EL-14-1530Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-217815 Permit Number: EL -7-14-1530
Scheduled Inspection Date: August 13, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: DOCKSTADER, BRYNN
Job Address: 1060 NE 104 Street
Miami Shores, FL 33138-2656
Project: <NONE>
Contractor: MOODY ELECTRIC INC
euimina Department comments
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1122320290220
Phone: (305)758-2000
200 AMP SERVICE UPGRADE 4 SMOKE DETECTORS I ""'Q r."""
AND 1 CARBON MONOXIDE DETECTOR INSPECTOR COMMENTS False
Inspector Comments
Passed
1
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 30 of 32
.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) 762.4949
`7ly
DING
PERMIT APPLICATION
Permit Type: Electrical
RECFIVED
JUL 10 2014
FBC 20 10
Permit No. L-1 4
Master Permit No.
JOB ADDRESS: I ®�® /U e f ®q 5 r
City: Miami Shores County: Miami Dade
Folio/Parcel#: 1 1-" of d- I al -- l --
Is the Building Historically Designated: Yes NO
Zone:
OWNER: Name (Fee Simple Titleholder): C--7fzi e, W id ® ill L4 Phone#:_ 762 % —
Email:
State: `L, Zip: 3:30-39
CONTRACTOR: Company Name: I &Q J C Ik (S Phone#: / ' 5 O
/
Address: 9 AW 9,os % 1
City: I
Qualifier Name:
State Certification or Registration #:
Contact Phone#:
DESIGNER: Architect/Engineer.
Address:
of Competency #:
Value of Work for this Permit: $ ®® ®� Square/Linear Footage of Work:
Type o . "s ertio ONewiepair/Replace
y
Descripon
Submittal Fee
Scanning Fee $
ODemolition
lo-� �'E q.�i t 3�d�4.at�S'�9f4 r
pia 'ai, * a
_w .%e t
Permit Fee $ 0 CCF $ CO/CC $
Radon Fee $ DBPR $ Bond $_
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $ -
r
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.
Signator
a�
O� or" "ht
The foreg ing instrument was acknowledged before me this i
day of �,2!0/ �, by� �—/ � � l, g Jwh is ersonalto me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission
CATHMN A. IDUFFI 1
Y Pdit - SUM of FWMa
011
Signa e -V F,00-�,
Contracto
The foregoing instrument was acknowledged before me this
.� 00-19
day of20 , by
who is pe y own to me or who has produced IW4
Commission N FF 6417
Bonded
ft*J.
APPROVED BY Nam Examiner
®l%f�
�TJ Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My CrIwuh,i
Re
jlAy 1r PubNt - SWe of FbWa
Comm. Expires May 11, 2011
Commission N FF 120746
Zoning
Clerk