EL-13-2780Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 206288 Permit Number: EL -12 -13 -2780
Scheduled Inspection Date: January 29, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: ROSADO, CARMEN Work Classification: Alteration
Job Address: 2 NE 110 Street
Miami Shores, FL 33161 -
Phone Number
Parcel Number 1121360040320
Project: <NONE>
Contractor: MOODY ELECTRIC INC Phone: (305)758 -2000
Building Department Comments
INSTALL NEW BREAKER PANEL IN GARAGE INSTALL
NEW SUBFEEL
INSPECTOR COMMENTS False
Inspector Comments.....
Passed
Failed /e,
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid
January 28, 2014 For Inspections please call: (305)762 -4949 Page 38 of 39
Miami Shores Village
Building Department
90050 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 � ( t 0
JOB ADDRESS: � (`/
FBC 20
Permit No.
Master Permit No. � / 3 —,,2;Z90
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO
Zone:
Tenant/Lessee Name: 9 Phone #:
Email:
CONTRACTOR: Company Name: O&V y" a Phone #: 30S � O-V
Address: /,�-j Vio ,5-1o'ee
City: Awld wl . State: �� Zip.33/so - ZI/O 6
Qualifier Name: U0411 U IV ®® Y Phone #: 3 -OS - % 59 " A ®OO
State Certification or Registration #: A' e ;�®f1 r/ &7'
Contact Phone #: 30 5" -25 6"0"' Email
DESIGNER: Architect/Engineer:
�2A
Certificate of Competency #: �lw
Address: ." P-r-v p 4Y-® M "d e leC /'a e . E-0
Phone #: �-4
Value of Work for this Permit: $ 16K,06 Square/Linear Footage of Work:
Type of Work: ❑Address DAlteration ONew ARepair/Replace ODemolition
Submittal Fee $ Permit Fee f �i ®� CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary
Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 11L-
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 certifled 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 OC=,, /Yrf R:Jq &:A�
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ✓/O V '20/3, by --) A-tj ,
who is personally known to me or who has produced Jct -- 10
As identification and who did take an oath.
NOTARY PUBLIC:
Sign
Contracto
The foregoing instrument was acknowledged before me this 96—
day of PC)Lf ,20 a, by 1 l® W ll[ ,
who is personally known to me or who has produced
Plans Examiner
Structural Review
(Revised 3 /12 /2012XRevised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
as identification and who did take an oath.
NOTARY PUBLIC:
.s: MARY PAT BRIGGS
MY COMMISSION A DD 9792 67
EXPIRES: May 11, 2014
Bonded Thru Notary Public Underwriters
Clerk