EL-12-383Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 170730 Permit Number: EL -3 -12 -383
Scheduled Inspection Date: April 04, 2012
Inspector: Devaney, Michael
Owner: PEREZ, JOEL
Job Address: 1167 NE 99 Street
Miami Shores, FL
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132050180080
Phone: (305)758 -2000
Building Department Comments
OVERHEAD SERVICE TO UNDERGROUND. EXISTING
HAS BEEN UPGRADED TO 200 AMPS.
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
572„
if/fr/7, f
April 03, 2012
For Inspections please call: (305)762 -4949
Page 11 of 22
Miami Shores Village
Building Department
0 6 ::;z
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 No.-E-1 \ 2 3
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): \)O Pie z_
Address:
Phone #:
City: ti' i nn 8 eke& State: Zip: 39 /38
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: e.24 r y
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: 00 Al lie-46 1L cA
Address: (MA 1U 4091
Phone #: ,DS -7ST-
City: M i 1 State: Zip: 3/6o
Qualifier Name: J O J MOON Phone#: :
State Certification or Registration #: 6 c tvo I I el Certificate of Competency #:
Contact Phone #:
Email Address:
DESIGNER: Architect/Engineer: l k Phone #:
Value of Work for this Permit: $ itfoo.00 Square/Linear Footage of Work:
Type of Work: ❑Address
Description of Work:
_ �®�
a/
❑Alteration
❑New LI epair/Replace
❑Demolition
5
* * * ** *** * *** * * *** * * * *** **************** Fees** * ******* * *** ************ **** * * * * * ******* **
Submittal Fee $ Permit Fee $ 71-4°'''C' E2 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
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State s Zip
Zip
Application is he y made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced pri r 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 and a reinspection fee will be charged.
er or Agen; Contra or
l ,
The foreg'oir1g instrument was ackno `le,,,d b = ore me this 5 The foregoing instrument was acknowledged before me this 5
day of ffiWUJilk, 20 I �—, by ,Joel. /ged
who is personally known to me or who has produced " who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
day of ni4P.04 n 14 , 20I0.—:by 07)200
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Exp
0464uPtti-
* * * * * * * * * * * * * * * **
APPROVED BY
MARY PAT BRIGGS
MY COMMISSION # DD 879287
•c;:
EXPIRES: May 11, 2014
;if NA,:qep Bonded Thru Notary Public Underwriters
Sign:
Print.
My
* * * * * * * * * * * * * * * * * * * * * * * * * * * * **
/kr-,A- Plans Examiner Zoning
ion ExIAT BRIGGS
#s MY COMMISSION # DD 979267
Q EXPIRES: May 11, 2014
Bonded Thru Notary Public Underwriters
* * *.... * * * * * * * * * * * * * * * **
Structural Review Clerk
(Revised 07/1 0/07)(Revised 06 /10/2009)(Revised 3/15/09)