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EL-13-2553 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-216529 Permit Number: EL-11-13-2553 Scheduled Inspection Date: July 25, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: CHEE-AWAI, CAMILLE Work Classification: Alteration Job Address: 1370 NE 103 Street Miami Shores, FL Phone Number (305)710-3331 Parcel Number 1132050300080 Project: <NONE> Contractor: F JIMENEZ ELECTRICAL CONTRACTOR, INC Phone: 3051556-5759 Building Department Comments NEW ELECTRICAL SERVICE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed El Failed _ Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 24,2014 For Inspections please call: (305)762-4949 Page 27 of 31 Miami Shores Village << g Building Department 10050 N.E2nd Avenue,Miami Shores,Florida 33138 Tel: (305)7952204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 l BUILDING Permit No.0-1`3---`AS53 PERMIT APPLICATION Master Permit No. P-c_14 3 -2-sg 6— Permit Type: Electrical JOB ADDRESS: 13 0 F— 10 3q City: Miami Shores County: Miami Dade zip:_33t38 Foho/Parcel#: Is the Building Historically Designated:Yes NO ✓ Flood Zone: OWNER:Name(Fee Simple Titleholder):_ e—' 14-M1 L-LE C f+tEE- 4'LZ AJ phone#: 3o S- G e$- -12-,+ Address:_ 12 .� City' VV 14 P41 S 4oRfr S State: --(=�t- Zip: 3 1' 3 s TenantImsee Name: Phone#: Email: CONTRACTOR:Company Name: fl�fi cj dr"J ,`' ,�' Phone#:( pos) ►-S75S Address: f ' r� City: k 60 State: L. p: d l �ualifier.Name:�,. • 6,5 d #, e,ft 2 Phone#: "S�l State Certification or Registration#: EG —1200=5-, Certificate of Competent #:, - Contact Phone#: 6 Email Address: DESIGNER:Architect/Engineer. Phone#: Value of Work for this Permit:$.1.4 ' Square/Unear Footage of Work: a ,Qw".vC:.✓ ' 1. 6V Typeof.WorkL OAddress Alteration U146 ORepair/Replace ODemoh on 1 u Description,of Work: I" Submittal Fee$ Permit Fee$ /J'®r®e, CCF$ CO/CC$ . Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ '/( 0 Bduding 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 CONMIENCEMENT 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature `-�r� --�—,a. Si ' gnaturu- Owner or Agent fir, The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before, e this, day of. Nov 20,L,by C2 mf7e (31--tf- -&A t , day of• v.. 20.1�,by t who is personally known�t^oym� r who has produced 4'. ^who�is 'songli known to me r who:l�as produced G 060.1/0 V"7As-identification and who did take an oath as i$enti&Ation incl who did take an oath. 1. NOTARY PUBLIC: NOTARY PUBLIC: Si / Sign: Print: /t ! S C�G'�'G�/� Print C' Y PSB ©AN (*. * * MISSION#EE 838183 My Commission Expires: aa.PaY P„erc EORIS GOMEZ My Commission Exp EXPIRES:January 25,2017 * MY COMMISSION#EE 838183 'ArFOF F<oBw ded pus Budget Notary,Senrices EXPIRES:January 25,2017 J1jgrF0pFIOP`OP Wed pvuBudget"SeMca APPROVED BY /I Examiner Zoning Structural Review Clerk (Revised 3/1=012)(Revised 07/10/07XRevised 06/102009)(Revised 3/15/09)