EL-12-2214Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
MC- 12- 22 eo
Inspection Number: INSP- 182815
Permit Number: EL -11 -12 -2214
Scheduled Inspection Date: December 12, 2012
Inspector: Devaney, Michael
Owner: PACHECO, MANUEL
Job Address: 9080 NE 2 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: METPLANET ELECTRICAL
Permit Type: Electrical - Resid n
Inspection Type: R gh
Work Classification: Al ration
Phone Number (305)336 -4908
Parcel Number 1131010190090
Phone: (754)214 -1695
Building Department Comments
AC ELECTRICAL
Infractlo 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
004
/2-
G 20 /Z
December 11, 2012
For Inspections please call: (305)762 -4949
Page 33 of 41
/3
DIVISION OF
Environmental Health
F nicht Departr-ent of Ilea
Miami-Dade Cfinrity kiealth Dep
OSTDS/Well Division
MON .SW 7.6 St. * UN/Hi, Li,
Address
()S ff)S #
Miami Shores Village
Building Department
10050 N.E2nd Avenue, Miami Shores, Florida 331
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMI.T APPLICATION
FBC 20 10
Permit Type: Electrical
di_
NOV 2 l 2092
Permit No.
Master Permit No. lG L -1 G -c2 � 9
l OWNER�
�--- �1 ?4deame (Fee Simple Titleholder): ) / / - , %%Cc
dress: q0 ctr3 ■ At)
cy:N. i S�tO4 5
$nant/Lessee Name:
Phone #:
State: F6-
Phone#:
zip: 5S) 32)
1:
[ JOH ADDRESS: J/0 go go o g2 P
City: P�Miami Shores
Folio/Parcel #:
County:
Miami Dade
4 the Building Historically Designated: Yes
Zip: 33136
Flood Zone:
[CONTRACTOR: Co ipany Name: g &47C70' Phone#:
/177- e7e
State: _J
Address: 627/
City:
Qualifier Name:
State Certification or R« eeggissttration #:
Contact Phone #: 7
t
Phone#:
cy #:
7 / 3 1')JCertificate of Compe
7� °/'� Email Address: �.�l
DESIGNER: Architect/Engineer:
Zip: 0. a
one #:
alue of Work for this Peanut: $ ` ®� Square/Linear Footage of Work:
Type of Work: DAddress ❑AAteration New DRepair/Repl.. ODemolition
fre.- ,...._40,-.....r
'Ires-rripti of-MTV--
** * * * * * * * * * * * * **** **** * * ****** ** *** *Ili *Fees **********d id*********** ****************** ***
O�
Submittal Fee $
Permit Fee $ /Fe, P 1
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ 0 ` 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, BOILRRS, 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 • attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job sits
for the first inspectio - win, h occurs seven (7) days after the building permit is issued. In the ab ence of suc posted notice, the
inspection will not .e ap.roved and a reinspection fee will be charged.
Signature �� ✓� = Signature _ 01�
Owner _or_Agent / . itractor _
/ The fore oi�ng ins m t was ackn wledged before thi / 1 The foregoing itestrument was acknowledged before me thi-_j
day of LO ME, 1v� by1 '•LIL A r 1 _11 day of t) 20,rbyldf 'l i ; � l '•1
who is nally known to me sr who has produced IV ho is personally known to me or who has produced PL. 1'
cation and who did take an oath. - ientification and who did take an oath.
NOTARY .PUBLIC:
Sign:
Print:
My Commission Expires:
Sign:
.00 Pin. .,7 c TANA THOMAS- OBORNE Print:
MY COMMISSION 3 DD 962467
My Commiss' es: EXPIRES: April 11, 2014
Thru ludget Nottoy $eMcas
**+x+x************* * *** ...; **** *****+ s**** ****** ** ***s ,+x************ *** *** ** x** **+ x******** *+x**+x**+s**********x ****
eta /�
.�3AAP Plans Examiner
APPROVED B
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk