EL-08-1570Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP -93334
C�
/0-
Permit Number: EL -8 -08 -1570
Scheduled Inspection Date: October 24, 2011
Inspector: Devaney, Michael
Owner: LEE, PATRICK
Job Address: 1122 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HI TECH ELECTRICAL INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132050170170
Building Department Comments
REMODEL ELECTRICAL FROM EXISTING SERVICE
Passed
■
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
October 21, 2011
For Inspections please call: (305)762 -4949
Page 22 of 22
Miami Shores Village
Buildin g Department
artment
10050 N.E.2nd Avenge, 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 No.
pCNVIV3D
FED 1 020/Vi
By: ....................
Master Permit No.F ® r
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) tOY - L € Phone #
Owner's Address \ (`� "� F- Ct 7-±f,
City '1La ` �LieOta r_.% State c%, Zip e
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done) t 1 Z.`Z E
City Miami Shores Village County I Miami -Dade
FOLIO / PARCEL # 113 Z ej 6 7 6 76
Is Building Historically Designated YES NO
Zip
Contractor's Company Name i �e I l,�e 4iktpet,, Phone #
t 1 Oa Qom 3 ? c4hvec.A,
Contractor's Address
City �,,J�*�. ,a c__ State
Qualifier Name ---ra uA �---' �J 1 .` 0.
State Certificate or Registration No. �EC / S' ub q).73 CerpPicate of Competency No.
Zip
Phone # 56S---3-1 3- 55z
Flood Zone
a c"3 -s-c-z
Contact Phone 3a
Architect/Engineer's
Value of Wor
Type of
Descr
3- -s-5-zz
a
E -mail
ble) '" Phone #
Square / Linear Footage Of Work:
'' ['New /New
Acre
7�/ ❑ Repair/Replace ❑ Demolition
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *** Fees************** ** ** * * * * * ** ** * * * * * * * * * * * * * * *,**
Submittal Fee $ Permit Fee $ % > aO CCF $ CO /CC $
Notary $ Training/Education Fee $ Technology Fee $
Q
Scanning $ J^ Radon $ DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $ 1, c
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to att' ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection whi rs seven days after the building permit is issued. In the absence of such posted notice, the
inspection will not be app,,.. a and a re -in, ction fee will be charged.
_AV/
Signature
Owner or Agent
The forego , instrument was acknowledged before me this 10
day of F , 20 10, by
who is personally known to me or who has produced FL fi)
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Signature
Contractor
The foregoing instrument was acknowledged before me this % l
day of _";c ►4c, ,20Q,by , Lg
who is personally own to me or who has produced
as identification and who did take an oath.
UBLIC:
* * * * * * * * * * * * * * * * * * *. ***•********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
/// eW/c:, Plans Examiner
Engineer
(Revised 07 /10 /07)(Revised 06/10/2009)
fission Expires: „,w ,,,®
eaPR" P:. Luis C. fsuerr.
r =Commission # DD641036
�;
ejii;.7i Expires: FEB. 11,4011*
�✓WWOPJOTARY.eores
Zoning
Clerk checked
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 79$.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder) P f rl
Owner's Address S...66
City State cL
Lk,
AUG 2J208
EY:
Permit No. El 01(-1510
Master Permit No. I � a.7 7
Phone # (31-ti
Zip -3-31-3r JA,
Tenant/Lessee Name Sq 1 Phone #
E- MAIL: I(Q $ % ttCtl.SA -awS�vU144in•05
Job Address (where the work is being done) tad._ l l Isk f `1-1 7
City Miami Shores Village County Miami -Dade Zip 3 3 3'8
FOLIO / PARCEL # 34).VS Z>
Is Building Historically Designated YES NO !■-"'
Contractor's Company Name
Contractor's Address
City 1 c .. State
Qualifier Name
Phone # Q� 93 - S3 t
Zip 37.7 "
Phone #
State Certificate or Re- istration No. EC- `3®'®" 8,13 Certificate of Competency No.1
E -MAIL: eb . i k_s . CC 14: eltiL--(' >c
Architect/Engineer's Name (if applicable) \ n∎sk- ' .. e(g Phone # 95r- 5 78 -0833
$. liorkn 4 fig. Ocki q Zas3
Value of Work For this Permit $
Type of Work: ['Addition
Describe Work:
Doa
5A iteration
Square / Linear Footage Of Work:
❑New
❑ Repair/Replace
4.• INVIC:11111•11M.
Demolition
x %WW ** * * * ** * * * * * * * * * * * * * * * * * * * ** * * * ** Fees***** r.*** * * * ** * * * * ** * * * * * * * * * * * * * * * * * * *t
Permit Fee $ -7.7-4"P U CCF $ CO /CC
Submittal Fee $
Notary $
Scanning $ Radon $
Bond $ Code Enforcement $
Training /Education Fee $ Technology Fee $
Structural Review. $
DPBR $
Double Fee $
Zoning $
Total Fee Now Due $
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. 1 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. t 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: 1 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 attac . Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which seven days after the budding permit is issued. In the absence of such posted notice, the
inspection will not be apps >ed,= d a reins tion fee will be charged
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of
who is
2Q-
20 DD by 1 t(i C,
rsonally known
NOTARY P
Signature
ontracto
The fore oing instrument was acknowl
day of 20()
me or who has produced who is personally known to me or who as produced
As identification and who did take an oath.
as identification nd who did take an oath.
NOTARY : I LIC:
Sign: Sign
Print: WY 1O OC U a
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * **
Print:
APPLICATION APPROVED . r:
(Revised 02/08/06)
My Com ission Expires:
1Feb 151 Zo1(
****** * * * *' * * * *** ****** ***** **** ****x wxwwwwwwx***
Plans Examiner
7S ,f% ®efi'" Engineer
Zoning