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EL-15-1036 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-233787 Permit Number: EL-4-15-1036 Scheduled Inspection Date: June 03, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: BERRY, NICKOLAS Work Classification: Addition/Alteration Job Address: 295 NE 91 Street Miami Shores, FL Phone Number Parcel Number 1132060133470 Project: <NONE> Contractor: M&D ELECTRICAL SERVICE INC Phone: (305)318-7005 Building Department Comments ELECTRICAL WORK FOR KITCHEN RENOVATION Infractio Passed Comments INSPECTOR COMMENTS False TO CLOSE PERMIT#EL-14-969 Inspector Comments Passed Failed 1 �� Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 02, 2015 For Inspections please call: (305)762-4949 Page 8 of 28 Miami Shores Village G N It EI a1- C�t�sidentiat 10050 N.E.2nd Avenue NE h ,. �... fa Pon: iditi.'. ' Miami Shores,FL 3313&0000 1 �1 31 vr#B US �P 0 K� s Phone: (305)795-2204 r FCOR`pA � 2 t Expiration: 11/2912015 Project Address Parcel Number Applicant 295 NE 91 Street 1132060133470 Miami Shores, FL Block: Lot: NICKOLAS BERRY Owner Information Address Phone Cell NICKOLAS BERRY 295 NE 91 ST MIAMI SHORES FL 33138-3127 Contractor(s) Phone Cell Phone Valuation: $ 1,300.00 M&D ELECTRICAL SERVICE INC (305)318-7005 Total Sq Feet: 0 Type of Work:ELECTRICAL WORK FOR KITCHEN RENOVAT Available Inspections: Additional Info: Classification: Residential Inspection Type: Final Scanning: 1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-4-15-55395 D13PR Fee $2.25 06/02/2015 Credit Card $ 160.70 $0.00 DCA Fee $2.25 Education Surcharge $0.40 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 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, PLUMB[ G,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I cert at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni Fu a ore,I authorize the above-named contractor to do the work stated. June 02, 2015 Authoriz Signa re:Owner / Applicant / Contractor / Agent Date Building Department Copy June 02,2015 1 Miami Shores Village Building Department APR 20' 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: _ Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2010 BUILDING Master Permit No.�zC— I S 4 O3y PERMIT APPLICATION Sub Permit NC.B..�— i-s-- 163 ❑BUILDING 2-6ECTRIC ROOFING REVISION ❑ EXTENSION 21�ENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: N S4r ee-�- City: Miami Shores County: Miami Dade Zip: 3313 ' Folio/Parcel#: 01Is the Building Historically Designated:Yes NO /l Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): /l/i C.L)ciG 1' f I V4 LSC'✓/y Phone#: -7,< q-5-79-3 Address: )-� (:� Aj 6- 1 <-fr e Q7 City: mI'a I"'I (e State: Zip: 3 13 d Tenant/Lessee Name: �1 Phone#: Email: t-\ CONTRACTOR:Company Name: iD Eli-( r< �ef a 3 t e _Phone#: y S� 3 ► -74 OS Address: e City: 0/1i fa State: �)60,; C S Zip: 3 ) 7 7 Qualifier Name: rkoSLSG►nn, C-G IPS Phone#: 30,s--31V--7oy,S State Certification or Registration#: C> r-- D b[p V(3 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 3W' W Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration 1:1New ❑1Repair/Replace ❑ Demolition Description of Work: a 2 h P W C) (`I r c )'r i C r Specify color of color thru tile: Submittal Fee$ Permit Fee$ A�©.dU CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ i O (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. 1 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. � J 7 , S ignaturel Signature OWNER or AGENT CONTRACTOR The for �ing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of -1 20 by day of 44 rl 20 /�, by l2 lvc, pJPr-qf who is personally known to T h os ucAn1 ./ /r 10✓t e 5 ,who is personally known to me or who has produced 0(r(/US L1 C0n CC as me or who has produced 06 U-erS 44C C as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: zwl�,�Iq7 Print: Print: : MY COMMISSION#EE843691 MY COMMISSION#EE843691 Seal: Seal: -?►�; EXPIRES October 15,2016 �i;,;�d EXPIRES October 15,2016 1407)39l 153 Flo W&NotaryServka.om N07)398 U�53 FbWallotaryServlp,oan ************************************************************************************************************ APPROVED BY ' � �/(� /� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)