EL-13-1176 Inspection Worksheet
Miami Shores Village 1 3 —117
10050 N.E. 2nd Avenue Miami Shores, L
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-204174 Permit Number: EL-5-13-1176
Scheduled Inspection Date: December 17,2013 Permit Type: Electrical- Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: RICHARDS, RANDALL Work Classification: Addition/Alteration
Job Address:10666 NE 11 Avenue
Miami Shores, FL Phone Number (305)335-4848
Parcel Number 1122320280690
Project: <NONE>
Contractor: LS CURTIS INC Phone: 305-892-0115
Building Department Comments
ELECTRICAL FOR BATHROOM ADDITION Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-192282. Need smoke detectors
added.
Failed
Correction ❑
Needed � �
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
December 16,2013 For Inspections please call: (305)762-4949 Page 15 of 30
Miami Shores Village
Buildin g Department
artment
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972 MAY 2 8 2913
INSPECTION'S PHONE NUMBER:(305)762.4949 _
FBC 20 L�
BUILDING Permit No. C L )3—11-7 f
PERMIT APPLICATION Master Permit No. P-r—,► I l 1 S
Permit Type: Electrical
JOB ADDRESS: 6.6 4 A16- VO4
City: Miami Shores County. Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): Phone#:
Address:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: r Phone#:1r[fl'/�sf'�Tf
Address: 2 Q /1A d
City: State �/ Zip: /'�y
Qualifier Name: /i r/ /Zt%.l Phone#: ��a'�A
State Certification or Registration#: : &��o d d, l 1 f'Certificate of Competency#: ,
�� r
Contact Phone#:,?csT� 0//J— Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work:for thits Permit:$ J6 J° 0 0 � Square/Linear.Footage of Work:
Type of Work: '13-Address-.. JoAlteration ONew ORepair/Replace ODemolition
Description of Work la
Submittal Fee$ Permit Fee$ 1,4'69-m d CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
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 COMME EMENT."
Notice to Applicant: As a condition to the issuanc a building permit with an estimated value exceeding$2500, the applicant must
Pr ood faith that a copy of the of commencement and construction lien law brochure will be delivered to the person
w ose grope is subject to attach Also, a certified copy of the recorded notice of commencement must be posted at the job site
tr the first nspection which curs seven (7) days after the building permit is issued. In the absence of such posted notice, the
i ection ll not be app r ed and a reinspection fee will be charged.
Si Si tur � �tore
g d "-
Owner or Agent Contractor
The for oin instrument was ac owledged efo met 's The foregoing instrument was acknowled ed before me
day of ,20�by m day of ,2(�j�,by �'_7.oV
,
who pe o Down to me 4orw h as produced who' personally kno me or who has produced
dentification and who did take oath. as identification and who did take an oath.
NOT C: - ° s NOTARY P LIC:
0 a
to �?
Sign: ep1��1�SS° Sign: ,�' � CAS8ANDRA N NE
Print: N° °<�° e�A� ti°"a Print: M MY t'OMAM8$ION 0 EE21941a
My Commission Expir _ /.`;:,'•'" 10 JL My Commission bmsav�osoea,
a e2, ;7
APPROVED BY ° Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012XRevised 07/10/07XRevised 06/10/2009)(Revised 3/15/09)