EL-15-643Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-232961 Permit Number: EL -3-15-643
Scheduled Inspection Date: April 21, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: RUIZ, ZACORY & SARA Work Classification: Alteration
Job Address: 133 NW 101 Street
Miami Shores, FL Phone Number (305)968-6063
Parcel Number 1131010220160
Project: <NONE>
Contractor: STARQUEST INC Phone: (305)233-2753
Building Department Comments
SMOKE DETECTORS UP GRADING GFI'S
INSPECTOR COMMENTS False
Inspector Comments
Passed[Er
Failed I&
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid
April 20, 2016 For Inspections please call: (305)762-4949 Page 55 of 56
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: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING (ELECTRIC ❑ ROOFING
MAR 2 3 2015
FBC 2010
Master Permit No31L % `i-�Z2
Sub Permit No.,&--/ /,4--^ 63
❑ REVISION ❑ EXTENSION [—]RENEWAL
❑PLUMBING [--]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: , 3.3 /%/I -t' d I .S 11Z -e f
City: Miami Shores County: Miami Dade zip: 33/5,0
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Phone#: 325-YGI?-&-"'s
Address: l33 &pj fD/sf �T•
State:
City: N
Zi x3/50
/�Q'rc',S p:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR,: Company Name: .� �► Yc� [ 'T" _%�'
Address: / % �CiCJ S� 14"c): e--�-
City:
Qualifier Name:
hone#: 3e 7% S- a a �
Zip: 331(
Phone#:
State Certification or Registration #: 1'e'l 3 oo / N 6/ Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 4 JISt7 Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace
_ .. \
Description of Work:
Specify color of color thru tile:
Submittal Fee $ ��Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
❑ Demolition
CCF $ CO/CC $
DBPR $ Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
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
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 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 charaed.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 20 J , by
Z241'r'c" l9U/ Z , who is personally known to
me or who has produced X2rJ n''a 04 /941�D as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
— day of ,af , 20 Z ---Ip— , by
Q ho is personally known to
me or who has produced �n as
identification and who did take an oath.
NOTARY PUBLIC:
APPROVED BY
(Revised02/24/2014)
Plans Examiner
Structural Review
Zoning
Clerk