EL-13-1075Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972 ((J7
Inspection Number: INSP- 193922 Permit Number: EL -5 -13 -1075
Scheduled Inspection Date: June 27, 2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: ,
Job Address: 47 NE 91 Street
Miami Shores, FL
Project <NONE>
Contractor: ATEXI SERVICES CORP
Lffel ililLallf =i
REPLACE OUTLETS IN KITCHEN TO GFI
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132060130110
INSPECTOR COMMENTS False
Inspector Comments
Phone: (786)251 -1604
Passed EJ CREATED AS REINSPECTION FOR INSP- 193773. Label panel.
Failed '
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
June 27, 2013 For Inspections please call: (305)762 -4949 Page 17 of 32
6
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138'
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Y
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS: �zz , Y F i I s/
. - - --
MAY 14 w1�
r
BC 201
Permit No. (--tu 3 — i q-7 S
Master Permit No. i2c' 13 —.(c °'i
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
Tenant/Ussee Name: Phone #:
Email:
CONTRACTOR: Company Name: AVMt FC-fC eom • Phone#: -78(' ZS-1
Address: 13915 0-6 `F Cf.
City: A). /KArn *r State: Ft., Zip: 331(01
Qualifier Name: AV4%JA W 0 Micr000- Phone#: 796 Z,St - 1 la ®++
State Certification or Registration #: Cc- 13 00W!o l Certificate of Competency #:
Contact Phone#: �BEK 323�020 Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ '30 0' 00 Square/Linear Footage of Work:
Type of Work: ❑Address DAlteration ONew [fIG-pair/Replace ODemolition
Description of Work: OC)TWT- 9&epLP -6MeM th9 UrCAW 0 1b C. . i , G . ir-
��. �-• ��x����x• ��x��������x�x�������x����• ���Fees���x����u��������x���u� ••��x����•••����x�•��x�n��x�•�u
Submittal Fee Permit Fee $ ® CCF $ CO /CC $
A'
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ •
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
u.- Mort &ge Lender's Name (if applicable)
Mortgage Lender's Address
City
state
Zip
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 inspectio hich occurs ven (7) days after the building permit is issued In the abs nce of such posted notice, the
inspection will not b ap roved and ,A tinspectionfee will be charged.
Signature Signature !
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 3� The foregoing instrument was acknowledged before me this -
day of Q , 20 Lb, by bi'Vl0.�'l a 1� +C.� day of , 20L-, by A-rna1- Vfn
who is personally known to me or who has produced who is personall known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: 0 Q O- Vl t
My Commission Expires:
APPROVED BY
L ,�. PL4,e,*— Nli�ei-ft
o�'}`rP4eo; JANICE AIMEE MATOS
i;
*, *` MY COMMISSION #FF011193
EXPIRES April 23, 2017
�9A 1/,0/fitVX1ans Examiner
as
NOTARY
Sign:
Print:
My Commission
+uwu rCnMM q1M
Notary Pwft - state of Rwwa
• My Comm. Expire& Aug 2S, 2011
a, Commission # EE 103M
ARouP N8009 Nov Assn.
Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06110/2009)(Revised 3/15/09)