EL-14-1488Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-222645
Scheduled Inspection Date: October 31, 2014
Inspector: Devaney, Michael
Owner: FALERO, ANGEL
Job Address: 1700 NE 105 Street 202
Miami Shores, FL
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP
Building Department Comments
REMOVE AND REPLACE 1 LIGHT FIXTURE AND ADD
GFPS OUTLETS AS NECESSARY
Permit Number: EL -7-14-1488
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)898-8841
Parcel Number 1122300500210
INSPECTOR COMMENTS False
Inspector Comments
Passed 1Z
Failed
a �
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Phone: (305) 551-4043
October 30, 2014 For Inspections please call: (305)762-4949 Page 20 of 24
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
FBC 20 10
Permit No.� �®
Master Permit No. iqe /�/_ /�
JOB ADDRESS: I_-100 1, ICS SlYee+_
City: Miami Shores County: Miami Dade Zip: 3+1 S%
Folio/Parcel#: I1 • 22SO . 66x:1 - C521Q
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): RnaeA } rrk( 0 Phone#: 30S 'SCM 7,V41
Address: 0+00 KBE kb'5 nYecA-
City: M;Cx(A i Sb6` C_-. State: 171 o e-Ap,_ Zip: 331 E8
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: "AnAi5 -$=Ieekf :CaL C,or p . Phone#: 3%Q 395
Address: IL%O3 5w 20 'Te rr
City:
Qualifier Name: Phone#:
State Certification or Registration #: Gcc t 3001ait&1 Certificate of Competency #: _
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 17
� Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ORepair/Replace ❑Demolition
Description of Work: �p / E�/' L/� i�1����/ 06-4-1 �ee- NM
800
Submittal Fee $ Permit Fee $ A�IP,'JCOd CCF
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CO/CC $
DBPR $ Bond $,
Technology Fee $
TOTAL FEE NOW DUE $ 1 GG °--io
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
State Zip
Application is hereby made wobtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issua{tce of a perin�t and that `all. work wh 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.
"WARISUNG 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 be approved and a reinspection fee will be charged.
Q Signature' Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this _2 _1 The foregoing ins ment was acknowledged before me this.
day of , 20 -., by A nc c\ =- krc day of , 20 , by�s +Lc� t�he2
who is personally known to me or who has produced FLL! who is personally known to me or who has produced*
! SfiQ-0U* • 3W • 064.9 As identification and who did take an oath. rA V:� k -e— as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Print: ±Vat W1
My Commission Expires:
APPROVED BY
REBECA M. PASTRANA
MY COMMISSION # MINN
EXPIRES: Fly 07, 2017
�� ay
w -Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Print: W" k, VLSI
My Commission Expires:REBECA M. PASTRANA
MY COMMISSION # EESM24
FR.V�, EXPIRES: FftwY07.2017
Zoning
Clerk