EL-13-2232Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 200356 Permit Number: EL -10 -13 -2232
Scheduled Inspection Date: April 03, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: AJAMI, KAMRAM Work Classification: Addition /Alteration
Job Address: 171 NE 102 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 1132060131840
Project: <NONE>
Contractor: FIVE STAR ELECTRIC SERVICE Phone: (786)356 -0162
sunatng Department comments
REPLACING SWITCHES RECEPTACLES AND LIGHT
FIXTURES IN KITCHEN AREA ONLY
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
April 02, 2014 For Inspections please call: (305)762 -4949 Page 3 of 32
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
FBC 20
SEA' 2 4 2013
JOB ADDRESS: 171 ne 102 street
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO X Flood Zone:
City:
U Nrn (Fee Simple Titleholder):kamran Ajami Phone #:954873 3999
17 e 102 street
State: f
iiessee- vame: Phone#:
ajamik @gmail.com
C�NTRACTOgR: Company Name:
Address:T
n City: 1aV9/fi`4;.
Qualifiers Name: �i'"
State Certification or
-'Contact Phone#: (p7
33318
i.)e__ SLQC 1l 5& ��aPhone#�%�1�� 13 fZ ®b %4Z
#: Ee, 13 a1* a 9 z3 Certificate of
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: 5bV . Square/Linear F000 ge of Work:
Type of Work: DAddress OAlteration ONew epair/Replace
Description of Work:
Submittal Fee $ Permit Fee $ 4?0®, ®P CCF $ MCC $
Scanning Fee $
Radon. Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
Bonding Company's Name (if applicable)
Bonding Company's Address
` City =
State
Mortgage 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 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. A
Signature YAM AL&- --L
Owner or Agent
The foregoing instrument yeas acknowledged before me this �_
day of , 20 _, by l ,
who is personally known to me or who has produced �--
As identification and who a an oath.
NOTARY PUBLIC:
/ / Contractor
The foregoinLy instrument was gcknowwlZleddged, bieffore me this - /
day of . 20 _, by .�fi�+� I'L�t�I17�itL�P ..
who is personally, known to me or who has produced
{! &cation and who did take an oath.
NOTARY PUBLIC:
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06110/2009)(Revised 3/15/09)
Zoning
Clerk