EL-13-416 Inspection Worksheet
Miami Shores Village
9
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 V ��
Inspection Number: INSP-186598 Permit Number: EL-2-13-416
Scheduled Inspection Date:April 23,2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: PREDRAG STARCEVIC, KAREN BLAIR Work Classification: Addition/Alteration
Job Address: 1225 NE 92 Street
Miami Shores, FL Phone Number (305)751-9333
Parcel Number 1132050270300
Project: <NONE>
Contractor: JAR COMMUNICATIONS INC Phone: (305)316-6907
Building Department Comments
ELECTRICAL WORK FOR BATHROOM REMODEL Infractio Passed Comments
INSPECTOR COMMENTS False
i
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
April 22,2013 For Inspections please call: (305)762-4949 Page 8 of 25
Miami Shores Village --
Building Department g�'B 2 8 2013
90050 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
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
Permit Type:Electrical , .�
JOB ADDRESS: �`2 2 S 1"/C 912 S/
City: Miami Shores County: Miami Dade Zip: 33)3
Folio/Parcel# //-305- 04-7-0300
Is the Building Historically Designated:Yes NO A.- ood Zone:
OWNER:Name(Fee Simple Titleholder): � //T Phone#
Address ALA e °2 . lee /
City: / 14 5''401 eS S.: ;4.0" li Zip: 23138
Tenanti1essee Name: Phone#:
Email:
CONTRACTOR:Company Name: -�?11 v✓+l er Phone:
Address: 11 Z6 tV1 3 2?1gW_
City: .m i BB,, State: 7�p; 3 31 2
Qualifier Name: ort. E'_ C;)a 4q16 Phone# 5` 3l 6'4 W 4
State Certification or Registration#: Z�c /_5 110 d 536 Certificate of Competency#
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ 3 6 U• #0 $quareUnear Footage of Work:
Type of Work: UAddress / Altera n ONew- ORepair/Replace ODemolition
Description of Work: !��• � L A •1-04r
Submittal Fee$ Permit Fee$ /5 a P ®J9 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Traintng/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 COMMENCEMENT."'
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature Signature
Owner or Agent Contractor
The foregoing instrument was ac kn ledged be me this The foregoing trume was acknowledged be me this S
day of .� ,20 9—by r1 day of_ 20L,3,by
who is personally known to me or who has produced who is personally known tome or who has produced i--�
As identification and who did take an oath as identification and who did take an oath
NOTARY P NOTARY PUBLIC:
Sign: Sign:
Print: Print:
;�R�P e�,, &'ABEL FUENTES My Co sio es:
pRY AVa�
My Commission „'r Notary Puhl;c.State of Florida y VANM MEMOS
e My Comm.Expires Mar 30, ¢ Nowy P -SUS N ,
OF,F�oP°o' Commission#DD 976991 014 • • Ay C=0-Ettt$fty 7,2015
ssn. �,• a. . ��� >�9eN•��+�N�� m
Mined=NOW Nowy Assn.
APPROVED BY �/L '—'P/� Mans er g
Structural Review Clerk
(Revised3/12I2012)(Revised 07/1010Wevised 06/10 ")(Revised 3/15/09)