ELC-14-2033Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-219914
Scheduled Inspection Date: September 29, 2014
Inspector: Devaney, Michael
Owner: ,
Job Address: 9710 NE 2 Avenue
Miami Shores, FL 33138 -
Project: <NONE>
M
Permit Number: ELC-9-14-2033
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number (954)553-0553
Parcel Number 1132060132350
Contractor: MESA BROTHERS INC Phone: (305)345-1974
tsunaing ueparltment comments
ELECTRIC FOR 2 NEW REFRIGERATION EQUIPMENT Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
September 26, 2014 For Inspections please call: (305)762-4949 Page 16 of 29
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS: !2�7 / ® 2 � /Aee_
SEP 16 014
FBC 20 LA -2
Permit No,
Master Permit No. F r - q - 152
City: Miami Shores County: Miami Dade Zip:
Foho/Parcel#:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple
City: A -Z a 'w r
NO L/
G W.141 s
State: tel®
)d Zone:
,e#h a`d 'F eft
e%3 % 57-�
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 'ao'�A�;p _72;-e Phone#: �
Address: --'s &) —/� -'7� Ale.
City: 1,!e State:�d
-r
Qualifier Name: Phone#:�f
State Certification or Registration #: eE - FOVZ49Z® Certificate of Competency #:All
Contact Phone#: '_1e�/P /R 7- �K Email Address:
DESIGNER: Architect/Engineer. Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑Address
Description off
❑Alteration ❑New
ZA
❑Demolition
Submittal Fee $ Permit Fee $ % ^O® CCF,4; 0 . 60 CO/CC $
Scanning Fee $ -3 ' C) C) Radon Fee $ 2 . DBPR $ 2 Bond $ 0
Notary $ 0 Training/Education Fee $6 Technology Fee $ °
Double Fee $ 0 Structural Review $
TOTAL FEE NOW DUE $
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 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 th."bwwe of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged
��be�ff ore me this
day o 20 A, by�� &/ h �
whois a to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires: O�
The foregoing instrument was acknowledged before me this —4
day of 20 _a, by
who is }s a or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
J§TARY P'UBUC M
STATE OF FLORIDA My
Comm# FF078181
Ex0fes 1/10 018
APPROVED BY )��j S 191' Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
STATE OF FLORIDA
Comm# FF078181
Tri
Zoning
Clerk
........ ...... . . .....
RICK SCOTT, GOVERNOR
STATE .-OF FLORMA
PA'
DE RTMLN-T* OF BUSHY PROMS
L-ICEI
KEN LAWSON, SECRETARY
0MIL.REGULATION
ING-BOAD' - Aim ft.
K-1 Om -4fch
-FS.
no
Ti AV
N
A'3
ISSUED:Oe/10/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1406100001578
4
000136