EL-14-1182 (2) Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-227347 Permit Number: EL-6-14-1182
Scheduled Inspection Date: January 30, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: GRIESBACH,JACOB Work Classification: Alteration
Job Address: 125 NW 100 Street
Miami Shores, FL 33150- Phone Number (305)444-6563
Parcel Number 1131010220320
Project: <NONE>
Contractor: AMENGUAL ELECTRIC INC
Building Department Comments
RE- LOCALIZATION OF LIGHT OUTLETS AND SWITCHES Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-227206. Add receptacles to
1z meet minimum code requirements.
Hall G. F. I. receptacle not working.
Bedroom egress door needs a switch and outside light fixture.
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 29, 2015 For Inspections please call: (305)762-4949 Page 24 of 34
Miami Shores Village _RECF1VRTE)!
Building Department artment JUN 66 2014 I
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305)795-2204 Fax: (305)756-8972 ' '
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20/a
BUILDING Master Permit No. /�z" Lyz
PERMIT APPLICATION Sub Permit No.Z_/ / -- //Ye�?
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
��/) ,r� CONTRACTOR DRAWINGS
JOB ADDRESS:_1 2—:5 / ' U /V 0,67 ) y�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): /d CD4,m 4 22:k k2J'4fjL Phone#: 015
Address: Z � , fatQ,�u cj Ci<' 5
City: / State: C_,1 Zip: -�2 3 13
Tenant/Lessee Name: Phone#:
Email: /'
CONTRACTOR:Company Name: AX4 6/ I fie Phone#: `n-V 54,10140 6y
Address: A'jo l ��✓y r
City: ttate: Zip: ' /-��
Qualifier Name: 6 Jqk4 Ell L,CY Phone#: e-?TV V106.3.6'
State Certification or Registration#: ��� /� r Certificate of Competency#: `�—
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
a O
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New /_ Repair/Rgplace.: ❑/�'06molition
Description of Work: �D l�2 1A //r 7—A%�O e �f I VI O U /o• i A"u U
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ Z2 494r_> CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
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 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.
Signature Sign Z'
OWNER or AGENT CONTRA TOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
L day of 'A4AI 20 1 `� by 9-0 day of Al 20 / by
wh own to 1 El! Eli wh is personally know o
me or who has produced as me or who has produced as
identification and who d take an ath. identification and who di ake an oath.
NOTARY PU LIQ NOTARY PUB
AU
`3EAU 1� 4+
AI 51: # 119045
MY C MMISSION #FF119045 `
Sign: '.,� EX Sign: '.?o.ti EXPIRES a.ay 2018
407 3fifi n1 3 1(407)-398-0 33 F;'^ :,,NntarvSe;. aim
( ) Floridallolaryservice.com Print:
Print:
Seal: Seal:
************************************************************************************************************
�L/y
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)