ . Zip:
Qualifier Name: CL,--(t_ C)-e_ r c S Phone #:
State Certification or Registration #: MOO / 77 3 0 Certificate of Competency #:
A C.
Phone #() s9 ag ( t.Q1U
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $
Type of Work: Address
Description of Work:
Alteration
Square/Linear Footage of Work:
UNew Ajtepair/R place
I,
❑Demolition
* * * * * * * * * * * * * * ** * * ** * * ** * *** **** * * ** Fees * * * * * * **** x **** **** x ****** * * * * * ******* * * ****
Submittal Fee $
Scanning Fee $
Notary $
Double Fee $
0 Permit Fee $
Radon Fee $
Training/Education Fee $
Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ 1091'' �O
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved a reinspection fee will be charged.
Signature 1� ✓/!
Owner or Agent
The fore • oing instrument was acknowledged before me this l
day of . ' , 20 , by ce a RC Cc° c Qc
who i .person :, y known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
NOTARY PUBLIC -_
My Commission Expires: p0'74, Sonia Saenz
3 =Commission #DD9292
, 1 ; Expires: OCT. 01, 2013
64ED' C ATL.4$TICBONDINGMS C.
B»NDEfl T'I;R
Contractor
The foregoing instrument was acknowledged before me this t91
day of &L., , 20.4 ,, by (�.
who is
ers onally known me or who has produced
as identification and who did take an oath.
NOTARY PUBLI
Sign: i
Print: A, 1� t
at�Y ""B9. ACHIELALSINA
My Commission Ex , e "•.
* t , * MY COMMISSION # DD 938965
EXPIRES: November 9, 2013
a'+rFOF,t.t,o Baited Thm Budget Maly Se vtoes
* * * * * * * * * * * * * * * * * * * * ** * * * **** ******************************************* ** ** ** * * * * * * ** * * * ** ***** * **** **
/�
APPROVED BY pr a" r' ? '� P�P1ans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk