EL-14-1267Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-216209 Permit Number: EL -6-14-1267
Scheduled Inspection Date: July 21, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: MILLAR, ROY
Job Address: 50 NE 104 Street
Miami Shores, FL 33138-2027
Project: <NONE>
Contractor: RAYS ELECTRICAL SUPPLY INC
comments
SERVICE CHANGE
Inspection Type: Final
Work Classification: Service Change
Phone Number (786)367-4039
Parcel Number 1121360130890
INSPECTOR COMMENTS False
Phone: (786)236-2777
Passed
Inspector Comments
Failed
J -61A Y' P_ ¢ /y,
Correction
Needed
❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
July 18, 2014 For Inspections please call: (305)762-4949 Page 21 of 23
BUILDING
Miami Shores Village Vkc�.,
Building Department artment ? JUN I 1014
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax (305) 756-8972 �--J
INSPECTION LINE PHONE NUMBER: (305) 762-4949
PERMIT A=ON
r-1BUILDINGELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
7N -t
JOB ADDRESS: 50 l l , NA
FBC 2010
Master Permit No. 6-/ //7
Sub Permit No.
❑ REVISION
❑ CHANGE OF
CONTRACTOR
❑ EXTENSION ❑ RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
Folio/Parcel#: �- �1-.���� " C%\?)'" Oft Is the Building Historically Designated: Yes
Occupancy Type: Load:
OWNER: Name (Fee Simple Titleholder): itllholder):
Address: 7� pl, E `
(�
Construction Type: Flood Zone: BFE:
City: S o State:
NO _
FFE:
6 o 5
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:��Q �S ��C�� Phone#:
Address:
City:
3
Zip: 3 l `Z
Ctualifier Name: �`_¢,l��t�' f) Z,, Phone#:
State Certification or Registration #: Z Gl 2� Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
City: State:
Zip:
Value of Work for this Permit: $ I.RUVA 'd, Square/LinearrFF,000ttage of Work:
Type of Work: El Addition E] Alteration 1:1 New EE Repair/Replace ❑ Demolition
Description of Work: �k- ww aea0ol' 0"S zee AVAC
a
Specify coloi of calor, thru' die: \
,
Submittal Fee $ i Permit Fee $ /5'a.-0159 CCF $ - : CO/CC $
Scanning Fee $
Technology Fee
Structural Reviews
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary
Double Fee $
Bond $ II
TOTAL FEE NOW DUE $ L
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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.
Ej7m M t
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 3 k) , 20 �y , by
tAiI t Iq q who is personally known to
me or who has produced I V)i as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal:
'" / VALTY RAYMORE
r���-
' MY COMMISSION #FF020273
EXPIRES Jute 19.2017
14071398.0153 FlorklallotmService.com
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Signature tel_
CONTRACTOR
The foregoing instrument was acknowledged before me this i�
day of 2 , 20�3� . by
ISo,dda�� Ilii Zo ,who isersonal y known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seal:
VA7[TY RAYMORE
MY COMMISSION #FF020273
g7 •Pi
1'oFpo°• EXPIRES June 19. 2017
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APPROVED BY ,^ d a V-Plans�Examiner
Structural Review
(Revised02/24/2014)
as
Zoning
Clerk
lkyls
LECTRICAL 2015 Opa-Locka Boulevard, Miami, Florida 33054
UPPLIES, INC. Phone: (305) 658-7133 - Fax: (305) 687-2235
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JUN �' 2014
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CITY
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AMORE
Y SSION #FF020273
EXPIRES June 19. 2017
(407)'M.0153 FWritlaWotaryServk e.c.m
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AY'S
LECTRICAL 2015 Opa-Locka Boulevard, Miami, Florida 33054
MUPPLIES, INC. Phone: (305)688-7133 - Fax: (305) 687-2235
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JUN Z-914
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