EL-09-1716Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 156518
Scheduled Inspection Date: March 02, 2011
Inspector: Devaney, Michael
Owner: PAZ, EMMANUEL
Job Address: 1291 NE 102 Street
Miami Shores, FL 33138-
Permit Number: EL -10 -09 -1716
Project: <NONE>
Contractor: AJL ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (239)565 -3103
Parcel Number 1132050200050
Phone: 305 - 895 -4971
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
March 01, 2011
For Inspections please call: (305)762 -4949
Page 37 of 44 A
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 J €1R 1 16,
Master Permit Noit m "I g1,1
BUILDING
PERMIT APPLICATION
FBC 20
�& ME
La OCT 1 9 1009
BY: �}
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) PA-z, Phone # Z 3'•q — 5'45 3 10
Owner's Address
City State Zip
Tenant/Lessee Name
Email
Job Address (where the work is being done)
Phone #
_` r
t2.a1. t 1 - 6 102
City Miami Shores Village County Miami -Dade Zip 33 1
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name AJL .1+ -Ti c Phone # 30S - 's--- 4'r? 1
Contractor's Address i2,545 Ois tct y „ �j l• ct 'a. VZL
City W La..im. t State F. I Zip 33 1 g 1
Qualifier Name ALt` p",. S LA) P 0 Phone # 30S =I-cl S ^ 471
State Certificate or Registration No. a Cm V3 0 0 ZOE 1 Certificate of Competency No.
Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ ( . In Square / Linear Footage Of Work: / ,—
Type of Work: ❑Addition EAlteration [New ❑ Repair/Replace
❑Demolition
Describe Work; 'j 46 � ie WOX ire, 4 < Ir v Lc-e 14e w cc� 1 S
le L 1 tAJ ii-i CL.5. 1:4---e-t_
az pvo eeQ p %1. tn�
* * * * * * **** *** * * * * * * * * * * * ** * * * * * * * * * ** *Fees** * * * * * * ** * *** * ** * ** * * * * * * * * * * * * * * * *x * * * **
Submittal Fee $ Permit Fee $ CCF $ CQ' 00 CO /CC $
Notary $ Training/Education Fee $ Technology Fee $ ■�
Scanning $ �• 00 Radon $ 10 I
• - k DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $ 3 1 0 • xe
See Reverse side ->
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 seve (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will s t be approve fee will be charged.
Signature ' Signature 16g. Jahr III 1-1114
Owner or Agen
The oregoing instrument was acknowledged before me this 1 ° The foregoing instrument was acknowledged before me this
day of OGT , 20 6g , by , day of 1 7, ®GT , 200/ , by
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. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: t. &J# t c'■`'I (Cy
pRhfO4
My Commission Expires:
LAURA FAFILEY
* MY COMMISSION # DD 646761
EXPIRES: March 16, 2011
Bonded Thor Budget Notary Services
• F.
0�lans Examiner
Engineer
e
(Revised 07 /10 /07)(Revised 06/10/2009)
NOTARY PUBLIC:
Sign: �j€ - L-
Print: I, Et, L, Vet ok eej t@ I UPA F LEY
My Commission Expires: * * MY COMMISSION # DD 646761
EXPIRES: March 16, 2011
'qr fOFF-0 `��O` Bonded Thor g
Bud et Notary Services
•
Zoning
Clerk checked