EL-13-1628Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number. INSP- 195560 Permit Number: EL -7 -13 -1628
Scheduled Inspection Date: February 25, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: GOMEZ, LINA
Job Address: 10109 N MIAMI Avenue
Miami Shores, FL 33150-
Project: <NONE>
Work Classification: New
Phone Number
Parcel Number 1132060131510
Contractor: EAB EGINEERING SERVICES Phone: (786)239 -1808
auilaing Department comments
NEW SWIMMING POOL ELECTRICAL
INSPECTOR COMMENTS False
Inspector Comments
Passed lo
Failed
Correction s ��
Needed `G
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid
February 24, 2014 For Inspections please call: (305)762 -4949 Page 5 of 42
3
Miami Shores village
Building Department
i 9�
90050 N.E.2nd Avenue, Miami Shores, Florida 33138 VL 1 9 HID
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 ter'
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
FBC 20
Permit No. .) ` ® •
Master Permit Note °ni
a
JOB ADDRESS: 1 C') I q fLsM '►
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: t t° 320 (D - C F3 15 1
Is the Building Historically Designated: Yes NO Flood Zone: 00'
OWNER: Name (Fee Simple Titleholder): L ► 0 n Li 1( Phone #:_
Address: t 0 L QC/ N M CLM 1
City: 1Ll 1 GutyQ I LSYI het° �i� State: F L Zip: 3 51,0
Tenant/Lessee Name: LN Phone #: JA
Email: Ni I "N
CONTRACTOR: Company Name: e A b s C—S' Phone#: 0 q° co-) Z73 C/ - t bo
Address: 13 56 q v'J 0q Sk 4 Ll'Z Z
City: 1\-A ► CsLM L State: Zip: ? 3 i S
Qualifier Name: -F-CtqpXdG f, tro Phone #: (- a to) 239 " t g uin
State Certification or Registration #: G G (3 Q 0 5 1 l3 Certificate of Competency #:
Contact Phone#: L7 B� Email Address:''XV ► C Q� 2�� d
DESIGNER: Architect/Engineer: VCA L)a (rel o Ply Phone #:
Value of Work for this Permit: $ 12-00 Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration liew ❑Repair/Replace ❑Demolition
Description of Work:
Submittal Fee $ Permit Fee $. P"O' ' 41e5�' CCF
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CO /CC $
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) N C
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 ust be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the s e such posted notice, the
inspection will Lbpproved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 1 The foregoing instrument was acknowledged before me this i8
day of 103 20 13 by Llnal G- 0n lez day of QW 20 by TE61UAlalX1 I?�W1'�'b
who is person y known tom or who has produced who is per tonally known t e or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY
NOT
Sign: Sign: —
Print: Print: I
Um- Il=W n0 NotroyPu* Ufa
My Commission Expires: My Commission Expires:
APPROVED B Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)