EL-14-1356Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 —
Inspection Number: INSP-217813 Permit Number: EL -6-14-1356
Scheduled Inspection Date: August 13, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: FERNANDEZ, MARTA
Job Address: 163 NW 102 Street
Miami Shores, FL
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP
euli
comments
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1131010230060
Phone: (305) 551-4043
INSTALL ONE NEW GFI OUTLET AND RE RECESSED I ""- I.....
CANS INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
August 12, 2014 For Inspections please call: (305)762-4949 Page 29 of 32
Miami Shores Village��j7��
g !JUNL22014
Building Department BY;
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
Specify color of color thru tile:
Submittal Fee $,
Scanning Fee $
Permit Fee $ CCF $ CO/CC $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
FBC 20LD
BUILDING
Master Permit No ,� "" I�
PERMIT APPLICATION
Sub Permit No.�-1�'l p
❑ BUILDING 1� ELECTRIC ❑ ROOFING
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING [:]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: �Cn� �� l��
City: Miami Shores County:
Miami Dade Zip:
Folio/Parcel#: C23. 00(0c::)
Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction
Type: Flood Zone: BFE: FFE:
OWNER: Na a (Fee Simple Titleholder)
, {'
lv "A*- �� Phone#:
Address: l63 t02- Sr --
City: State:
r ` Zip:
Tenant/Lessee Name:
Phone#:
Email:
CONTRACTOR: Company Name:��L..f
Phone#:
40
Address: 12 3
A
City: AI Oi m i State:
-
-1�a c �c . Zip: g s-2�-1 135
Qualifier Name:
Phone#:
State Certification or Registration #: l?)C)O A144
Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address:
City: State: Zip:
Value of Work for this Permit: $ /Wry `
Square/Linear Footage of Work:
Type of Work:. ❑ Addition F-1Alteration
El New IDRepair/Replace El Demolition.
�� /► °�
Description of Work: ;. "- s y�e._ O� I 1
/�
1 A� (T'�C—'
Specify color of color thru tile:
Submittal Fee $,
Scanning Fee $
Permit Fee $ CCF $ CO/CC $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $
Double Fee $
Bond $
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
Zip
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 the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
— q�c-�
�AOwn§or Agent Contractor
The fore oing instrument was acknowledged before me this The fore oing instrument was acknowledged before me this
day of , 20l'�, by <'�1Qr�. �elnAnC�eZ day of , 20, by �ra �2r�e2 ,
who is personally known tome or who has produced�� who is ersonally known to me or who has produced i–► -t);
&( _ As identification and who did take an oath. OVI Tri ke— as identification and who did take an oath.
NOTARY LIC: NOTARY P IC:
Sign: a, Sign:
Print: 2 Print:
My Commission Expires: REBECA M. PAIMANA My Commission Expires:
Wir"MY COMMISSION # EUM624 + REBECA M. PASTRANA
EXPIRES: Febnmy 07.2017 MY COMMISSION # EE872624
7051 EXPIRES: Fabrumy 07, 2017
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APPROVED BY
Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk