EL-14-1414Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-220344
Scheduled Inspection Date: October 01, 2014
Inspector: Devaney, Michael
Owner: PEARSON, LEONARD
Job Address: 246 NE 103 Street
Miami Shores, FL 33138-2431
Project: <NONE>
Permit Number: EL -7-14-1414
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Service Change
Phone Number
Parcel Number 1132060134880
Contractor: A CUSTOM ELECTRIC SOLUTION INC Phone: (954)868-6809
13uiiding L)eparltment comments
SERVICE CHANGE
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-220159. Water heater installed
in front of panel not allowing for 3 feet clear space.
Failed
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
September 30, 2014 For Inspections please call: (305)762-4949 Page 26 of 41
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑BUILDING ELECTRIC ❑ ROOFING
RJEEIVED
JUN26214
13"x':
FBC 20
Master Permit No. R� 6 ?
Sub Permit No. 40 '5�"r aw
REVISION
❑PLUMBING F� MECHANICAL E] PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: 2-4(o 46-
EXTENSION E] RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores Countv: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): � � s Phone#:
Address: Z4i'o f4r lo -5 -ML-
City: k VDD 1 S#® Le'75 State: Vi_ Zip: 'i5 156
Tenant/Lessee Name: Phone#: 30.S 19(o d -Duo
Email: r "
CONTRACTOR: Company Name: Phone#:wM�, W
Address:
City: State: ,ice Zip: AM—Z
Qualifier Name: 4 Phone#: _e/� _X_ 29�A�
State Certification or Registration #:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ �C�Q Square/Linear Footage of Work:
Type of Work: ❑ Addition �I Alteration ❑ New ❑ Repair/Replace
_ QQ ®I
Description of Work:
Specify color of color thru tile: -1,00,04
Submittal Fee $ Permit fee $ CCF $ CO/CC $
Scanning Fee $
Technology Fee
Structural Reviews
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary
Double Fee $
Zip:
Bond $
TOTAL FEE NOW DUE $ �J _
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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 notbe approved and a reinspection fee will be charged.
Signatu
OWNER
The foregoing instrument was acknowledged before me this
day of 20 , by
IiiGV �2�f7/®1� , who is personally known to
me or who has produced
Signature �A
CONTRACTOR
Toing instrument was acknowledged before me this
7Fday of ---120 �� , by
4&0b4i'
w o is personally known, o
as me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
as
Sign. Sign:
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Print: '(f_F� ..�� ..KS.... Print: royr/b
* * MY COMMISSION 4 EE089085 Seal:
Seal: EXPIRES: July 1, 2015 FlAk11LT011
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EXPIRES: OwnW 3.2017
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APPROVED Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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