EL-13-711Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-212379 Permit Number: EL -4-13-711
Scheduled Inspection Date: May 14, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: LLERENA, MARK Work Classification: Addition/Alteration
Job Address: 1550 NE 103 Street
Miami Shores, FL 33138 -
Phone Number (786)290-8051
Parcel Number 1132050310110
Project: <NONE>
Contractor: RAVEN ELECTRIC INC Phone: 305-221-3339
Building Department Comments
electrical for trellis Infractio Passed Comments
INSPECTOR COMMENTS False
Passed
Failed \
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
reinspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP-189006. Not ready.
May 13, 2014 For Inspections please call: (305)762-4949 Page 27 of 35
.� Miami Shores Village
Building Department
90050 N.E1nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.$972
INSPECTION'S PHONE NUMBER: (3055) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS: _ �- _ 4. f . 105
�
FBC 20
APR 0 9 2013
Permit'-
Master Permit No.
City: Miami Shores County. Miami Dade Zip: 3'
Folio/Parcel*
Is the Building Historically Dated: Yes NO Flood Zone:
OWNER: Name (Fee Simple
LWA
it;1�.
city: tK W LVV 110® S 4 J state: , ( zip: --:33 t 39
Tenant&,essee Name: Phone#•
Ems:
CONTRACTOR: company Name:' 1i ®@k� ' '� Phone#: q 5l r z iD
Address:
city: State: Zip:
Qualifier Name: 15 S CUA e �� ,�� e� dr �� Phone#: ci S-( L e
State Certification or Registration #: �� 1 �`� �" I Certificate of Competency #: 0-2- 6 000 C�
Contact Phone#: � 4 � 5--1 i leo Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permlb $ Square/Linear Footage of Work:
Type of Work: OAddress OAlteration ONew Mepair/Replace ODemolition
Submittal Fee $ Permit Fee $ ®® CCF $ CO/CC $
Scaring Fee $ Radon Fee $
DBPR $ Bond $
Notary $ TrainingMiucation Fee $ Tecbnology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
Bondbtg Cq,�pany's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage sender'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 b proved and a reinspection fee will be charged.
SignatureSignature e
Owner or Agent Cc
The foregoing instrument was acknowledged before me this►�'�'
day of , 20 �, by M ML 1—Ua"0 "-Z-- ,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
My(
The foregoing instrument was acknowledged before me this
day of 04it . 201 -,
who is personally known to me or who has produced
as identification and who did take an oath.
APPROVED BY
,?G /,*
Plans Examiner
Structural Review
(Revised 3/12CO12)(Revised 07/1MM(Revised 06/1012004)(Revised 3/15/(0
NOTARY PUBLIC:
Sign:
My Commission EXPIRES: April 1, 2015
,11511 8uoued Thru Notary Pubft Uaderwrfters
Zoning
Clerk