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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 c, z 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 77777777 , PN :qtr Miami h - S ores Village �..��rmr�7"` tllt� 1 � E a �identil 'S. 10050 N.E.2nd Avenue Miami Shores,FL 33138-0000Pearm­,_ tic rtY� till# r Phone: (305)795-2204 1. y , y� �sk ...: 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: c . 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