EL-15-767Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-232247 Permit Number: EL -4-15-767
Scheduled Inspection Date: April 13, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: LUNA, LUISA FERNANDA Work Classification: Service Change
Job Address: 10090 N MIAMI Avenue
Miami Shores, FL 33150-1216
Project: <NONE>
Contractor: FELLO ELECTRIC INC
5wiamg uepartment comments
RELOCATE THE PANEL
Phone Number (305)757-3133
Parcel Number 1131010210090
INSPECTOR COMMENTS False
Inspector Comments
Passed Eq
Failed
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Phone: (786)290-7576
April 10, 2015 For Inspections please call: (305)762-4949 Page 24 of 25
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue N
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Parcel Number Applicant
10090 N MIAMI Avenue 1131010210090
Miami Shores, FL 33150-1216 stock: Lot: LUISA FERNANDA LUNA
Owner Information Address Phone Cell
LUISA FERNANDA LUNA 10090 N MIAMI AVE (305)757-3133
MIAMI SHORES FL 33150-1216
Contractor(s) Phone Cell Phone
FELLO ELECTRIC INC (786)290-7576
of Work: RELOCATE THE PANEL
one[ Info:
kation: Residential
linq: 1
Fees Due
Amount
CCF
$1.20
DBPR Fee
$2.25
DCA Fee
$2.25
Education Surcharge
$0.40
Permft Fee - Additions/Alterations
$150.00
Scanning Fee
$3.00
Technology Fee
$1.60
Total:
$160.70
Valuation: $ 1,800.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL -415-55054
04/03/2015 Credit Card $ 160.70 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFI IT: I certify that all a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an ning. Futhermo�,VIhorize the above-named contractor to do the work stated.
April 03, 2015
Au fioriised Signature: Owher / Applicant / Contractor / Agent Date
Building Department Copy
April 03, 2015 1
iami Shores Village
PERMIT APPLICATION
ilding Department
V.E.2nd Avenue, Miami Shores, Florida 33138
el: (305) 795-2204 Fax: (305) 756-8972
TION LINE PHONE NUMBER: (305) 762-4949
FBC 2010
Master Permit No.l— I � ®"���
Sub Permit No.
❑BUILDING R ELECTRIC ❑ ROOFING E REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:, ftf'O H14"`f
City:4141 Almft Miami Shores County: Miami Dade Zip:.. 'ca
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Address: /40ft IQsA&�
City: ,�sa� State: )i! Zip: 33%g'6
Tenant/Lessee Name:
Email:
e#:
CONTRACTOR: Company Name: Jia& G/g am l0»G Phone#: 'Wo—eye) 7-5— q,
Address: 4�D x _.W /3t3aani 1
City: FYI. [tri / f State: �0. Zip: 3V[C2
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
one#:
Certificate of Competency #: 04 F. C23'137J 2-,&
Address: City: State: Zip:
Value of Work for this Permit: $_ / IR".0v Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New 5? Repair/Replace
Description of Work:
Specify color of color thru tiler
Submittal Fee
Scanning Fee $
Permit Fee $ 1-4 CCF $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews
(RevisedO2/24/2014)
DBPR $
❑ Demolition
CO/CC $
Notary $,
Double Fee $
Bond $
TOTAL FEE NOW DUE $ -
Bonding Company's Name (if applicable)
Bonding Company's Address
City
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 standard's,;of all laws regulating
construction in this jurisdiction. 1 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. " � �'A r ..
"WARNINf Td -OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCED-'MAY
RESULT IN YOUR PAYING TWICE FOR IMPRQVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITh II;I.ENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimatW e e *q--P50QX"itpplicant must
promise in gopd gjth Mat a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose propel �Aect to attachment. Also, a certified copy of t1 e7 corded notice of commencement must be' s `ot6 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.
. ' . '' • ' P sem!-, •. ?+
Signature Signature
OWN or AGENTCONTRACTOR
�, _.< Witt� ' `ted .;
The foregoing instrument was acknowledged before me this The foregoing ,jnstrument was acknowledgedtbefore me tHis
(39-- day of -P P-1 , 20 (.S , by
who is personally known to
me or who has produced1-1)0\0- U►QkN�- as
identification and who did take an oath.
NOTARY PUBLIC:
e
Sign:
Print:
*daft°, .�.il l�20 15 by
K0'-�-- Z f L0A tQ®®G , who is personally known to
me or who has produced � i>e-»c. uZzNS (�§s
identification andv ho take an oath.
NOTARY PUBLIC: ' i
Print:
Seal: Seal: L4P'0�NotaryPSindia Notary PUWIC StateofFlorida yComSindia Alvarez Expires 09f0312018
` My Commission FF 156750
APPROVED BY / sZ Dffosk Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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APPROVEDA DATE
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