EL-13-1909Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-197778
Scheduled Inspection Date: March 10, 2014
Inspector: Devaney, Michael
Owner: ,
Job Address: 10650 NE 10 Court
Miami Shores, FL 33138 -
Project: <NONE>
Permit Number: EL -8-13-1909
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number
1122320280930
Contractor: CASSIA ELECTRICAL CONTRACTORS INC Phone: (954)650-5840
Isunaing uepartment comments
LOW VOLTAGE
INSPECTOR COMMENTS False
Inspector Comments
Passed
e
Failed
f � A l�
Correction ( /`"/
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 10, 2014 For Inspections please call: (305)762-4949 Page 3 of 24
BUILDING
Miami Shores Village
Building Department
10050 N.E2nd Avenue, Miami Shores, Florida 33138
Tel: (365) 795.2204 Fax: (305) 756.8972
INSPECTION'S PRONE NUMBER: (305) 762.4949
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS•® � C c!
FBC 20
AUG 2 2 F 0 e3
;r:� _ �e=_aevam�0000°o�o
Permit No. ,- r s
Master Permit No. J 131 (
City: Miami Shores County. Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple
City:
0
1ja
State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: < X61 'V +! e�
City: A&1� / State:, Zip:
Qualifier Name: / Phone#:
State Certification or Registration #: D .� 30 e Certificate of Competency #: ��5 000 2
Contact Phone#: (516e— rlCr,,j ^Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ i o -D Square/Linear Footage of Work:
Type of Work: OAddress Alteration j New tepair/Replace
Description of Work: `�' U 1 �__�
Submittal Fee $ Permit Fee $ Ap"Oe- do CCF $ CO/CC $
Scanning Fee $
Notary $
Radon Fee $
Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
ODemolition
TOTAL FEE NOW DUE $ 1140 MU
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 *erk 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 roved and pection fee will be charged.
Signa Signature
Agen Contractor
The fore oing ' was acknow ged 7re e On The foi
day of 20 h day ofd
who is p oiSally Imoto me or whd`hs produced 'l' L—
identification and who did take an oath.
ARY PUBLIC: - -
otatY Public . VgeP 23. Zu "'
M� r
Oomm�ssio° alNotaty peen.
BondedZhT 10 1% 1111
Zoning
Clerk