EL-07-645 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,
xtore*
FL
Phone, (305)795-2204 Fax: (305)756-8972
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Inspection Date: 05/07/2007 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: DEL ORTIZ, MARIA Work Classification: Addition/Alteration
Job Address: 54106 Street NE
Miami Shores Village, FL Phone Number
Parcel Number 1121360060040
Project: <NONE>
Block: Lot:
Contractor: STATEWIDE ELECTRICAL SERVICES INC Phone: (305)592-6965
Building Department Comments
UPGRADING GFI OF NEW BATHROOM
MAY 0 8 200
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection
Fee
75
No Additional Inspections can be scheduled until
re-inspection fee is paid.
Friday, May 4,2007 Page 2 of 2
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Miami h -
S ores Village �..��rmr�7"` tllt� 1
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'S. 10050 N.E.2nd Avenue
Miami Shores,FL 33138-0000Pearm,_
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Phone: (305)795-2204 1. y , y�
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...:
Expiration: 10/0112007
Project Address Parcel Number Applicant
54 NE 106 Street 1121360060040
MARIA DEL ORTIZ
Miami Shores Village, FL Block: Lot:
Owner Information Address Phone Cell
MARIA DEL ORTIZ 54 N.E. 106 ST.
Contractor(s) Phone Cell Phone
Valuation: $ 1,000.00
STATEWIDE ELECTRICAL SERVICES (305)592-6965
__._..._.. — __ _ Total Sq Feet: 0
Type of Work:ELECTRICAL Available Inspections:
Additional Info:UP-GRADE
Classification:Residential Inspection Type:
Underground Rough
Fire Alarm
Alteration
WW
Final
Relocation
Service Change
Meter Box
Fees Due Amount Total Amt Paid JAmtDue
CCF $0.60
Education Surcharge $0.20 $0.00 $0.00 Permit Fee-Additions/Alterations $100.00Scanning Fee $3.00 Payment Type:
Technology Fee $2.50Total: $106.30 q5n
APR ®
U4
In consideration of the issuance to me of this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated
April 04,2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Wednesday,April 4,2007 1
Miami Shores Village r '=
Building Department artment A APR 6 2 2007
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 B Y.-
Tel:
.Tel: (305)795.2204 Fax:(305)756.8972
BUILDING %- Permit No. f—Lak Cf 40
PERMIT APPLICATION "fl >�S Master Permit No.
FBC 2004
Permit Type(circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) La.®u ect-I I(ACL oy+_ 1 Z Phone# S05 4 9 G 14 3®/
Owner's Address rj 4 a- ( Lo (P +
Cityk1 CCk J-At� c7 NQS State Zip ?11"6138
g
Tenant/Lessee Name Phone#
Job Address(where the work is being done) . �J ��- C� S-t
City Miami Shores Village County Miami-Dade Zip 2D ( �
FOLIO/PARCEL#
Is Building Historically Designated YES NO
(� Phone# 9-10G S� 2- 6 S
Contractor's Company Name � ��.��U.91 � Ui,
Contractor's Address ®Cj W Q + C Q
City (4kick6 State Zip
Qualifier Name_ o LI M �0 ' Phone#
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
Value of Work For this Permit$ D a Square/Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑N w ,,,,((�� ElRepair/Replace ❑Demolition
Describe Work: CSC dQ nb
Submittal Fee$ Permit Fee$ CCF$ J,0 CO/CC
Notary$ Training/Education Fee$ Technology Fee$ LSO
Scanning$ Radon$ DPBR$ Zoning$
Bond$ Code Enforcement$ Double Fee$
Structural Review.$ Total Fee Now Due$
See Reverse side
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 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 Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20_,by day of ,20_,by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTAPUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
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APPLICATION APPROVED BY: -�?,A/i2 laps Examiner
Engineer
Zoning
(Revised 02/08/06)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,N fiami Shores,Florida 33138
Tel: (305)795.2204 Fag: (305)756.8972
BUILDING _ Permit No.
PERMIT APPLICATION Master Permit No.
FBC 2001
Permit Type(circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) -AjjZPhone# e.F
Owner's Address 5Y A45 10,6 5
City ® -r1-AXe7 State Zip 331.,31
a
Tenant/Lessee Name Phone#
Job Address(where the work is being done) ;Y/ lle 10,6
City Miami Shores Village County Miami-Dade Zip
is Building Historically Designated YES NO )V
Contractor's Company Name Cla/®e P 1/1LcS Phone# 305'6g��� �S
Contractor', Address ?i 7- eG cls
City a `State— Zips®f�
Qualifier
Architect/Engineer's Name(if applicable) Phone#
$Value of Work For this Permit --) o® a oa Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New "k( air/Replace ❑Demolition
Describe Work:
Submittal Fee$ Permit Fee$ CCF$ CO/CC
Notary$ Training/Education Fee$ Technology Fee$
Scanning$ ` Radon$ Zoning Bond$
Code Enforcement$ Structural Plan Review.$
Total Fee Now Due$
(Continued on opposite side)
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 he 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 iinspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
first
inspection will not be approved and a reinspection fee will be charged.
Signature CaN ®( Signature
Owner or Agent ontractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _aO
day of 120_,by day of AfOWtl ,20&,by ,
who is personally known to me or who has produced who is personall^y known to me or who has produced
lmftiidentification and who did take an oath. as identification and who did take an oath.
NOTARY PUBT TOGOp� NOTARY PUBL
g`—� d Sign:
Sign:
Print. Ad 2L
7 Print:
My Commission Expires: My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. - ��0 -t Certificate of Competency No.
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
Chc 12/15/03