EL-12-623Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
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Phone: (305)795 -2204 Fax: (305)756 -8972 RLrC1 d fl _... 2iI�]_ 1
Inspection Number: INSP- 194933 Permit Number: EL -4 -12 -623
Scheduled Inspection Date: July 30, 2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: SFARA, VERONIQUE
Job Address: 1080 NE 105 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: PARDIME ELECTRIC INC
comments
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)799 -2006
Parcel Number 1122320280090
NEW ELECTRICAL INSTALL KITCHEN AND 4.5 BATH ' -�a_
COMPLETE REWIRE AC CONNECTION AND EXTERIOR INSPECTOR COMMENTS False
LIGHTING
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP- 194908. Contractor called at
9:45 a.m. to cancel.
Failed
Correction el
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
July 29, 2013 For Inspections please call: (305)762 -4949 Page 15 of 34
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
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INSPECTION S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS: 1000 1-26 165
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Permit No. �r L! "L_
Master Permit No. I L — I;z 142-
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes % NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): Phone #: — CPD(jo
Address: 2�
City: AA L4 State:
Tenant/Ussee Name: Phone #:
Email:
CONTRACTOR: Company
Addres 44:n.ZS ,_5
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DESIGNER: Architect/Engineer: Phone #:
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Value of Work for this Permit: $� . d� Square/Linear Footage of Work: 33
Type of Work: ❑Address
DAlteration , New
O�Repair/Replace
ODemolition
Description of Work: V6
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Submittal Fee $� l� Permit Fee $ CCF $ CO /CC $
Scanning Fee $
Radon Fee $
DBPR $
Bond $
Notary $
Training/Education Fee $
Technology Fee $
Double Fee $
Structural Review $
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TOTAL FEE NOW DUE $ 1
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.
Signature �-
Owner or Agent `
The foregoing instrument was acknowledged before me this
day of q, 20 IZ, by U�(1AQ(Ak [JSW6t(U S+CA
who is personally known to me or who has produced IFDL
S 1WO -"s 55- 2e-% identification and who did take an oath.
_ Signa
Contractor
The foregoing instrument was acknowledged before me this
�P day of DN / V ) , 20_L2-,by -� • S�VI�t� �1 ,
who is personally known to me or who has produced }% �-
J- -5�6106) q-M identification and who did take an oath.
NOTARY PUBLIC: - - NOT PUB' �� 7 F
Notary Public State of fionda yOA Notary Public State of Florida
Clarissa Egan Clarissa Egan
Si ", s ° My Commission /30940881 N My Commission DD940681
f o¢� Expires 11/18/2013 r . Expires 11110/2013
sip: Sign:
Print: Pct% ► 5S *-1 A Print: A A
My Commission Expires: !1 I / 2013 My Commission Expires: 1 Ip /Z0 13
APPROVED BY 11G Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07XRevised 06 /10)2009XRevised 3/15/09)