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EL-13-2090/3 - Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-209764 Permit Number: EL -9-13-2090 Scheduled Inspection Date: March 27, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: PICARD, MATHIEU Work Classification: Pool - Private Job Address: 401 NE 103 Street Miami Shores, FL 33138-2456 Phone Number Parcel Number 1122310150130 Project: <NONE> Contractor: ON CALL ELECTRICAL CONTRACTORS INC Phone: (786)388-5880 Building Department Comments ELECTRIC FOR POOL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments PassedEl� Vz p0401l)- Failed Correction Needed ❑ °� Re -inspection Fee No Additional Inspections can be scheduled until®G �� re -inspection fee is paid. March 26, 2014 For Inspections please call: (305)762-4949 Page 24 of 28 Miami shores Village Building Department c�g�� SEP 16 2013 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fag: (305) 756.8972 + ; INSPECTION'S PHONE NUMBER: (305) 762.4949 ` ' FBC 2010 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: Permit No. L —209 D Master Permit No. cqn�T City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: �> - 0 0 � � L- � � �` � Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): A7 d k 0 1 l C f -V `QPhone#: Address: L-�o I 1�,2 L (_ '-�3•5 1 3 City: �S C "l 0 IL - - State:p�-3 1 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: ® y 1 (_ ut` I c Phone#: -715 0 3U S �� Address: -) L' �- (21 1-2 !- 0 " ::; `� I City: Ik- k ► t=! I -\. �, ( State: (_ Zip: 373 Qualifier Name: �C k" 4 "o`N � l ( E r,-�_� Phone#: State Certification or Registration #: Certificate of Competency #: r -7C C)C' C)C) c-1 7 Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ �"T() Square/Linear Footage of Work: Type of Work: ❑Address DAlteration New ORepair/Replace Description of Work - Submittal Fee $�Permit Fee $ Y,0140'' ZPt$ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO/CC $ DBPR $ Bond Technology Fee $ ❑Demolition TOTAL FEE NOW DUE $ 2- 6 - �� 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 2instion fee will be charged. Signaturei Qui -N-LL,; Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me s The foregoing instrument was acknowledged before me this—q— day hisday of _01 , 20 -, by °J AJ K 6 E2 U 1 C.A gV day of 200, by k,o' I,/ t who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: as identification and who did take an oath. NOTARY PUBLIC: Sign: Y Sign Print: p(p ES: Qec�mber 17,201 Print:17 20 A ES : :.'___ PAY WMMISSlQN # EE 048167 My Commission Ex �'� My Commiss„No�und APPROVED BY Plans Examiner Zoning Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009XRevised 3/15/09) Clerk Miami- Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fag: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 FBC 20 -- - --- BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 40/ 00 E/ 03 s r City: Miami Shore, Folio/Parcel#: 1 / 2-2 Is the Building Historically Designated: Yes County: 0 Permit No. E L - 7— 3 --2o Fo Master Permit No. 810 9 — /.3 — -,�� 7 Miami Dade ,dip: 33 f, NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 0 -ti / A G RPhone#: Address: L ko %�J 'F_ 1 03ST City: AA !�;l7 O 12- State: V Tenant/Lessee Name: J Email: -Sr / CONTRACTOR: Company Name: �-% t e% C- / a / c Phone#: N 6Q % :i 7V Address: -7 40 0 /-) W % -?f- I / City: l / State: 7-t— Zip l 2 - Qualifier Qualifier Name: 0,�1.-' I F) l� I I I -e !S Phone#: State Certification or Registration #: Certificate of Competency #: - � 0000 �Y7 Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Value of Work for this Permit: $ Square/Linear Footage of Work - Type -- Type of Work: DAddress DAlteration XNew ORepair/Repke f g °. ODemolition Description of Work: rM _P u/ S 4r� 1--) t2/ -C,4 Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Los 3 =tpe aC-/Lj CCF $ CO/CC $ DBPR $ Bond Technology Fee $ TOTAL FEE NOW DUE $. '7y'rjr_� 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 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 einspection fee will be charged. Signature Signature ' `--L--.- Owner. Owner or Agent - Contractor The foregoing instrument W#S acknowledged before me this �� The foregoin ' trument w s acknowledged before me this day of Q- , 20 , by t� y t AR 7 %t t V ,► C. --0 , day of �` , 20)�, by �S2 V ► /1 (91119-S who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: 4e4e4eJntr9r4r4r4c4e4etL Y�Y3e3edesF�Y3rJrc�Y3ede:F�sYs4ksF�Y�Yk3e3nY�Y4r�3r3r3e�Y:Y�k3e�Y9e4e�Y3e9e3e3nk3c4r9rok3c�Y�Y�Y3nY9e3rt1e4cFr3e4r4r�Naedr&4cic3c9r3cdc3esF3e�Yde�Y9e4e4c4c4eFr�4e�Y�Y3eFr��sY3e APPROVED BY Plans Examiner Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Zoning Clerk