EL-14-234Inspection Worksheet
Miami Shores Village.
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 209828
Scheduled Inspection Date: March 28, 2014
Inspector: Devaney, Michael
Owner: ERIC DIAZ, ROBERT BAKER
Job Address: 260 NW 112 Terrace
Miami Shores, FL 31368 -3332
Project: <NONE>
Contractor:
MESA BROTHERS INC
sullaing uepartment Comments
UP GRADE ELECTRICAL SERVICE
Permit Number: EL -2 -14 -234
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number
INSPECTOR COMMENTS False
Inspector Comme
Passed
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
1121360010280
Phone: (305)345 -1974
March 27, 2014 For Inspections please call: (305)762 -4949 Page 20 of 23
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) 962.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
FBC 20
Permit No.
FEB 06 2014
Master Permit No._ E/ / L/ -
JOB ADDRESS: 2,46 1 W i t -.?, r'` T-P.rlr&C -C
City: Miami Shores County: Miami Dade Zip: 3 3 IS
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titlehol
Address: ZG 21 N IJ ( e
City. /A I aA- I-E N
TenimvLessee Name- ��
Email: � � 4� .1 b 0— 41./1
J�0 �0_J '3Q
T�p/�r&e 4P-
s
y/!r) S
State: V, L- zip. W V3 G
CONTRACTOR: Company Name: �fi —�/��f 1 Phone #:°' �j
Address:
City: e, ! State:
Qualifier Name:
r
State Certification or Registration #: Certificate of Competency #: -Af
Contact Phone #: :_A� o;44 - l Z Email Address: re,� 45;�cl a' Q 41?4
DESIGNER: Architect/Engmeer: Phone #:
r
Value of Work for this'Permit: $� Square/Linear Footage of Work:
Type of Work: DAddress ,, r Alteration ONew/ ORepair/Replaee .., ° • `° - Wemolition
Description of Work: tll i°�� � . ' d yl c� S - �tec4vt P tic- d2__
Submittal Fee $ S-P• 0 Ci Permit Fee $ ®4-;' CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ j, V
Bonding (gompany,'s Name (if applicable) _
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) _
Mortgage Lender's Address
.ax-�
zip I -- -
City State 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 nce of such posted notice, the
inspection will not by appr v and a reinspection fee will be charged.
. 'A �;,,
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this
day of M , Z0 &, by $a1* Art, -,✓✓/°
ittt=fication or who has produced
and who did take an oath.
NOTARY PUBLIC:
Joanna M Pellciano
My Commission FF 082753
Expires 01112/2018
The foregoing instrument was acknowledged before me this
day of 1.G 20 4, by .o ,
who is personally Lown to me or who has produced "Ie
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Dom: JAM 21.2818
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APPROVED B , �,A G V IY Pans Examiner Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)