EL-13-2633Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-212378 Permit Number: EL -11-13-2633
Scheduled Inspection Date: May 14, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: LLERENA, MARK Work Classification: Alteration
Job Address: 1550 NE 103 Street
Miami Shores, FL 33138- Phone Number (786)290-8051
Parcel Number 1132050310110
Project: <NONE>
Contractor: RAVEN ELECTRIC INC Phone: 305-221-3339
Building Department Comments
LOW VOLTAGE
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
INSPECTOR COMMENTS False
Inspector Comments
May 13, 2014 For Inspections please call: (305)762-4949 Page 26 of 35
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
JOB ADDRESS:
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FBC 20 l 0
Permit No. FLA 3 (o3 S
Master Permit No.t-cr
City: Miami Shores County: Miami Dade zip.
Folio/Parcelik
Is the Building Historically Designated: Yes NO
Flood Zone:
OWNER; Name (Fee Simple
Tenant/Lmsee Name: Phone#•
CONTRACTOR: Company Name:
Address: 1901.7, 4
city..
QualifierName:
State Certification or Registration #•
Contact Phone#. , Email Address:
of Competency #• `
DESIGNER: Architect/Engineer. Phone#: -
Value of Work for this Permit: $-tc;, Square4"ear Foo
age of Work
Type of Work: E3Ad&ess DAlteration r 44ew ORepair/Replace• ODSmolition
Description of Work:
ie*irir�k�r&#�k�trir**irt+k�kkA�ka� iFr,t�k,kkk,R,k,k�kwtk,Y�kdrF��Yir+kir*+k�rht*�rk�k�k�r**drirk�,t #nk*ski.�ew�Yk�F*deiririe,k�a�k,kira
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $
DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Doable Fee $ Structural Review $ _ L
Bduding 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 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, BOU"S, 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 be approvgd and a reinspection fee will be charged. ler—\
Signature \ Signature{
Owner or Agent 44L
The foregoing instrument was acknowledged before me this
day of , 20 l by L/ A�d
Contractor
The foregoing instrument was acknowledged before
]q11VlIqq7*
day of A 20 J, by ,/
who is personally known to me or who has produced who is personally known to me or who;bas produced
�` identification and who did take an oath. ? � f lamas identification and who did take an oath.
N TARY P LIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commissionires:- -rpa4fteammm- - -
DAMAYIVEGA -
°�� DYI �� MY COMMISSION # EE 066066
:.;__
MY COMMISSION # EE 0�(�6,6066 0 EXPIRES: April 1, 2015
I uCUIIOB�fS' Y •..•o?.c Bond h���N�fan�p
&�YYl�tkkdrk4rdr&dk u1 ft �k�k�Ytkirinkir4r4nkak TdYiRiR9Nll�I
APPROVED BY Plans Examiner
Structural Review
(Revised 3/12012)(Revised 07/10/07)(Revised 06/10)2009)(Revised 3/15/09)
Zoning
Clerk