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EL-14-1494 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-215745 Permit Number: EL-7-14-1494 Scheduled Inspection Date: July 14,2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: W. W. Owner: GHEE-AWAI, CAMILLE Work Classification: Temp for Test 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: 305/556-5759 Building Department Comments 30 DAY TEMP FOR TEST Infractio Passed Comments � INSPECTOR COMMENTS False Inspector Comments PassedEl Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 11,2014 For Inspections please call: (305)762-4949 Page 21 of 26 Miami Shores Village JUL 1 0,4 Building Department BY: 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 F B C 20 BUILDING Master Permit No.f.. /6-13 —259 PERMIT APPLICATION Sub Permit No. ilc 614 -- d gy - ❑BUILDING WELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 677 9. e. t o , � City: 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): CA-1-Ck``Q a ee, NW Ol Phone#:�30,g� (06. 3 Z 7 cj Address: ,.370 4v-lg . 1p3sr' City: Me~ 9� State: -let, Zip: ' Tenant/Lessee Name: Phone#: Email: I rc CONTRACTOR:Company Name: Phone#:(39s��s-G Address: fNe44 ©K.ck. pew. ou 4 ''-19 City: 0.i4t State: Zip: 33&9 Qualifier Name: R1�X.LSGD c� —fC Phone#: 0-05j a - S) State Certification or Registration#: O .27/7Certificate of Competency#: DESIGNER:Architect/Engtheer: 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 Description of Work: 3� � f. r'l�w�►�tl.no.nN gie-A a YceemC Specify color of color thru tile: Submittal Fee$ Permit Fee$ d G' ®fes 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 . v R 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,bf 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..", ' B • �,4 � a Notice to Applicant: As a condition to the issuance of a building,permit*w th pn estCrnpted value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement a�d 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 9e pbsted 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 Signatpre OWNER or"AENT' .a CONTRACTOR The foregoing°instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ��'� 20 ,by• II�L day of �v 20J by I4Q`L. JrVL ,';�ho is lona yJc►e�rn to �fY�N�SCo �t�+ENGL who is personally known to me or who has produced \��` '�sr;, as Igor who has produced as IS identification and who did take th: �/z �'% identification and who did take an oath. NOTARY PUBLIC: _=' �, a` - NOTARY PUBLIC: Sign: / Si Print: ��r�rr....... �`� Print: My COh NSSIOid#EE 836183 Seal: Seal: * I EXPIRES:January 25,2017 �r9rFOF FL�P`oe Bolded TW Budget Notary S"C0 k**4k k*k#k k k**Rk k+k k k+k k k k**#k kffi**&k#k*+k k k*ffik k k k ek k k k+kk+k+k k k k k**k k k*k k k*k k+k k k k*k k k ak ak k#**k k*+k k k*#k k+k k k k k k k k**ek k k k APPROVED BY ll J7id% Plans Examiner • Zoning Structural Review Clerk (Revised02/24/2014) ,S�ORy. Miami Shores Village Building Department some ..".M 10050 N.E.2nd Avenue Miami Shores, Florida 33138 fit ,y` Tel: (305) 795.2204 oR Fax: (305) 756.8972 AFFIDAVIT FOR 30 DAY TEMPORARY-ELECTRIC SERVICE NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED. It is understood that the temporary-electrical approval by the Miami Shores Village, Building Department given in connection with the building being constructed under: Building Permit N: C-l0. 15 _2-3&5 Electrical Permit N: CZ- -If •!.3`25,53 At Address: /370 Al.G. /OS ST Miami Shores, FL For Owners: CA"L ue Ctli-L-E 14W i*t , and is being given only for construction��rpo�e car for testi ng,,the, olloping equipment in said structure: A-C A400-eaf The owner does herby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and ,ancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of ie building concerned is occupied before final inspections are approved and/or obtained a Certificate of Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will result in your being unable to obtain future Temporary for Test permits. I, �-r}v� rc�1 i1 z / � , being first duly sworn, depot %andlsay�that I am the owner of the above described property, and that I agree that the structure covere ),11,� t4��,ent shall not be occupied until the building contractor has obtained approval of final inspect(ensIn r'r0b'C;Aiq a Certificate of Occupancy of Completion. Note: Failure to comply with the pr&Ist6di/6f1i 'a !davit will result in your bein �to btain future Temporary for Test permits. = : PdOW'Vn LIC Co ` Signature of Owner `fes'°S N�� e �t I, 15E�tm'� 04'rNt2 , being duly sworn, depose and say thrabfidh� the Electrical Contractor for the above-described pr perry and that the electrical installations as now existing Will not create a safety hazard if tempor ice is connected. Signa ure of Electriftl Contractor Signa re,64 �Y.F{REQ.January 25,2011 being first duly sworn, depose and say that I am the Building Contractor of the above described property and that I will not permit occupancy of this building until final inspections have been c r by thn r tors and sub-contractors concerned and final approval by the inspection division obtai d and hat ave the I luthority insofar as the owner of said property is concerned to prohibit occupancy until uch fin tiorls are obtained and/or a Certificate of Occupancy or Completion is issued. 1AP rAd gnat o wilding ntractor Signat a of Not * MYCOWISSION#EE838183 EXPIRES;JanLary 25,2017 '"',,F��o�a°~ Bend ThtN 1 Nou7 6ervN� Signature of Inspector Signature of Notary