EL-15-1592 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-238130 Permit Number: EL-6-15-1592
Scheduled Inspection Date: July 02, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: SILVERMAN,ADRIA I Work Classification: Alteration
Job Address: 1321 NE 103 Street
Miami Shores, FL Phone Number (305)542-0908
Parcel Number 1132050300120
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP Phone: (305) 551-4043
Building Department Comments
INSTALL NEW HI HATS IN THE LIVING ROOM AREA. Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed En
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 01,2015 For Inspections please call: (305)762-4949 Page 39 of 47
f59 .
°mss i, Miami Shores Village
10050 N.E.2nd Avenue NE � � r [�
Miami Shores,FL 3313&0000 iED
3
KF— mss AP
Phone: (305)795 2204 , `
CORIt)Q'
"V, 'N" �su0ll� � 1 Expiration: 12/2812015
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Project Address Parcel Number Applicant
1321 NE 103 Street 1132050300120 � � � �
ADRIA I SILVERMAN
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
a
ADRIA I SILVERMAN 1321 NE 103 Street (305)542-0908
MAMI SHORES FL 33138-
1321 NE 103 Street
MAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
Valuation: $ 8$0.00
ATLANTIS ELECTRICAL CORP
(305)551-4043
Total Sq Feet: 0
Type of Work:INSTALL NEW HI HATS IN THE LIVING R Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Review Electrical
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# EL-6-15-56126
$2.25 07/01/2015 Check#:6529 $ 115.10 $50.00
DCA Fee $2.25
Education Surcharge $0.20 06/26/2015 Cash $50.00 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $165.10
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 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 an ing. Fut t rmore, I authorize the above-named contractor to do the work stated.
July 01, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 01,2015 1
Miami Shores Village
Building Department } JUN 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204:Fac:_(305)756-8372 ---- I
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2010
BUILDING Master Permit No. .LI
PERMIT APPLICATION _Sub Permit 114n.
BUILDING 2-fLECTRIC F-1 ROOFING E] REVISION EXTENSION RENEWAL
PLUMBING F_J MECHANICAL PUBLIC WORKS M CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:,� 132.r /V Lf /0 3& Sf
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: (1 Constru�cjtion-_Type: / LFlood Zone: BFE: FFE:
-OWNER:Name(Fee Simple Titleholder): J'-ff P#one#:
Address: / 32.1 / Z /0 3 a St
City: �'!►�'�Y!/l% ghyit,--- State: f Zip: :3313'y
Tenant/Lessee Name: /V i Phone#: /L)
Email: i I/��0-IS 1 uP�✓YI/9ri�� 112Y1
o
CONTRACTOR:Company Name: A( L A Pri J u� �^ i C In Phone#:
Address: I Zv.: SCJ LC -(��-
City:. (�r ( State: Zip: 3 '> I �T
Qualifier Name: Phone#: ' - -G 7 `�
State Certification or Registration M EC- ( UO (5 (A Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
w
Value of Work for this Permit:$ Square/Linear Footage of Work:
(
Type of Work: � } Addition �Alteration F-1 New 0 Repair/Replace El Demolition-
Description of Work: .�-w5 1 ✓�^-J ' ��Jc C d�?�� t �
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ dQ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ ( d
(Revised02/24/2014)
Ir
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. 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.
"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.
SignatureSignature
V 1y .x
OWNER or GENT CONTRACTOR
The foregoing instrument was acknowledged be o e this The foregoing instrument was acknowledged before me this
Z day of _S CJYL 20 by day of U t K ,20 (sem by
who-is personally known to t P1� ( SCA 0E_bwho is personally known to
me or who has produced 1 L S y/(r `7 c 6-'7 S lJ as me or who has produced `—L DLI VES as
identification and who did take an oath. identification and who did take an oath. L l S�
NOTARY PUBLIC: Notary PUMic gf2ft of Florida NOTARY PSandra DeMea
UBLIC
My Commission FF 156122
Expkes OW020201a
Sign:
Print: Pri
Seal: Sea. ;o Sindia Alvarez
a My Commission FF 156750
OF��i�A Expires 09/03/2018
APPROVEDB� ��(i ruey�S Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)