EL-13-1754 Inspection Worksheet J l
Miami Shores Village / _ / Z�3
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-201902 Permit Number: EL-8-13-1754
Scheduled Inspection Date: October 24, 2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: CRESPI, CRISTINA Work Classification: Alteration
Job Address:1200 NE 91 Terrace
Miami Shores, FL 33138-
Phone Number
Parcel Number 1132050010490
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
MOTOR FOR BACK GATE infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 23,2013 For Inspections please call: (305)762-4949 Page 30 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 03
BUILDING Permit No.7
PERMIT APPLICATION Master Permit No.
Permit Type: Electrical
JOB ADDRESS: U o ft- A C( r J_e_ 1t Cc
City: Miami Shores County: Miami Dade Zip: 331 f�)g
Folio/Parcel#:
Is the Building Historically Designated:Yes NO ✓ Flood Zone:
OWNER:Name(Fee Simple Titleholder): (2"h L V1'-h rLa_ CA--k4 p h Phone#: 3�5 � -q q a"
Address: ( � I T—e ✓VGL u_
City: tNi l a .y ls` l Ott State: Zip: 3
Tenant/Lessee Name: ''��II __ Phone#:
Email: C�ACL.°t. M�LLVL t.i CLC4b (Glr
CONTRACTOR: Company Name. Phone#:
Address:
City: State: zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ 245)3 Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration 94ew tKepair/Replace ODemolition
Description of Work: M0 UP[ 6 RA k, %"n 1(1 P Gl,ti
���� �� x�xmx�xxxxxxx�x�xxxx�xmFeesxxxxxxxxxxxxmxxx�xxx�x��xx��xxx�xxxx�xxxxxx�
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
f .
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 Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me thiv The foregoing instrument was acknowledged before me this
day of k)(9 20 15,by l-1Z4t1yPl , day of ,20_,by
who is personally known to me or who has produced r4—W who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: ���` �111iii�«h����i NOTARY PUBLIC:
�J� (115 S'1/v �i�i
Sign: 6 Sign:
Print: NOTARY PUBLIC .
Print:
• sioo #
My Commission Expires: �'�' ommis••EE173059 My Commission Expires:
OF
���x�x� ��x�xx��x��x�xx�x���x�x�x� ��x�x�x�*�
APPROVED BY �,,t Plans Examiner �Zoning
Structural Review Clerk
l
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(Revised 3/I2/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)