EL-13-1128L,
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP- 205233 Permit Number: EL -5 -13 -1123
Inspection Date: January 03, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: VOGTNER, ALINA Work Classification: Alteration
Job Address: 53 NE 98 Street
Miami Shores, FL Phone Number (954)452 -0110
Parcel Number 1132060131140
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP Phone: (305) 551 -4043
Buildinc Department Comments
REMODEL KITCHEN, MASTER BATH, AND MASTER
BEDROOM.
Infractio Passed comments
INSPECTOR COMMENTS False
Passed
Inspector Com
Failed El
Correction
Needed
Re- Inspection a
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
For Inspections please call: (305)762 -4949
January 02, 2014 Page 1 of 1
Miami Shores Village
Building Department
90050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 1
INSPECTION'S PHONE NUMBER: (305) 762.4949
0
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
Permit No.� / ljdc
Master Permit No.
JOB ADDRESS: 5� 0 G C r-9 01
City: Miami Shores County: Miami Dade Zip:I�iS
Folio/Parcel #: l I 390LO G13— \y0
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): 'tsc-�- nr, 10hrC Phone#:
Address: G5 Mr
City: &AJ_rx CA,- 5.VNat es State: Zip: Sao Qz
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: �� rc �,�Phone#: (s
Address: �y_ (2.i✓0 � S� Z'`' ( r�—
City: M "non I State: r'� Zip: _ 3:5n
Qualifier Name: %2 r, C RA,-k z - Phone#: Z 696 — 3 M-6 S'�2
State Certification or Registration #: C — 3 00 (5t 4'1 Certificate of Competency #:
Contact Phone#: ) � " 3 � S — ( � r`9 Email Address: � r, ✓t �r,, a4 0- `'' "� C_ e C C) ( ° C�0 ,--f
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $ 4 000. "" Square/Linear Footage of Work:. Lgo2s,kk aml clx
Type p�Work ' OAdd ess'- . 7AAlteration flew ORepair/Replace ' ODemolition
Doirjliobd 6f Woik- g, _CRS r n�csa n � r 1�c1c�tYl
./ ���x�x. �xx�x�x���x�x��aw�x���e��������Fees�������x���+ ��x��x�+ �����x����a�x���x�x��x� +������������
Submittal Fee $ Permit Fee $ �' Z-� ° ®� CCF $ CO /CC $
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
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address _
Zip
City State Zia
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 commencement and construction lien law brochure will be delivered to the person
whose properti, is subject to attachment. Also, a certified copy of the recorded notice of c•ommenc•ement must be posted at the,job site
_for the ,first inspection which occurs seven (7) dal-s after the building permit is issued. In the absence clf such posted notice, the
inspection will not be approved and a reinspec•tion fee will be charged.
Signature Signature �
Owner or Agent
The foregoing instrument was acknowledged before me this _-__
day of 010A 20 16L, by
who is personally known to me or who has producedhL4! 42a5
6% 5R— C2-+ -A As identification and who did take an oath.
NOTARY
Print:
My Commission Expires: °� 00f EXPM-UNNNY07.
uuu u�euu
Contractor
The foregoing instrument was acknowledged before me this
day of M 20 5 by T(caatL+.i; -W
who is .er`F songlfv kno7A to me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
_sn.,
APPROVED BY �dP Plans Examiner _ Zoning
Structural Review
(Revised 3 /12 /2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Clerk