EL-13-907Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 211136 Permit Number: EL -4 -13 -907
Scheduled Inspection Date: April 22, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: ESPINOSA, JUAN Work Classification: Alarm
Job Address: 309 NE 99 Street
Miami Shores, FL 33138- Phone Number (214)235 -9336
Parcel Number 1132060135490
Project: <NONE>
Contractor: ADT LLC
tsunaing Department comments
BURGLAR ALARM
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 21, 2014 For Inspections please call: (305)762 -4949 Page 25 of 33
Miami Shores Village
Building Department APR 3 0 `013
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS:
FBC 2010
Permit No.
Master Permit No. IF L1 3 —610
City: Miami Shores County: Miami Dade Zip: 047l�a
Folio/Parcel #: f 1 3'ya L U) 3 SV 5 0
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): /h / Phone #:
Address: C309 /f/6;_ Vv j_/_
City: / I 22A & le 3 State: Flo"
/ Zip: 1 �/Jl
Tenant/L.essee Name: Phone #: LEA& � J —
Email:
CONTRACTOR: Company Name: Phone #:��I�����s3
Address: a k'z y-�
City: i /k4 -122 � State: 5r/ _- Zip:
Qualifier Name: �/? Phone #:
State Certification or Registration #: // Certificate of Competency #: _
Contact Phone #(Ag �� Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ l • Square/Linear Footage of Work:
Type of Work: DAddress Alteration ❑New ❑Repair/Replace ODemolition
Description of Work:
Submittal I'ee $ °'� Permit b ee 5 /®411 • 010 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
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 ELEC°I'RICAL 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.
er �zf —f
The fo ng instru ent was acknowledged before me this
day of � �, 20 -1-& by — l/# J 0o PPP WOSA
,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission
APPROVED B
BEM BRIERRE
W COMMISSION d EE 100904
EXPIRES: June 7, 2015
®ended Tin Notary Puf fto UndanmBsm
Signature
Contractor //'0j��
The foregoing instru e t was acknowledged before me this�v"-
day of l , 20 y
who is personally known to me or who has produced
tf,'n z ep i
® Plans Examiner
Structural Review
(Revised 3 /1212012)(Revised 07 /10/07)(Revised 000/2009)(Revised 3/15/09)
NOTARY
4 0 l.l..i� s
andAT EDWARD;
iNOTARY PuNX
STATE OF FLNtr.
My Commission Expires:
`?AI'1/7
Zoning
Clerk