EL-04-365 (2)Inspection Worksheet
Miami Shores Village 61D�)Oe
L .
10050 N.E. 2nd Avenue Miami Shores, FL /6
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-198202 Permit Number: EL2004-365
Scheduled Inspection Date: January 28, 2014 Permit Type: Imported Permit
Inspector: Devaney, Michael Inspection Type: Final
Owner: ORTEGON, AMANDA Work Classification: <NONE>
Job Address: 9950 NE 4 Avenue Road
Miami Shores, FL 33138-2451 Phone Number
Parcel Number 1132060171160
Project: <NONE>
Contractor: MB ELECTRIC SERVICE CORP Phone: (786)325-3383
comments
ELECTRICAL PIPING SPA - MASTER PERMIT BP04-1672
INSPECTOR COMMENTS False
change of contractor and renewal 8/2/13
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-198053. Need plans.
Add G. F. I. breaker for pump.
Add door and window alarms or pool barrier.
Repair wiring in pump room.
Failed
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
January 27, 2014 For Inspections please call: (305)762-4949 Page 1 of 29
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305-795-2204
Printed: 1/612005
Applicant: VICTOR
Owner: ORTEGON
JOB ADDRESS: 550 NE 101
Contractor
Local Phone:
Electrical Permit
Permit Number: EL2004-365
VICTOR
ST
Contractor's Address:
Page 1 of 1
Parcel # 1132060171160 Legal Description: MIAMI SHORES SEC 4 PB 15-14 LOTS 1-2-3 BLK 95 LOT SIZE SITE VALUE
Fees:
Description
Amount
FEE2005-184
Building Fee
$225.00
FEE2005-185
CCF
$1.20
FEE2005-186
Training and Education Fee
$0.40
FEE2005-187
Technology Fee
$5.63
FEE2005-188
Submittal Fee
($50.00)
Total Fees:
$182.23
Permit Status: APPROVED Permit Expiration: 6/20/2005 Construction Value: $225.00
Work: ELECTRICAL PIPING SPA - MASTER PERMIT BP04-1672
Signed:
(INSPECTOR)
Total Fees: $182.23
Total Receipts: $0.00
� JT�
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fag: (305) 756.8972
BUILDING EOVED Permit No. 565 .
PERMIT APP,L,ICATION DEEC 2 2 94 aster Permit No. &1/ _t
FBC 2001 _ - -
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder) 111LM i!
-Y '� l ),-
Owner's Address �- �I.l NI
City ., vl� /� L State Zip
Plumbing Mechanical Roofing
Phone #�?�'�' �', `> 7-
Tenant/Lessee Name Phone #
Job Address (where the work is being done) ` /�' / �` P5 - 49 � S4
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO,
Contractor's Company Name
�l /A /q
Phone
Contractor's Address ✓�L Gt' %�^t%!'-U�
City �%� - �%�'L�� t State Zip
N
Qualifier
State Certificate or Registration No. ��Certificate of Competency No.
Architect/Engineer's Nam (if applicable) Phone #
$ Value of Work For this Permit ;9; 0(/ o r Square Footage Of Work:
Type of Work- ❑Addition ❑Alteration �ew ❑- ltepair/Replace ❑ Demolition
Describe Work:
Submittal Fee $ Permit Fee $ . CCF $ o CO/CC
Notary $ ��' Training/Education-Fee $ Technology Fee $
Scanning $ Radon S.
Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ a • i9
(Continued on opposite side)
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 EMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CONIMENCEMENT."
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 propertyis ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection whicor occurs even (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approle4daw a reinspection fee will be charged.
Owner or Agent
Signature �En
Contractor
n
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this A-1-1
r�f
day of � 200 , by �%�r%� �� %i ��C� , day of �s , 20`26 by
who is personally known to me or who has produced who is personally 1t*���LOr who has produced
As identitication and who did take an oath asiden ' cation and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: AwSign:
Print: ' My C"Mini,, Print:Q!�A - 1_,eWAAFF oftw
Saftff
My Commission Expires: a w fires �p°�"ibef �.e My Commission Expires: %°" area t�o387�2008
APPLICATION APPROVED BY:�%�j`/� _ ��i��®� Plans Examiner
Engineer
Zoning
Cho 05/13/03
Date
tsuiamg inspection xequest
fl, f <
Type Insp' n
Permit No.
M
Company
Phone ##
Inspection
Approved
Correction ❑ ���� �f
Re-Insp'n Fee
.e
1
Building Inspection Request -
Date
Type Insps n
Permit No.
Name
Address
Company
Phone ##
Inspection Tate
Approved
Correction
Ile-Insp' n Fee
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