EL-13-921Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 190434
Permit Number: EL -5 -13 -921
Scheduled Inspection Date: May 29, 2013
Inspector: Devaney, Michael
Owner: VALDES JR JTRS, ALFREDO
Job Address: 151 NE 93 Street
Miami Shores, FL 33138-
Project:
<NONE>
Contractor: M &D ELECTRICAL SERVICE INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)975 -6413
Parcel Number 1132060133040
Phone: (305)318 -7005
Building Department Comments
SERVICE REPAIR
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 Comme
57e--
?No)/
May 29, 2013
For Inspections please call: (305)762 -4949
Page 14 of 32
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
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
\ S \ N - ` 3 S-km
JOB ADDRESS:
IP 01 0.13
FBC20(0
Permit No. CL, i 3 4111
Master Permit No.
City: Miami Shores County: Miami Dade
Folio/Parcel #: 11— 3a-o— 0 13— 3 010
Is the Building Historically Designated: Yes NO )' Flood Zone: Ai 0 .
OWNER: Name (Fee Simple Titleholder): , 1 --rr' e� 0 �U dt1 a.,g V ✓� • Phone #: 3 C - -7s- -CVO
Address: 1 1 1 3 .
Ark ! n +► " \ a V i - (..1‘ OP e . - - . � State: )--- Zip: 3 3 1 3 g
Zip: 3 1 3 e
TenantlLessee Name: Phone #:
Email: \I 00 c e :S \ o Q-.11).v dl60w4n. e vt e.+
COrTRACTOR Company Name: de d � / c,�F C Satyr ea. Phone #: 305 —3/g- 700S
Addsc: - 2- //S ' .. se...) (22 c7
City: At r State: ir/
Qualifier Name: SL 4 j dO,(d /e-t
State Certification or Registration #:
Contact Phone #: 3 C - 3/g7Qo S
Email Address:
Zip: (77
Phone#: 305 •-i /8 YOO $
Certificate of Competency #: Of a 000 ®Y0
449A dies Qr e cc7•u�:a (sew /c-e
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ £ 5 e • a 0 Square/Linear Footage of Work:
Type of Work: Address DAlteration New f Repair/Replace Demolition
Description of Work:
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * *** * **
Submittal Fee $ P
Permit Fee $ /-4 G''67C'
Scanning Fee $ Radon Fee $ DBPR $ Bond $
CCF $ CO /CC $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
wner or A t
The for _oin instrument was acknowledged before me this /lir
day of
who is perso s :1 ly known to me or who has produced
As identification and who did take an oath.
,20a1a, A Ald� j
Sign:
Print: l ,r RAI /
EE
My Commission Expires: '►'$'eR NY M liSi0 ° EXPIRES: November 7 s2016
ew
itatari
Contractor
The fore oing ; . trument was acknowledged before me this /
day of , 20 / ;y JS _00,44,1 11DejIr ►er5
w o i, n •rsonallv known to me or who has produced
as identification and who did take an oath.
" My Commission Expires it.Y. Puko LUIS FERNANDEZ
MY COMMISSION # EE 838160
EXPIRES: November 7, 2016
Bonded Thor Budget NAY Swims
APPROVED BY ! #j ‘02- /' , IGa V Plans Examiner Zoning
Structural Review
(Revised 3 /12 /2012XRevised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09)
Clerk
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MAY 01 2613
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Miami Shores Village
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APPRO\'ED
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SUBJECT 10 CCMPIJANCE W111-1 Ali FEDERAL,
STATE ANu LUN 1 r1ULL:S AND REGULATIONS
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