ELC-14-1529Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-216008
Scheduled Inspection Date: September 04, 2014
Inspector: Devaney, Michael
Owner: , CHARTER SCHOOL
Job Address: 11301 NW 5 Avenue
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Building Department Comments
Permit Number: ELC-7-14-1529
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number
112136000060
Phone: (305)758-2000
FURNISH AND INSTALL TWO NEW RANGE OUTLETS IN Infractio Passed Comments
THE KITCHEN FROM EXISTING 200 A PANEL I
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed .2 v #e
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
September 03, 2014 For Inspections please call: (305)762-4949 Page 7 of 26
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
JUL 16 2014
N
FBC20L0
Permit No. 111 _I9
Master Permit No.
JOB ADDRESS: I 1361 I J . Lu- c-;9-t—
City: Miami Shores County: Miami Dade Zip: 3 3138
Folio/Parcel#:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple
NO ✓ Flood Zone:
State: *:LO de-[ OA Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: (4 (9 1.) (A) 4
�: 34470 •zfo-o
City: I A- M1 • State: Zip: WO
Qualifier Name: 2o H -Q A4gg: Phone#: IA4 Zoo ' 06✓�3
State Certification or Registration #: E�- G 0C) 43 111 `Certifiiccate of Competency #:
Contact Phone#: _36F 7-�$ • 2006 Email Address: /O h n c -a -u- _
DESIGNER: Architect/Engineer: MA- Phone#:
Value of Work for this Permit: $ i 1']U• : Square/Linear Footage of Work:
Type q��rC O Address , �era�on w 7lep acODemolition
DescrYiiicliiof'ork• f S'I- ' E_;%' "`'Ii r
4W,? Y6I tic o' ' ti9a u sa
vwr 20
All
{:. V
Submittal Fee $ � Permit Fee $Ali/e, CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
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 $2.00, 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 a reinspection fee will be charged.
Signature Signature V
p
Own o gent Contractor
The foregoing instrument was acknowledged before me this
day of 20%-, by l /�'Id h0ldS ll rf)
who is perso lly known to me or who has produced
As identification and who did take an oath.
The for ing instrument was acknow!Ie�ed before me this
day of 20 4; by l 1
who is pgsonallknown to me or who has produced
6
as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
1
Sign: Sign:)M
Print:
e �`�NVPB
"""'+a Print: • �' � •• y MT Mm
M Commission Expires: MARY00IFloW.
.= NOWy Pdit • Uta o/ Flog
Y P Iron, My Commissio ��� voy My Comm. Espires lby 11.:ExCommisshm #� FF 1207.CommissiO
owe
APPROVED BY Y Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012XRevised 07/10/07XRevised 06/10/2009XRevised 3/15/09)