EL-14-1641!ZL N 16 3q,
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-222646 Permit Number: EL -7-14-1641
Scheduled Inspection Date: October 31, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: WADE, RUTHANN Work Classification: Alteration
Job Address: 452 NE 92 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060140040
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP Phone: (305) 551-4043
comments
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REMOVE AND REPLACE KITCHEN CABINETS VVI111IIQIIW
INSPECTOR COMMENTS rP�D�DG'V
False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 30, 2014 For Inspections please call: (305)762-4949 Page 21 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 LINE PHONE NUMBER: (30S) 762-4949
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BUILDING Master Permit No. " " 103
PERMIT APPLICATION Sub Permit No. FL—``{ —1(09
❑BUILDING [ETMCTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL,
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF []CANCELLATION ❑SHOP
City: M
Tenant/Lessee Name:
State: � Zip:
Email:
CONTRACTOR: Company Name: �� �ol►�1 Phone#:
Address:
City: t--X� State: F -t-- Zip:
Qualifier Name: _ p�`� C—bnn Phone#:
State Certification or Registration #: � l -z 1 Certificate of Competency #:
DESIGNER: Architect/Engineer:
e#:
Address: City: State:
Value of Work for this Permit: $ i1 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑
Description of Work:
❑ New ❑ Repair/Replace
�< _("
Zip:
❑ Demolition
Specify color of color thru tile:
Submittal Fee $5° Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ a
CONTRACTOR
DRAWINGS
LlAA
JOB ADDRESS: -11N MC
City: Miami Shores
County:
Miami Dade
zip:
1
Folio/Parcel#:
, p
Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction Type: Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
�\�-an �T'
LD DG C-
y �
Phone#�6--?Z ` 3 [C / O/
City: M
Tenant/Lessee Name:
State: � Zip:
Email:
CONTRACTOR: Company Name: �� �ol►�1 Phone#:
Address:
City: t--X� State: F -t-- Zip:
Qualifier Name: _ p�`� C—bnn Phone#:
State Certification or Registration #: � l -z 1 Certificate of Competency #:
DESIGNER: Architect/Engineer:
e#:
Address: City: State:
Value of Work for this Permit: $ i1 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑
Description of Work:
❑ New ❑ Repair/Replace
�< _("
Zip:
❑ Demolition
Specify color of color thru tile:
Submittal Fee $5° Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ a
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
Zi
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 not be approved and a reinspection fee will be charged.
Signature at, w'"" X Signature
OWNER or AGENT
CONTRACTOR
The foregoing instru ent was acknowledged before me this The foregoing instrument was acknowledged before me this
day of _ 20 1y by OC day of J . 20 JH by
AM who is personally known to C who is personally known to
me or who has produced T" as me or who has produced t�NL :#L G'1Y1 'FA -e— as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
i
Sign: Sig .
Print: Print:
`REBECA M.PASTRANA
Seal: ° My COMNIISSION N EE872624 Seal: afk%%
�BECA M. PASTRANA
� > TRES. Fd ry 09,2017 MY CONWSSION H EES72624
EXPIRES: Fe=WY 07,2017
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)