EL-13-775Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 189998
Permit Number: EL -4 -13 -775
Scheduled Inspection Date: April 25, 2013
Inspector: Devaney, Michael
Owner:
Job Address: 1260 NE 98 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ALLIED ELECTRICAL SERVICES INC
Permit Type: Electrical - Resideng I
Inspection Type:
Work Classification: Addition /Alteration
h
Phone Number
Parcel Number 1132050090320
Phone: (786)566 -0863
Building Department Comments
CHANGE DEFECTIVE FUSE LOAD CENTER IN
RESIDENTIAL HOME FOR NEW
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
4
7;
April 25, 2013
For Inspections please call: (305)762 -4949
Page 41 of 49
BUILDING
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
ZEMIEWE
AFR 1 6 25i3
FBC 20
Permit No. El 1 I 3
PERMIT APPLICATION Master Permit No.
Permit Type: Electrical
JOB ADDRESS:
City: Miami Shores County:
Folio/Parcel #: '321)r 17 32
/2L7 Nit Ir s7
Is the Building Historically Designated: Yes
Miami Dade
zip: 33 lid
OWNER: Name (Fee Simple Titleholder): /162
Address:24 ! .�i '/4 &'/)
NO Flood Zone:
PO( er-1,
City: 44016 / State: [�
L'
/4, hi (y Phone #:
LJ
Zip: /1'
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name: Al I �" �l".e r e/M ����j -� i Phone #:
Address:: /0 it% /4' 57
City: m / / State: r."6/
Qualifier Name: Slew ! ierr J
State Certification or Registration #:
Contact Phone #:
Zip: 33 i'c Y
Phone #: 1/11-5W -N �3
/3 (41132-
Certificate of Competency #: 12e ps0o0
'75 3 Email Address: 5/0/0"t PesettAkp "leid- W-ein P-
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $
Type of Work: ❑Address ` UAlteration
Description of Work: /t
r V' '/
Ar�Lt61 W
Phone #:
Square/Linear Footage of Work:
ONew ORepair/Replace
UDemolition
teR #t
Le' • -
Submittal Fee $ Permit Fee $ /17.9 e,
Scanning Fee $ Radon Fee $
Notary $ Training/Eucgtion Fee $
Double Fee $ Structurof 4 4.4w $
s.
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State / / \ / / Zips
Mortgage Lender's Name (if applicable) 71/
Mortgage Lender's Address dj
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.
cS
"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 absent o h posted notice, the
inspection will not be app?pved and a reinspection fee will be charged.
\k"
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this /
day of
, 20 /3, by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: AtJ X�C.to , ,,_
Print: i5 bE
My Commission Expires:
Signature I/
ontractor-
The fore
day of
h• is pers
trument wa ac
,20h,by
to me or who has produced
ation and who did take an oath.
edged bef
Sign:,
Print: .
My Commissio
.A Plans Ex
er
Structural Review
(Revised 3 /12/2012XRevised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09)
Zoning
Clerk
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ZONING DEPT
BLDG DEPT
SUBJECT TO COMPLIANCE WITH ALL FEDERAL
STATE AND COI INTY RULES AND REGULATIONS
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