EL-14-1005Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-213188
Scheduled Inspection Date: May 29, 2014
Inspector: Devaney, Michael
Owner: ,
Job Address: 101 NE 110 Street
Miami Shores, FL 33161-7045
Project: <NONE>
Permit Number: EL -5-14-1005
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1121360040230
Contractor: HIGHGRADE ELECTRIC CONTRACTORS CORP Phone: (305)576-8807
suiming uepartment comments
NEW UNDERGROUND SERVICE
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments X���
May 28, 2014 For Inspections please call: (305)762-4949 Page 32 of 32
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Miami Shores Village
BUILDING
PERMIT APPLICATION
ig Department
kvenue, Miami Shores, Florida 33138
795-2204 Fax: (305) 756-8972
JE PHONE NUMBER: (305) 762-4949
APR 2* 2014
FBC 20
Master Permit No.,43 —A6 13
Sub Permit Na�
❑BUILDING
*ELECTRIC
❑ ROOFING REVISION
❑ EXTENSION
❑RENEWAL
❑PLUMBING
[:]MECHANICAL
❑PUBLICWORKS ❑ CHANGE
CONTRACTOR
❑ CANCELLATION
E] SHOP
DRAWINGS
JOB ADDRESS: / U� /VL` 17o
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO _
Occupancy Type: RIES Load: Construction Type: Flood Zone: BFE: FFE:
LA,C—
OWNER: Name (Fee Simple Titleholder): t3 '. L Q-eO 1+=j kjX21 Cp t n S 1 Phone#: o`S' :S J Ci
Address: 342tOO N .','-iap- JAG.
City: e-,'-y-N: State: PL Zip: 2125
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: H;QV-1 esr-c.Ae Phone#:
Address: 3 fv 1 3 S' W 1(g0 -*-'0 A. -C-.
City: J-Y-bt State: r1 Zip:
—moo
Qualifier Name:
So S -9 86 . =L 16'8
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Addr City:
AUATPA2 ?f U1 - 20L
Value fsil'fri * fdt.this)Permita;$,': r '= Q Square/Linear Foot ib4f410=
- J11*19 win pig-
ti'®�. de E vtri nw
Type M ttok 8 t Addition [ rail New ❑ epr ! � envr a�evo �
X190 y ..
1 C EEI +� u$wi%p Ptpi'U:Oi 03%;ml
�-�'ro ► � e_ G►!' ,�,.�' �CS'-�-r�c"1 h..,.1 � I � C`•�-v--i ec`a 1
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 1S0 40'19 CCF $ CO/CC $
Scanning Fee $
Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $ _
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip Y
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 appr d and a reinspection fee will be charged.
Signature Signature
Ow er or gent diaContractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me (, —
this day ofA2r 1 .20 L& by LY) t e—� re -
20 by t� rX ,
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:
Sign: ,• Nowy R is - Sub. of Ram
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7,7443
Print -
My Commission Expires:
1`NWXA
as identification and who did take an oath.
JOSE M. SANTANA ' -
Notary Public - State of F
Av Comm. Expires Feb 24, MY
My Commission Expires:
la /y
APPROVED BY /j hwy Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
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11USTOMER NAME:
(Name of the customer who will be opening the account / Nombre do la
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Overhead to Underground Conversion
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Service Address: City: '{`ho
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Example
#2
Instructions:
1. Building address
2. Pole location
ADDRESS 3. Indicate existing meter location on your home
(ex. 123) 4. Existing overhead wire to property
(Indicate with solid line)
#1 5. Cable route for new underground conduit
6. Street name
7. Indicate how many underground risers
are on pole: 0 (see FAQ #10 for detail)
#6 Street name (ex. First St.)
Instructions:
1. Building address
2. Pole location
3. Indicate existing meter location on your home
l� t M %t o S*. 4. Existing overhead wire to property
(Indicate with solid line)
5. Cable route for new underground conduit
(Indicate with dashed line, show cable route footage)
6. Street name
7. Indicate how many underground risers
f are on pole:_ (See FAQ #10 for detail)
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