EL-13-801 • V
•
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-196800 Permit Number: EL-4-13-801
Inspection Date:August 07,2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: LAURENT,SYLVIA Work Classification: Alteration
Job Address:790 NE 97 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060142190
Project: <NONE>
Contractor: HI-TECH ELECTRIC&FIRE CORP Phone: 3051225-1447
Building Department Comments
ALARM Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed 1E
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
August 06,2013 Page 1 of 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 APR 17 013
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:rA 0 a a
City: Miami Shores County. Miami Dade Zip: 313
Folio/Parcel#: /
Is the Building Historically Designated:Yes NO V/ Flood Zone: o
OWNER:Name(Fee Simple Titleholder): S\/�y1®. Phone#: ?XS- 335-W-03
Address:, I`7 G® N C cri-� -s#vI��-F-
City: M lay,; ;560 m State: F 1331IS S
Tenant/Lessee Name: A)I Phone#: -3oS--151—416 G
i
Email:
CONTRACTOR:Company Name: IYLt-/L'eri �Q.� Phone#: 7 2�•��/
Address: 15O'a S&..l /0/4"-
city: 10 4&e!if, State: Zip: 33♦ -
Qualifier Name: A"W+A •—Af f i.4o' Phone#:
State Certification or Registration#: &G 13&1a U!! �Certificate of Competency#: /
Contact Phone#:_M 5 Z`'-d 9'3/ Email Address: ��I ��!/�it� zod lo dp,k e llOW O. C.,�t,�•
DESIGNER:Architect/Engineer: Phone#: �qr-op or li 7Z
Value of Work for this Permit: $ *A7
Square/Li#ear Footage of Work:
Type of Work: ❑Address DAiteration *ew ORepair/Replace ODemolition
Description of Work: 4"Pemw. L;p`j JAS• Ly W NOG* - 11^0r. /Zo fI
Submittal Fee$ 5-6. v, Permit Fee$ I'S✓�l�D CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
I
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 69 Signature
Owner or Agent Contractor
The foregoing instrument was ackno ledged before me this /,5/41 The foregoing instrument was acknowledged be re me this
day of r 20 L3,by �U l A L (j e day of ,'L20 L.7,by, Q IMJ rZ 41 I/l
who is ers y kno o me or who has produced who ' personally known me or who has produced
identification and who did take an oath. c as•identification and.who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
¢a.• O�#EE108490
Print: Print:
• .. •, u 04,2015
My Commissio aom My Commissi ,
\ }�PPz�w�
APPROVED BY laps Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07XRevised 06/10/2009XRevised 3/15/09)