EL-14-1103Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-215490
Scheduled Inspection Date: July 10, 2014
Inspector: Devaney, Michael
Owner: PINEIRO, KEVIN
Job Address: 51 NE 99 Street
Miami Shores, FL
Project: <NONE>
Contractor:
ATLANTIS ELECTRICAL CORP
i3waing Department comments
LOW VOLTAGE
Permit Number: EL -5-14-1103
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)303-7344
Parcel Number 1132060131280
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Phone: (305) 551-4043
July 09, 2014 For Inspections please call: (305)762,4949 Page 39 of 44
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
7MAY7219 2014
BY:
FBC 20 ks->
Permit No. — I �A — 1103
Master Permit No. ` 1 o ` 1 �'73Z3
JOB ADDRESS: S\ 0 C 17 1
City: Miami Shores _ County: Miami Dade Zip: b
Folio/Parcel#:
ti
Is the Building Historically Designated: Yes NO >0 Flood Zone: tj0
OWNER: Name (Fee Simple Titlehh+older): pj &_-7 a -C) Phone#:
Address: (
City: r\-4
Tenant/Lessee Name:
Email:
State: r—L_ Zip:
CONTRACTOR: Company Name: °I'tLt L Phone#:
Address:
City:
Qualifier Name: 40jr-\S CSD
State Certification or Registration #: cc i_;O o I
EllZip:M�
Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $r00'�— Square/Linear Footage of Work:
Type of Work: ❑Address dAlteration ❑New ❑Repair/Replace
Description of Work:
Submittal Fee
Scanning Fee $
Permit Fee $ 10,0 • ,P CCF
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CO/CC $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $
❑Demolition
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 the absence of such posted notice, the
inspection will not b approved_ and a reinspection fee will be charged.
Signature Signature�-- Ro�j
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 2g
day of , 20 4, by h(.et � n ?i1 P i r ,
who is person ly known to me or who has produced I -a4
1(e_ As identification and who did take an oath.
Print:A44MML
My Commission Expires:MY cOl iwii6N a EEsrtsu
1__ a F EXPIRES: Febramy 07, 2017
The foregoing instrument was acknowledged before methis-2S
day of , 20 1�(, by�165n!/
who is per ally known to me or who has produced
C, Irl X7 Ie as identification and who did take an oath.
NOTARY
My Commission Expireu� MY COMMISSION S EEM24
`elwv EXPIRES: Fdm=y 07, 2017
APPROVED BY Plans Examiner Zoning
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Clerk