EL-14-2140�II
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-226525 Permit Number: EL -10-14-2140
Scheduled Inspection Date: March 18, 2015
Inspector: Devaney, Michael
Owner: AMANDA B SAMPLE, MICHAEL
MAAITC\/CDI1C
Job Address: 77 NW 100 Terrace
Miami Shores, FL 33150 -
Project: <NONE>
Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP
comments
INTERIOR REMODEL REMOVE LOWER KITCHEN
CABINETS THEN PUT BACK DETACH AND RESET SINK
AND OUTLETS REMOVE AND REPLACE TILE FLOOR
MINOR WALL REPAIR PLASTER
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1131010180300
INSPECTOR COMMENTS False
Phone: 305/228-1384
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-226365. Label the panel and
install 2 pole breaker for the dish washer and disposal.
Fixed appliances on a 20 amp. breaker.
Add smoke / carbon monoxide detectors where required.
Failed �E
Correction —
Needed ❑ -fes' ��
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 17, 2016 For Inspections please call: (305)762-4949 Page 14 of 34
A
IV
iami Shores pillage
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 PrELECTRIC ❑ ROOFING
RC1 012®14
FRC 20 0
Master Permit No.�, 2,)
Sub Permit No. FZZ ' /�
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING F] MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 77 NW 100TH TERRACE
City: Miami Shores �o County: Miami Dade Zip:
Folio/Parcel#: tk_ ..J t ®t _rj t� ^ o c o® JS the Building Historically Designated: Yes NO
Occupancy Type Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee simple Titleholder): AMANDA SAMPLE aaj iChl? ( A� � Phone#: 305-797-22221�y� S -�
Address:
77 NW 100TH TERRACE 6414
City: MIAMI SHORES State: FLORIDA Zip: 33150
Tenant/Lessee Name:
Email: A-UWA 'n
CONTRACTOR: Company Name: INDUSTRIAL ELECTRIC.�� one#: 305-986-8721
Address: 10257 NW 9 ST., CIR 205
City: MIAMI state: FL. zip: 33172
Qualifier Name: 1 ! �� Phone#: 954-923-3677
State Certification or Registration #: EC13002182 Certificate of Competency M
DESIGNER: Architect/Engineer: N/A Phone#:
Address: City: State:
Value of Work for this Permit: $ 450.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New
Description of Work: REMOVE AND RESET OUTLETS
Specify color of color thru tile.
Zip:
M Repair/Replace ❑ Demolition
Submittal Fee $ Q ermit Fee $ CCF $ ®rQOO CO/CC $ 7'
Scanning Fee $ Radon Fee $ �� ^ �� DBPR $ ? ' ° Notary $
Technology Fee $ >��,� Training/Education Fee $ ® - �Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ B
(ReAsed02/24/2014)
_s
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 charged.
SIgnatur
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of d7 20/'7p` . by
'4191'-11i6112 e21 who is p n y known tol/
r who has produced as
Identification and who did take an oath.
Signature /Ju&-,
CONTRACTOR
The foregoing Instrument wadacknowledged before me this
-k day of M J/r 20 T by
es 00M I who Is personally known to
or o produced as
�t(ficat on and who did take an oath.
NOTARY PUBLIC: NOTARY P ELIC:
i
Sign: Sign:
Print: t� �' Ld` Print: Q y!r
1
Seal: Seal:
,a�""'•�. RAUDEL COMPDfttaryksa.
mot+Rr ao��c 14AYMW BAIaR10S � �•� r P`e;'•,
MY COMMIS #EE 20 53 = Notary Public - Sid
• - . �( •- My Comm. Expires J
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APPROVED BY / �"Cj`,C�Plans Examiner o ng
Structural Review
(Revised02/24/2014)
Clerk