EL-13-1132 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 Ora 2
Inspection Number: INSP-197430 Permit Number: EL-5-13-1132
Scheduled Inspection Date:August 15,2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: JORGE, MARIA Work Classification: Alteration
Job Address:42 NE 94 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060130330
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP Phone: (305)551-4043
Building Department Comments
BATH REMODEL Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction �� � /3
❑Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 14,2013 For Inspections please call: (305)762-4949 Page 45 of 46
Miami Shores Village
Building Department MAY 2 2 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. ` //. i
PERMIT APPLICATION Master Permit No;
Permit Type: Electrical
JOB ADDRESS: q2. Mt 9q- .
City: Miami Shores County: Miami Dade Zip: 3 3 t 3$
Folio/Parcel#: 11 -��%-0 l3-e 3 3 a
Is the Building Historically Designated:Yes NO X Flood Zone:
OWNER:Name(Fee Simple Titleholder): tA K4V-tH , 04-&F-- Phone#:
Address: ycz- t'?- 6'r,
City: !d%�*s- s t.t�2oS State: L Zip: S 631
TenantAxssee Name: Phone#:
Email:
CONTRACTOR:Company Name: AIIAPTt S
Address: Z- 00 3 3(L.) ZD (�
City: V4( A-,—I State: Zip:_ 3 3 (? T
Qualifier Name: NL--\-c\-, ..-,� A✓'L2, Phone#: 7 OG -3 S r-G
State Certification or Registration#: 6C- (3 00 /5?l 4 Certificate of Competency#:
Contact Phone#: �� " J - �4-7 mail Address: _S4 s► 1 �(QC'Itvi c c��a �s-7
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ S o' Square/Linear Footage of Work: P .
Tye of Work. QAddress. ❑Alteration XNew ❑Repair/Replace ❑Demolition
De�c'rlptiplr'Gt�i'c►�k V-� - bA�� t � i;lfa4�i t r $ii�w C tbc,-- (i) 6FV l ew'tj
Submittal Fee$ 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$
Bonding Company's Name (if applicable)
Bonding Company's Address _
City_ State T Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address r ��
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 u copy of'the notice of'c•ornmencemeni 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 pasted notice, the
inspection will not be approved and a reinspection fee will he charged.
r
Signature _ _ Signatu _
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this ICS The foregoing instrument was acknowledged before me this��
day of... &A-r ,20 a,by �yr� day of d 20-,by 1 E 06
who is personally known tome or who has produced` J WO who i person-11 nown to me or who has produced
X13—52-1414 --GAs identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY UB
Sign:� Sig "
� Print: AM.PASTltANA
Print:
My Commission Expires: MYCOt S81aNNP.B> u My Commission Expires: B •F&my
%� m.lpl7
a
APPROVED B a� Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)