EL-12-388Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number INSP - 174258
Scheduled Inspection Date: June 04, 2012
Inspector. Devaney, Michael
Owner: , AAM INVESTMENTS LLC
Job Address: 118 NW 94 Street
Miami Shores, FL
Permit Number: EL -3 -12 -388
Project: <NONE>
Contractor: RELIABLE ELECTRIC CORP
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)466 -4243
Parcel Number 1131010330750
Phone: (305)218 -8653
Building Department Comments
SMOKE DETECTORS, GFI IN KITCHEN AND BATH
REPAIRS
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- 170762. No access at 3:40 p.
m..
June 01, 2012
For Inspections please call: (305)762 -4949
Page 15 of 22
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): JIM
Address: ZO7
Permit No.
Master Permit No.
-17*k4e.-57721154
City: En2r10- State:
Tenant/Lessee Name: A/ 1 74
oe,g,
21c- Phone#: 46-0/3)
-31
Phone#: N/4
Email: A%/ 5 Z- /// 2 e c /xa 12 a !,4,
JOB ADDRESS: /1y,0 S
City: Miami Shores
County:
Miami Dade
Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO >,
Flood Zone:
CONTRACTOR: Company Name: /' 4 c.ck 722C' ci Phone #:
Address: / _ %/c g 74 £/
City: ,,,p7)/04 » 9J) State: 14 Zip: ,� C 2
Qualifier Name: ,f�,)G �a i",102 z) Phone #:
State Certification or Registration #: A ( 1 `! Po Certificate of Competency #:
Contact Phone #: a r) °Z %7g 653 Email Address:
DESIGNER: Architect/Engineer: �ya. Phone#:
)T) 27,0'4.I —_)
Value of Work for this Permit: $ OP ) Square/Linear Footage of Work:
Type of Work: OAddress DAlteration New Repair/Replace ODemolition
Desc 'ption f Work: 5 /)O/ . Vie/Ts—C/04 4 / ,i2 /5 /A) /> /72/f(;
**+x********** * *** ** ** ****** ****w+ x****** Fees********** ******* *+ n**** *************x:+x******
Submittal Fee $ Permit Fee $ /.&-- ' eO 2 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 Zip
iv/4
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 and as inspection fee will be charged.
Signature
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My Commission Expires
be me this
as produced
l' V `identification and who did take an oath.
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a` , Notary Public State of Florida
o, co4 Commission # EE 128810
i l «''" Bonded Through National Notary Assn.
****** * * ** ****** * ****
APPROVED BY
Signature
Contractor
The forego' g ins ment was ackno ledged b
day o , 20 1,, by n
is rson t y ]�pwn to me or who h. produced
dentification and who did take an oath.
NOT • y ) PUBLIC: -
/2-
`22--/7 Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Sign:
Print:
My Commission
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Weir-A tall Fir
'nq' , State 0
o °Pa , otary Public - 3 2015
8i 1 s Nly Comm. 128810
;�, Q: Commission # EE Assn.
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Zoning
Clerk