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EL-12-2093i i Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 181483 Scheduled Inspection Date: November 13, 2012 Inspector: Devaney, Michael Owner: SAMSOE, LINDA Job Address: 65 NW 105 Street Miami Shores, FL 33150 -1241 Permit Number: EL -11 -12 -2093 Project: <NONE> Contractor: FIVE STAR ELECTRIC SERVICE Permit Type: Electrical - Residential InspeJ n Type: Rph Work Classiliication: Alteration Phone Numbe Parcel Number 1121360050270 Phone: (786)356 -0162 Building Department Comments UPGRADE SERVICE TO 200 AMPS Infractio Passed Comments INSPECTOR COMMENTS False Passed C7 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments November 09, 2012 For Inspections please call: (305)762 -4949 Page 33 of 36 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 BU DING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 4 6— /V /' lam" S FBC 20 MMOMEW-Sri NGV052012 Permit No.'1 12-2V) Master Permit No. City: Miami Shores County: Miami Dade Zip: & 3 / 5-0 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: // i OWNER: Name (Fee Simple Titleholder): .2--/ /./,621-9 S /16ti„s-U67 Phone #: 2 e9 74- --76/e2 Address: ' 5 /V. W /0s-- S 77 City: /i % "- / State: i JI Tenant/Lessee Name: Email: CONTRACTOR: Com Address: City: Qualifier Name: .. 1. UN V40 el a...1,.. -2. ke,.t1 • Phone #: ' 1 _) 3 °- 01 6a. State Certification or Registration #: " 13 �a (2q 2 3 Certificate` of Competency #: /�� Contact Phone#: C74J JSb L' 1 6-5.-. Email A ess: Y �� (x.10 l� o Corr) DESIGNER: Architect/Engineer: any Name: Phone#: Phon Zip: 3 /� State: ZiP: -3 1 4-7 3 ND A- Phone #: Value of Work for this Permit: $ !ital.)' '' Square/Linear Footage of Work: Type of Work: ❑Address ❑Alter lion s New *Repair/Replace ❑Demolition Description of Work: 6r,,ICI Je. e '3 1 Ce.. 4v (Do ris (i Co A i ( Ccc0geR i.ccse IR. w * * * * * *** ** * * ** : *** ****+ x******** ** ***** Fees************** * *** *+ nix *** * *** * *+r************* Submittal Fee $ Permit Fee $ 44-212.47,4? CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 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 AIFH)AVIT: 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 fContractor Signat Owner or Agent The foregoing instrument was acknowledged before me this ,� The foregoing instrument was acknowledged before me this 5 day of (1 ,20L ,by day of // ,20I3.,by who is personally known to me or who has produced i..■ who is personally known to me or who has produced b� As identification and who did take an oath. as identification and who did take an oath. NOTA;. BLIC: NOTARY AP BLIC: yr My Commission ExpireNARy �,, PUB ExpiL"Cs.s4 U E n TE # OD DP1W 013 d 9 NONED; Com LMah *** ******** *+ kik*d:: k*s k*dsds*****+ k***** * ******skN=** ** * ***** AUMIX*MtM ** Plans Examiner Zoning Sign: Print: My Commission Expires: d, ►i Commission # DD397929 !tarok= JUNE i ,2013 DI4cev1fd Sign: Print: Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk EurnaCAL OVERHEAD OR UNDERGROVND SERVICE (MANGE JOB ADDRESS Ti 011- d2e irle.+1 COM 13-A- F/ 33 q7.3 OINSTRACTIMOROWNER C tidal Ai/re /red) If a s iA r" 6-18c-#/c (- �TV,�e T OF SERVICE: UNDERGROUND ,s` OVERHEAD ALL CONDUCTORS SIu PER NEC ARTICIZ 220 ALL UNDMICIRDL n) SEEMS COMXICTORS MUST HAVE _A WARNING MA NIrASMc oNDLEWIL al) (3) SERVICE ENTRANCE COMET AND WIRE SZE CU ORALIENIPHUM / a ® ®naiw...rC it ccoAJd4rt OVERHEADSERVICBCONOUCTORS SHALL COMN.YWIIH NECZKIPATIX II SATING MW METER OR MAIN COMBO GROUND ROD ORc,ALv APPROVED BY i ELEcnacuanvismor r- N NB TABLE2St.66 SOBFEEDM COMIEWr CONINSTTYPE W1ItBBITE EQIIPMEW SIZE MUMS APPROVED BY IGLEMIC4C7) c ji � APPROVED WOMB OWRIOb oh &11resS = LIC S M fE OFFLORIDB Fritz Mathurin Commission #Dn897929 ''••...�•.. Expires: JUNE 19, 201'. —In ilaHTFIR'f3ATLANTICBONDINGCQ., N:.