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EL-14-1373 -3fpp cSd Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-214890 Permit Number: EL-6-14-1373 Scheduled Inspection Date: July 07, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: WILLIAM J.JURBERG, R. ANDREW DE Work Classification: Pool - Private DACC Job Address:9350 NE 12 Avenue Miami Shores, FL 33138- Phone Number (305)609-3851 Parcel Number 1132050070150 Project: <NONE> Contractor: HIGHGRADE ELECTRIC CONTRACTORS CORP Phone: (305)576-8807 Building Department Comments NEW SWIMMING POOL/ FOUNTAIN ELECTRICAL Infractio Passed Comments GROUNDING AND POOL EQUIPMENT INSPECTOR COMMENTS False Inspector Comments Passed IE Failed Correction �✓ �� `�� Needed ❑ Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 06,2015 For Inspections please call: (305)762-4949 Page 2 of 33 Miami Shores Village cNTFT:)i Building Department JUN 26 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B Tel: (305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-49 FBC 2/0 /0 BUILDING Master Permit No./3B' PERMITPP CATION Sub Permit No�l /�-- ,� ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:- __l ��C� IVB �<<-- RrV� Cit : 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): {<� » Phone#: Address:!j,i�J'�, ME Q- AQ& City: H i A I�t�� <;,402V�- State: T l Zip: 3 Tenant/Lessee Name: Phone#: Email: nn� CONTRACTOR:Company Name:�df --7g41 ,— Phone#:'3d2 j g'�C n o Address: 4 4- City: a` / State: �— Zip: Qualifier Name: Phone#:�� a State Certification or Registration#: E�.�50/S"/.�� Certificate of Competency#: 'G '3 DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ ��© Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Desai Wp-q of WRr& Specify color of color thru tile; Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE c (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, t inspection will not be approved and a reinspection fee will be charged. 0 Signature �'� —� Signature OWN or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 4 day of �"�� 120 1-4 by T day of 20 by 1V�br PSS ,who is ersonal--_"--'bwn to who' ersonally known o me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: PAL R Sign: .nye.,• .`liar ntis•.• J.PALMER Print: +° `� Notary Public-State of Florida print: +° `� Notary Public-State of Florida -•, .• y o x -•. .•e My Comm.Expires May 23,2016 Seal: +r a�� Commission#EE 173842 Seal: %^ pP;� Commission#EE 173842 Bonded Through National Notary Assn. Bonded Through National Notary Assn. ************************************************************************************************************ IF APPROVED BY �/L a�lwi�e- Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)