EL-13-800 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-198961 Permit Number: EL-4-13-800
Scheduled Inspection Date: September 12,2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: MACHEV, LUANN Work Classification: Alteration
Job Address: 1700 NE 105 Street 312
Miami Shores, FL Phone Number (305)310-5774
Parcel Number 1122300500500
Project: <NONE>
Contractor: LS CURTIS INC Phone: 305-892-0115
Building Department Comments
ADD 3 SMOKE DETECTOR Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed 2 �
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 11,2013 For Inspections please call: (305)762-4949 Page 12 of 16
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i Village� Miami Shores a S g � APR I � r�
14AJ Building Department s
L`s 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 No. F `5
PERMIT APPLICATION Master Permit No.
FBC 20 t�
Permit Type:Electrical
OWNER:Name(Fee Simple Titleholder): ZAo� � Phone#: 3V,5--2.10 -,5-77L1
Address: I MV ? #-
City: B g&l �///�® /0 s 5 I-es s State: Zip:
Tenant/Lessee Name: A Phone#:
Email: 1�1 i 1F s-1 r! 441AIZI e 401- - CAVY"
JOB ADDRESS: 7 0
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 22o-G -I-e L
Is the Building Historically Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: L S Curtis inc Phone#: 786-486-1961
Address: 20341 NE 30 Ave #108
City: Aventura State: FL Zip: 33180
Qualifier Name: Lewis S Curtis Phone#: 786-486-1961
State Certification or Registration#: E C 0 0 0 317 5 Certificate of Competency#:
Contact Phone#: 786-486-1961 Email Address: aasteve(a)aol com
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: OAddress OAlterati ONew ORepair/Replace ODemolition
Description of Work: �� C
Submittal Fee$ Permit Fee$ 100'x® CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
q
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 pos tice, the
inspection will not be and a rei c ' fee will be charged.
Signa e - Signa
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this � k The foregoing instrument was acknowledged before me this
day of
el'.20 L3,by (- " day of l X ,20`�,by 406-d tom/ ,
who is personally known to me or who has produced__ t! who is pyr y known ton r who has produced
As identification and whq� Ia�g�th. as identification and who did take an oath.
NOTARY PUBLIC: V\ •••• ''
�s NOTARY PUBLIC:
..q '
'mom `o ':� -
Sign: _ °_.: = Sign.
CASSANDRA N NIEBBIA
Print: %O�, :'_+r+i� Print'
T. 4' • : MY ON9 19418
My Commission Expires: •2 �4' •......... `\1• My Commi . es: EXPIRES Ady 2rh 2018
/'�f/lII11III11N���\\\ <• •39&'0103 n WN ftk nom
eR
APPROVED BY //� l� �'� Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)