EL-13-1953 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-198092 Permit Number: EL-8-13-1953
Scheduled Inspection Date: September 04,2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: OBREGON, MICHAEL Work Classification: Addition/Alteration
Job Address:441 NE 101 Street
Miami Shores, FL Phone Number
Parcel Number 1132060170660
Project: <NONE>
Contractor: MOODY ELECTRIC INC Phone: (305)758-2000
Building Department Comments
INSTALLATION OF CUSTOMER SUPPLIED MOTION Infractio Passed Comments
SENSOR FIXTURE INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections lease call: (305)762-4949
September 03,2013 p Page 17 of 26
Miami Shores Village
Department a�E
Building p AuG 2, 7 2013
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax: (305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949 � a
FBC 20
BUILDING Permit't No.
PERMIT APPLICATION Master Permit No.
Permit Type: Electrical
JOB ADDRESS: q_*l 5Tet�F-T
City: Miami Shores County: Miami Dade Zip: i 1 1225
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): AM- 1n149*1C. Q44"&✓ Phone#: �D.r rz-7 •d®Q�
Address: Lr 41 A)46- /D/ Ark*&,r^
City: A7/~1 SMD +lt+ State: ,*Go Ae-iDA Zip: 3"3138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Phone#: •16f' X10Itt"
Address: �4-9 AJ&J fG�
City: Me A-m I - State: Zip:
Qualifier Name: 0 t k-d.�' �D�'�-Y Phone#• 45-r-ZWS -7-02"
State Certification or Registration#: aie,0'0-0 //*9 Certificate of Competency#:
Contact Phone#: ZZZW' D%o J723 Email Address: 42A o? dPe&* • �' ®
DESIGNER:Architect/Engineer: .tJ�i Phone#:
Value of Work for this Permit:$ d�8 "� Square/Linear Footage of Work:
Type of Work: OAddress OAlteration dNew ORepair/Replace ODemolition
Description of Work: 4W,57—C- L'lJSTllht t�4 JW V Tio A) 45tk�-J%0r-----
Submittal Fee$ Permit Fee$ e9zf 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) 4)W
Bonding Company's.Address
City State Zip
Mortgage Lender's Name(if applicable) 4Z&
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 WOO, 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 p sted notice, the
inspection will not be approved and a reinspection fee will be charged.
- I
Signature Signa
Owner or Agent Contractor
The forego' g instrument was ac edged before me this A7 The foregoing instrument was acknowledged'before me this
day of 20 L A by �� � � ® day of 20 t,by � 4 1)
who is perso known to me or who has produced who is persona.4 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: NOTARY PUBLIC:
Sign: mft &t &c,,v,,q Sign:
j
Print: Print:
M Commission Expire z„0y MARY PAT BRIGGS —I
My p ,e;�:.�;��, MARY PAT BRIGGS My Commissio
MY COMMISSION#DD 979267 =*: :*= MY COMMISSION#DD 979267
EXPIRES:May 11,2014
EXPIRES:May 11,2014
Bonded Thru Nary Public Underwriters Bonded Thru Notary public Underwriters
$C�l�.'LF'�G7TC�CSti7k'�..Z..k'�'3C�'k1F'k'JC '�C'k'Yk"x�:'�G'J1t'JY'k9C'J13C3.'3C�.'��CSY'1C�CSti h'tiC�t ��..�.
APPROVED BY 14e - Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012XRevised 07/10/07)(Revised 06/10/2009XRevised 3/15/09)