EL-14-764 2C
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-212650 Permit Number: EL-4-14-764
Scheduled Inspection Date: June 03, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Rough
Owner: HOLT,JAMES Work Classification: Alteration
Job Address:361 NE 97 Street
Miami Shores, FL 33138-0000 Phone Number
Parcel Number 1132060135760
Project: <NONE>
Contractor: OHMS ELECTRICAL CONTRACTOR Phone: (954)974-3840
Building Department Comments
LOW VOLTAGE Infractio Passed Comments
INSPECTOR COMMENTS False
r/" � ®/l Inspector Comments
Passed En/ CREATED AS REINSPECTION FOR INSP-212631.
Failed
Correction
Needed
Re-Inspection 0
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
June 02,2014 For Inspections please call: (305)762-4949 Page 22 of 41
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795-2204
Fax: (305)756-8972
/Workers Compensation and
°Liability Insurance must have
VDescription of Operations stating
type of contractor or Contractor
License #.
A Miami Shores Village
Building Department
artment
10050 N.E.2nd APR 1
/ Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972 BY.
v INSPECTION'S PHONE NUMBER: (305)762.4949
BUILDING Permit No. -- 7�
PERMIT APPLICATION gaster Permit No. (Z C 13—X39 1
Permit Type: Electrical
JOB ADDRESS: 3& 1 /V C q-74 n S- r e Q t
City: Miami Shores County: Miami Dade Zip: JJ 1,
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
-79
OWNER:Name FeeSimple Titleholder): Phone#: '{�S
N Address: 3 (Pi I v lE 9112� �+r
City:�w aryl'i S Ylor e S State: IFZip:33 1 c3 9
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:® V)M5 8 )f L4 r I C 0 1 � _Phone#:C1 S 4-q1 q -3 g q 6
Address: Al 0 1 �I��trl K5 LOCAJ
City: I�°_ r 9 C- -e_ State: EL Zip: 3 3
Qualifier Name: ust—, E5pa't Phone#: 9 51 `5 Z D_9 y (m(,6
State Certification or Registration#: ,E 00 O 12 gCt Certificate of Competency#:
Contact Phone#: 5 ZO-q b Email Address:t e-S7 GL 4 l kCA tD®M ryl Se 1 CC .n_1P_4
DESIGNER: Architect/Engineer: �bt n 7 f-Ca\p t .e S 0 Phone#:
Value of Work for this Permit:$ Z I SW ° Ob Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: d Ga
Submittal Fee$ Sy `�' Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
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 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
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 whit 'pccurs seven (7) days afier the building permit is issued. In the absence of such posted notice, the
inspection will not be appr n a inspection fee will be charged.
Signature Signature
'�k' wn r9i Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,2011,by. 5�/AMcAiw— day of A OC t ,2011,by e ,
who is personally known to me o is personally known to me or who has produced
,..
+4P{tY OUB'q o
As identi ctio whcffletERO as identification and who did take an oath.
MY COMMISSION#FF001475
NOTARY PUBLIC: f�''•.'EovF:oP ' EXPIRES March 25.2017 NOTARY PUBLIC:
(407)3 8-0153 FloridallotaryService.com
Si Sign: tA
- N AbPrint: / /�D Print: �, �," otar Public I rida
es un .2015
My Commission Expires: My Co ire&flnMission #EE 71341
Bonded Through National Notary Assn.
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009XRevised 3/15/09)