EL-14-1010Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 I C)09
Inspection Number: INSP-218472 Permit Number: EL -5-14-1010
Scheduled Inspection Date: August 26, 2014
Inspector: Devaney, Michael
Owner: BROWN, JACKI
Job Address: 895 NE 95 Street
Miami Shores, FL
Project: <NONE>
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (317)431-8575
Parcel Number 1132060142950
Contractor: AJL ELECTRIC INC Phone: 305-895-4971
comments
CHANGE SWITCHES AND OUTLETS ADD SMOKE .....a�uV . o�`.. .,.,......�..w
DETECTOR HI HATS INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction G
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
August 25, 2014 For Inspections please call: (305)762-4949 Page 36 of 39
Miami Shores Village
Building Department MAY 15 20%
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY'
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 ZG
BUILDING Master Permit No. ^ 100 y
PERMIT APPLICATION sub Permit No.E 1 1 LI —10) n
BUILDING
ELECTRIC
ROOFING
REVISION
EXTENSION
[j RENEWAL
PLUMBING
MECHANICAL
OPUBLICWORKS
[:]CHANGE
CONTRACTOR
CANCELLATION
[:] SHOP
DRAWINGS
JOB ADDRESS: 0 6
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Occupancy Type:
OWNER: Name (Fee Simple
city:
Tenant/Lessee Alv
Email:
Is the Building Historically Designated: Yes NO
Load: Construction Type: Flood Zone: BFE: FFE:
State: IC -b Zip: 'jai -3t
ne#:
CONTRACTOR: Company Name: �� C. �L G . Phone#:
Address: 09'57Y J5i SCAM de,- -44'72,(o
�Q `� s
City: , V l "0 B A 0.1" State: Zip
Qualifier Name: 4 tj--, %orjy '/ /-("Po% �. Phone#:
State Certification or Registration #: jCC— /3 ® 0 Z-0 0q Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: City:
331 ?1
State: Zip:
Value of Work for this Permit: $ 1, t5 12— Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: C
SSnecifii color of color thru tile:
Submittal Fee $ Permit Fee $ 0 CCF $ CO/CC $
Scanning Fee $
Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $ 1 IS10
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
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 $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 % /_FYI_ Signature
Owner or Agent Contractor
The foregoing instrurpent was acknowledged before me this _
day of 20 Ab, i ;all i� cn, d+�'�
who is personally known to me or who has produced
NOTARY PU
Sign:,
Print:
My Commission
As identification and who did take an oath.
The foregoing instrument was acknowledged before me this
day of cl r4Y ,1 .20 L\�, by 4W 141 ®tie �Li u' ,,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
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Print: `.� L-,
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