EL-15-185Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-227524 Permit Number: EL -1-15-185
Scheduled Inspection Date: February 13, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: PALACIOS, CARLOS Work Classification: Alarm
Job Address: 290 NE 103 Street
Miami Shores, FL 33138-2431 Phone Number (305)389-7042
Parcel Number 1132060134850
Project: <NONE>
Contractor: PROTECT YOUR HOME Phone: (866)502-3559
5miaing loepanment comments
INSTALLATION OF A LOW VOLTAGE ALARM SYSTEM.
INSPECTOR COMMENTS False
Inspector Comments
Passed DT_
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
February 12, 2015 For Inspections please call: (305)762-4949 Page 15 of 29
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BUILDING
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
PERMIT APPLICATION
FBC 20
Permit No.
3� 5cf,(63
JAN 2015 j
BY: i
Master Permit No._IE�= (5
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: o�_ fD l i `
City: Miami Shores County: Miami Dade Zip: ���✓
Folio/Parcel#: l
Is the Building Historically Designated: Yes
CONTRACTOR:
Qualifier Name:
NO Flood Zone:
Ir
State Certification or Registration #: �,(: 13M5� &I ) Certificate o/f Competency #:
Contact Phone#: )14 -r) 2®- r) g 20 Email Address: `firm , }slam' d gmd ei f red. Cc
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ `� • ®� S uare/Lmear Footage of Work:
Type of Work: ❑Address DAlteration ew DRepair%Replace
Description of Work: 9+;Bl 164 1 ® n 0 X -8 1®dp 0 ('yA vll;/11 ln,r
(`
Submittal Fee $ Permit Fee $ / 0 x.04' CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
DDemolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
e.. .
Mortgage Lender's Address
City
State
zip
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
1WROVEVIENTS 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature/ � \ \ - / Signature
Owner or Agent Contractor
The foregoing instrument was ackn`�ed this
day of, 20 �, by ,
ced-
r,e eo; �tla ally��w,Midett=Vnd
w o did�G��(Aswho did take an oath.
NOTARY PUBLIC:
AZZ_.
r' �1i� IXy
Mill 1 • 1Wf$
APPROVED B
(Revised 07/10/07XRevised 06/1=009XRevised 3/15/09)
The foregoing instrument was acknowledged before me this
day of . 20 _, by ,
who is personally known to me or who has produced
as identification and who did take an oath.
Plans Examiner
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
zoning
Structural Review Clerk