EL-15-105Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-229341 Permit Number: EL -1-15-105
Scheduled Inspection Date: March 04, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: TRACH, PERRY
Job Address: 339 NE 96 Street
Miami Shores, FL
Project: <NONE>
Inspection Type. Final
Work Classification: Alteration
Phone Number (954)274-6277
Parcel Number 1132060135900
Contractor: CASSIA ELECTRICAL CONTRACTORS INC Phone: (954)650-5840
suuamg uepanment comments
REPLACE BREAKER BOX.
INSPECTOR COMMENTS False
Inspector Comments
Passed E2
—'
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 03, 2015 For Inspections please call: (305)762-4949 Page 34 of 38
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department JAN 2015
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION UNE PHONE NUMBER: (30S) 762-4949
FBC 20 10
Master Permit No. 0:5
Sub Permit No.
❑BUILDING X ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL E] PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 339 NE 96 St
City: Miami Shores County: Miami Dade Zn: 33163
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Perry Trach Phone#: 201207-7171
Address: 13902 Fiji Way Apt 229
City: Marina Del Rey State: Ca Zip: 90292
Tenant/Lessee Name: Phone#:
Email: Perrytrach@gmail.com
CONTRACTOR: Company Name: Cassia Electrical Phone#:954 650-5840 Glen 954 274-6277
Address: 8261 NW 48h street
City: Lauderhill State: Florida Zip:33351
Qualifier Name: Glenworth Walker Phone#:
State Certification or Registration #: Certificate of Competency #: EC13005907
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 950.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New CK Repair/Replace
Description of Work: Replace Breaker Box
Specify color of color thru We.-
Submittal
e.
❑ Demolition
Submittal Fee $ Permit Fee $ b6i?o 40 CCF $ CO/CC $
Scanning Fee $
Technology Fee $,
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Structural Reviews $ Bond $ L/
TOTAL FEE NOW DUE $ I� .
(RevisedO2/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) Caliber Home Loans
Mortgage Lender's Address 8201 Peters Rd. Suite 1000
Zip
City Plantation State FI Zip^33324
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 low 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 In cti hich occ en (7) days after the building permit is issued. in the absence of such posted notice, the
inspection will a opp and areinspectionfee will be charged.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of . 20 by
pe,ccq r%c b . who is personally known to
me or who has produced 1 TA , as
identification and who did take an oath.
NOTARY PUBLIC:
SignatureZZ4-:)4�__'
The forellying instrume : was acknowledged before me this
15'q day of 20/3 , by
ho is personally known to
me or who has produc pp- ,L as
identification and who did take an oath.
NOTARY PUBLIC: _.ML
Print:
Seal:
APPROVED BY 4 $. i® GC " Plans Examiner
Structural Review
(ReWsed02/24/2014)
iO
Zoning
Clerk
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