EL-14-102Z2 / 3 4zq
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 207335 Permit Number: EL -1 -14 -102
Scheduled Inspection Date: February 21, 2014 Permit Type• Electrical - Residential
Inspector: Devaney, Michael . Inspection Type: Final
Owner: KOTALIK, KENNY Work Classification: Alteration
Job Address: 950 NE 100 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 1132060340200
Project: <NONE>
Contractor: FIVE STAR ELECTRIC SERVICE Phone: (786)356 -0162
comments
FIRE DAMAGE HOUSE WIRING UP A HOT WATER
RUN220 ELECTRICAL LINE WATER HEATER/ DRYWALL/ INSPECTOR COMMENTS False
PANEL
Inspector Comments
Passed [:O_
Failed
,7
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 20, 2014 For Inspections please call: (305)762 -4949 Page 18 of 34
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Miami Shores Village
Building Department JAN 2 2 2014
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20
BUILDING Permit No. E l N -- La 2
PERMIT APPLICATION Master Permit No. c— l 3 -- -MZ �-
Permit Type: Electrical
JOB ADDRESS: It 66 PLP �( G)� si
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
OWNER:
city:
Tenant/L.essee Name:
Email: M .S 001
Simple Titleholder): _V C•V 1
'E 1 U0 `1'Shect
1101 es State:
mqm at)), (-/,Ym
NO Flood Zone:
i— 3 5) -244 (P
Bi
_=1Ci. i�J(�,
Company Name: f +V 4 AU c"° Elect r t-c- 5ero tcx Phone#: 6 U77C.,°- 0
n % A � I �.
City: wY�
Qualifier Name: 3
State Certification oo
Contact Phone#: l 1
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ ! -00. Square/Linear F�oZpa
e of Work:
Ur
Type of Work: ❑Address ,vAlteration ONew ' Bi r/Replace
Description of Work: („2 t r 1 n
(In ji 1 n (I 41/)0c
Submittal Fee $ SD ` �d Permit Fee $ �✓ ®� �' CCF $ CO /CC $
Scanning Fee $
Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $
ODemolition
V4
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
IlVIPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMNENCEMENT:"
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 in pection which occurs seven (7) days after the building permit is issued In the absence of h posted notice, the
inspection wi not b pproved a a reins iion fee will be charged
or Agent I v Contractor
The foregoing instrument was acknowledged before me this2 �O
day of V--ImP PJC, , 20 j5, by Jan NIM 11 en ,
The foregoing instrument as acknowledged before me this 261fr,
day of , 20 , by Vipgnu
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY
Sign:
FERNANDEZ
Who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY P IC•
^o�ommission 9 FF 42370 Sign ,,• os °a U ANNE ERNANDEZ
Print: . M Commission Expires Print: °ys Cammission
August 04, 2017 • tea. MY Commission Expires
My Co My Co fires: August 04, 2017
APPROVED B J Plans Examiner Zoning
Structural Review Clerk
(Revised 3 11=012)(Revised 07 /10/07)(Revised 06110/2009)(Revised 3/15/09)