EL-13-996Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 194200 Permit Number: EL -5 -13 -996
Scheduled Inspection Date: June 25, 2013
Inspector: Devaney, Michael
Owner: MEADOR, STEPHEN
Job Address: 429 NE 102 Street
Miami Shores, FL 33138 -2452
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)693 -8782
Parcel Number 1132060170790
Phone: (305) 551 -4043
Building Department Comments
REMOVE AND REPLACE EXISTING LIGHT FIXTURE AT
SAME LOCATION FOR BATHROOM REMODEL
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
June 25, 2013
For Inspections please call: (305)762 -4949
Page 29 of 30
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
FBC 20
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BY: O .00001,000..07P0tW90p P4.
BUILDING Permit No. t (1)
PERMIT APPLICATION Master Permit No. ;` f ;' t 37
Permit Type: Electrical
JOB ADDRESS: "449...9 I■St 162- St,
City: Miami Shores
County:
Miami Dade Zip: 1 $
Folio/Parcel #: 11 - 520L0 ° 0 R- Cad -RCS
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): " e Pteit) INAreic1c i Phone #: - i- irlig 2.
Address: 412- L)6 (0Z Sk .
City: i/1/4.1 i a YY1 ■ '%9TQS State: Fi-- Zip: ..t -
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name: 4,-1-1:01-is 8 (ei° i fail Phone #: ° ??Sr- ° q,c)
Address: 12F60 eta 3 2-0 -re rc,
City: ' ' i C,Ii}fl ( State: Zip: 1
Qualifier Name: 1t\ Li'ECC) dreg Phone #:
State Certification or Registration #: EC_ 160o 191-1 Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 5-c6 ® ` Square/Linear Footage of Work:
Type of Work: OAddress OAlteration New ORepair/Replace ODemolition
Description of Work: ty10\i2. reOf'(+n P eitsi; i► bv-e z■e. (13cAt;on
***************************************F **** ** r*** ** * ** ** ** ****** *,t**** ** u ******* ***
Submittal Fee $ Permit Fee $ Arm " v CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ /j f L ' t�
Bonding Company's Name (if applicable) k) I pt
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) (i llr
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 a reinspection fee will be charged.
Signature /f7 Signature
Contractor
Owner or Agent
The foregoing instrument was acknowledged before me this
The foregoing instrument was acknowledged before me this
day of�, 20 j, by SAP ohe(\ Me�cbe , day of 20 13, by 'Ercaner Te,re2
who is perso y known to me or who has produced ft bL# 13(6 who is perso y known to me or who has produced
97 --(et - '-fs6 -0 As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires:
NOTARY PUBLIC:
My Commission Expire
* * * * * * * * * * * * * * * * * * ** *** *, rat, ** *** *** ****** t*,r* r*,r** ****** ter * ***** **** ****** **** *** ***** *,r,x * *** *,a x*,r,t ****
APPROVED BY
0/2 I3 �s' v,3 Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /12/2012XRevised 07 /10 /07)(Revised 06 /10/2009XRevised 3/15/09)