EL-15-1533 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-237579 Permit Number: EL-6-15-1533
Scheduled Inspection Date: June 26, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: ACOSTA, JUAN CARLOS Work Classification: Low Voltage
Job Address: 128 NE 99 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060132270
Project: <NONE>
Contractor: AMENGUAL ELECTRIC INC
Building Department Comments
LOW VOLTAGE Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction L3
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
June 25, 2015 For Inspections please call: (305)762-4949 Page 20 of 32
41
Miami Shores VillageRsi� Ittil�
10050 N.E.2nd Avenue NE
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Miami Shores,FL 33138 000
Phone: (305)795-2204 R '
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Expiration. 12122/2015
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Project Address Parcel Number Applicant
128 NE 99 Street 1132060132270
JUAN CARLOS ACOSTA
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
JUAN CARLOS ACOSTA 128 NE 99 Street
MIAMI SHORES FL 33138
128 NE 99 Street
MIAMI SHORES FL 33138
Contractor(s) Phone Cell Phone LValuation:
$ 300.00
AMENGUAL ELECTRIC INC 0
Type of Work:LOW VOLTAGE Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Review Electrical
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# EL-6-15-56053
DBPR Fee $2.00 06/22/2015 Credit Card $50.00 $58.60
DCA Fee $2.00
Education Surcharge $0.20 06/25/2015 Credit Card $58.60 $0.00
Permit Fee-Additions/Alterations $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
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`AF IDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction a d zoning. Fu ore I authorize the above-named contractor to do the work stated.
____ June 25, 2015
ut orized Signature:Own - / Contractor / Agent Date
Building Department Copy
June 25,2015 1
rL�W5
Miami Shores Village R
Building Department JUN 2 0,
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 ��y —_-- -'
INSPECTION LINE PHONE NUMBER:(30S)762-4949
L L 2 / F C 016 —�o�
BUILDING Master Permit No. _
PERMIT APPLICATION Sub Permit No.
❑BUILDING LECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
� C CONTRACTOR DRAWINGS
JOB ADDRESS: i-zS t^ n. cl-1 4-L
City: Miami Shores County: Miami Dade Zia: �3 S l 3 A
Folio/Parcel#: Is the Building Historically Designated:Yes NO >;
Occupancy Type: Load: Construction Type: Flood Zone: EFE: FFE:
OWNER:Name(Fee Simple Titleholder)Q C� v ACOZ Phone#: 'ala `31
Address: ri- - is Wim' 357 3—C7 J 13
City: n&o'N ; State: - Zip: W3 It
Tenant/Lessee Name: tet. Phone#:
Email:
CONTRACTOR:Company Name: cAA l5l • l Phone#:
Address: -AA��d J N -�.
City: fState: Zip: Z�
Qualifier Name: 4AAAP e 1 ? Phone#:
State Certification or Registration#:eO �� / J �/ Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Unear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
,,...•.Description of Work: L-O W Q01-65
Specify color of color thru tile:
Submittal Fee$�Sa ` 0�) Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ G
(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. the absence of su as d notice, the
inspection will not be approved and a reinspection fee will be charged. r
Signature Signat
NER or AGENT CONT ACT R
The foregoing instrument was acknowledged before me this Th fe f oing instrument v/as'ackn wle gedk�eore g this
day of 20 by f� day of 20 L' J ,by
who is personally known to a qi,6k who is personally known to
me or who has produced y- � as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUB9::
Sign: Sign:
Print: Print:
Seal �+' JORGE ROSSEAU JORGE ROSSEAU
t� MY COMMISION#FF119045 Seal: V MY COMMISION#FF119045
EXPIRES MAY 4,201 S EXPIRES MAY 4,201!!
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APPROVED B Plans Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)