EL-15-1932 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-246157 Permit Number: EL-7-15-1932
Scheduled Inspection Date: October 21,2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: RIVERO,ARIANNA Work Classification: Alteration
Job Address:280 NE 95 Street
Miami Shores, FL 33138-2712 Phone Number
Parcel Number 1132060133710
Project: <NONE>
Contractor: HENRY RODRIGUEZ ELECTRICAL CONTRACTOR, INC Phone: (305)554-5711
Building Department Comments
RELOCATE 2 OUTLETS Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed En
Failed
Correction17
�C
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 20,2015 For Inspections please call: (305)762-4949 Page 44 of 50
pe
sstor s i Miami Shores Villaget9 tl7 Ty�1B`�IE3Gt�IC� ;R@sl lal
10050 N.E.2nd Avenue NE j �l& 5ds1:/ A)tt)flt1
Miami Shores,FL 33138-0000
Phone: (305)795-2204 i"'$1t17tcf&Ells_ �
8131201 Expiration: 02/27/2016
Project Address Parcel Number Applicant
280 NE 95 Street 1132060133710
ARIANNA RIVERO
Miami Shores, FL 33138-2712 Block: Lot:
Owner Information Address Phone Cell
ARIANNA RIVERO
FL
110 SW 12 Street
MIAMI FL 33130
Contractor(s) Phone Cell Phone Valuation: $ 250.00
HENRY RODRIGUEZ ELECTRICAL CC (305)554-5711 Total Sq Feet: 00
Type of Work:RELOCATE 2 OUTLETS Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning:3 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# EL-7-15-56543
DBPR Fee $2.25 08/31/2015 Check#:13896 $ 115.10 $50.00
DCA Fee $2.25
Education Surcharge $0.20 07/30/2015 Check#:13799 $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 informati is curate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the ab -n a ontractor to do the work stated.
August 31, 2015
Authorized Signature:Owner / pplicant / ctor / Agent Date
Building Department Copy
August 31,2015 1
Miami Shores Village c _�4 �
Building Department 7BY
uL °95
10050 N.E.2nd Avenue,Miami Shores,Florida 33138L�
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20OLQ 5411
BUILDING Master Permit No.)°
m
PERMIT APPLICATION Sub Permit No.E— ?.5 " 19, 7—
F-]BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 280 NE 95 ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3206-013-3710 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):ARIEL EXPOSITO &ARIANNA RIVERO Phone#:
Address:280 NE 95 ST
City: Miami Shores state: FLORIDA Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: HENRY RODRIGUEZ ELETRICAL CONTRACTOR Phone#: 305-5545711
Address: 14522 SW 142 PLACE CIR
City: MIAMI State: FLORIDA Zip: 33186
Qualifier Name: HENRY RODRIGUEZ Phone#: 305-554-5711
State Certification or Registration#: EC0002411 Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ` o Square/Linear Footage of Work:
Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ _S�4D !® Permit Fee$ lei���6 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 a a ment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection whi o urs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appro ed nd a reinspection fee will be charged.
Signature Signature
OW ER or AGENT CONTRACTOR
The fore oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 , by da of 20 !� by
V11�°l �U� who is personally known to +� UVA Z who is rsonally know to
me or w has produced�l�JLJ1 U�1`d� me or who h nproduce
as
identific ton and o did to an oath. identificatioh.
NOTAR B NOTARY P ign• Sig
Pnnt: 1 c sa.te Print:
Seal -' ,r, 1�5,Fr 162 Seal:
P ;, 216 n _
ILI
APPROVED BY � j�jlrs Y40— Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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ADD SMOKE/CARBON MONOXIDE DETECTORS.
ANY AND ALL CLOTH AND RUBBER
INSULATED CONDUCTORS TO BE REPLACED,
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290 NE 95 ST, Miami,F1,33138