ELC-12-1028Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
cc- 1A-M)3
Inspection Number: INSP- 174443 Permit Number: ELC -6 -12 -1028
Scheduled Inspection Date: June 27, 2012
Inspector: Devaney, Michael
Owner: , SHORES SQUARE INVESTMENTS
Job Address: 9025 BISCAYNE Boulevard
Miami Shores, FL 33138 -0000
Project: <NONE>
Contractor: OHMS ELECTRICAL CONTRACTOR
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Temp for Construction
Phone Number
Parcel Number 1132060110051 -25
Phone: (954)974 -3840
Building Department Comments
TEMP FOR CONSTRUCTION
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
June 26, 2012
For Inspections please call: (305)762 -4949
Page 15 of 36
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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.€1 a I 1-102 3
Master Permit No. 11 —Il7q 3
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical c /
OWNER: Name (Fee Simple Titleholder): 3h®�D �.� -M��7 Phone#:
Address: A itij (L 1 ,/
City: ei C State: - Zip: 3 5l 'f
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS:
90 2c 61.0.i„,,e, 61%4_,
City: Miami Shores County: Miami Dade
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: OI1 04-19 Phon 1.,, q —3
Zip: 33/-3q/
Address: \ I1 ° (. r , g d
City: ,% Stater Zip: 330 6:3 Qualifier Name: to se %�1
State Certification or Registration #: C...0000 9 Certificate of Com.etency #.
Contact Phone#: 015 Lb S 2 CI LAA0 Email Address: C eA f
c
DESIGNER: Art/Engineer: A
Phone#:(
O(in50�
Phone #:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: DAddress
Description of Work:
DAlteration DNew
❑Repair/Replace
❑Demolition
Submittal Fee $ Permit Fee $ f e' /00 CCF $
Scanning Fee $ Radon Fee $ DBPR $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
CO /CC $
Bond $
ONIMP
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e're Building Relationships"
CGC036059
Angel Araujo
8348 N.W. 56th Street
Doral, FL 33166
•
Office 305/592 -0552
Fax 305/592 -0559
Mobil 786/553 -2307
Email aaraujo @t- and -g.com
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 F.LRCTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOIT FRS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AIFIDAVIT: 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.
Signature
Owner or Agent
The foregoing instrument was acknowledged before rile this
day of , 20 _, by
Signature X
cam'.
Contractor
The foregoing instrument was acknowledged before me this V
f?.6i /f
day offs , 20 if, by
who is personally known to me or who has produced who is pers
,00
144„,
As identification and who did take an oath. ` %N
ode tificamm. �ofl.a&it� .. oath.
,1' otary PubIJC - State a
NOTARY PUBLIC: Expires Se .
• o„°���� Co„s3on # EE.,481
Hugh lW inna' Nottliiist
Sign: Sign: _
Print: Print: J e:-a2'77 A • "f�e,s'—
My Commission Expires: yl^�`/t'S
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * ***
APPROVED BY
*, x******+sm**** * * ******** * *w* ** *way* apse+ s**** ****** ++x***** *** ** * *** ***+x*+s*+se+x***
xaniiner Zoning
Clerk
Structural Review
(Revised 07 /]0 /07)(Revised 06 /10/2009)(Revised 3/15/09)
MIAMI
COUNTY
Building
11805 SW 26th Street
Miami, Florida 33175 -2474
786 - 315 -2100
miamidade.gov
AFFIDAVIT FOR 30 DAY TEMPORARY ELECTRIC SERVICE
ELECTRICAL CATEGORY 26
ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION
UNLESS APPLICATION IS RENEWED OR CERTIFICATE OF OCCUPANCY OBTAINED.
It is understood that the temporary electrical approval by the Miami -Dade Building Department is given in connection
with the building being constructed under the Building Permit # 1 /L . and Electrical
Permit # LCC /L (1 224g at address eit 0,25 � , .r e P/ 2
for owner: ,.�.�,�; 4 and is being given only fdr construction purposes or for
testing the following e'uipment in said structure:
The owner does hereby agree to assume the responsibility of maintaining the installation in such manner that there
is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the
purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been
called for and approved by the inspection divisions concerned, and /or a Certificate of Occupancy or Completion
is obtained.
The undersigned also understands that the temporary electric approval is subject to rescission and cancellation
and electric power can be cut off at the discretion of the Building Official and will be disconnected if the building
concerned is occupied before final inspections are approved and /or a Certificate of Occupancy or Completion
is obtained.
I, , being first duly sworn, depose and say that I am the owner of the above
described property, and that I agree that the structure covered in this agreement shall not be occupied until the
building contractor has obtained approval of final inspections and /or obtained a Certificate of Occupancy or
Completion. Note: Failure to comply with the provisions of this affidavit will result in your being unable to obtain
future Temporary for Test permits.
Signature of Owner
1, Jose,
the above - described property
temporary service is connecte
Signature of Notary
MyCommission Expires:
, being duly sworn, depose and say that I am th
and that the electrical installations as now existing will no
d.
Signature of Electrical Contractor
fety haRa+RdFH DERICK
Nbtary Public - State of Florida ;
'r My Comm. Expires Sep 22.21
,,,,,� vitt B Commission # EE 132722
Signature of otary , Ak
My Commission Expires:
I, , being first duly sworn, depose and say that I am the Building Contractor
of the above described property and that I will not permit occupancy of this building until final inspections have
been called for by the contractors and sub - contractors concerned and final approval by the inspection division
obtained and that I have the authority insofar as the owner of said property is concerned to prohibit occupancy until
such final inspections are obtained and /or a Certificate of Occupancy or Completion is issued.
anded Thrown Rion,'
Z
Z°15
Signature of Building Contractor
Signature of Electrical Inspector
123_01- 124 6/06
Signature of Notary
My Commission Expires:
Date:
Date released to FPL:
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