EL-13-2748 ` -
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-215417 Permit Number: EL-12-13-2748
Scheduled Inspection Date:July 08,2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: HALPERN, MARK Work Classification: Alteration
Job Address:9377 NE 9 Place
Miami Shores, FL 33138- Phone Number (305)610-6688
Parcel Number 1132050070100
Project: <NONE>
Contractor: MCAULEY ELECTRIC INC Phone: (954)533-2815
Building Department Comments
ADD OUTLETS AND LIGTHS Infractio Passed Comments
FOR 2 BATH ROOMS AND KTICHEN INSPECTOR COMMENTS False
Inspector Comments
Passed 4Wy_,�X
Failed � �
X
✓
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 07,2014 For Inspections please call: (305)762-4949 Page 40 of 43
Miami Shores Village '� k � VY
s—
BuildingDepartment
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Y------
Tel:
--o_oTel: (305)795.2204 Fag:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20
BUILDING Permit No. V_L i �3
PERMIT APPLICATION Master Permit No. 1 -c�
Permit Type: Electrical
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes NO ,�/ Flood Zone:
OWNER:Name(Fee Simple Titleholder` Phone#: ��'
Address: ��� � /V
City: /l/�&4 - .54 e1 State: t`/- zip.
Tenant/Lessee Name: Phone#:
Email: r
CONTRACTOR:Company Name: �r�� � Phone#:
Address:1 MF-714h 8—V if -
City: L.Q01A Ito State: IPL- Zip: 3--2S ---
Qualifier Name:Z f-% I-Ap poled Phone#:
State Certification
��o����rRegistration#: EC, 1 q?,- Certificate of Competency#:
Contact Phone#:((`Z'1-53 Z_q 1 '5 Email Address: )�_e e__6nC&C0CQCCA °
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑Address alteration UNew ORepair/Replace ODemolition
Description of Work: XIAL4 J A 0 4, IT e
Submittal Fee$450 Permit Fee$. �®��''� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$ �}—
TOTAL FEE NOW DUE$ —L
f 1�:
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 inspec ion which occurs seven (7) days after the building permit is issued. I the absence of such posted notice, the
inspection will not a approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing ins ent was acknowledged-before me this The foregnin a instrument was acknowledged before me this'd
day of ,20L!5-,by 1�`�00O U UU—M 1 day of DaY
Niter,20 >by�CrKtkhQrs ft Uk'���
who is personally known to me or who has produced who i , ersonally known t me or who has produced
As identification and whoe � an oath. as identification and who did take an oath.
NOTARY PUBLIC: °`\\ Ar/ � NOTAR . UBLIC:
Sign: _ _ !m
®t. •��;rr. G
Print: - Print:
. �� ..� ,,, .� TANYA FOX
My Commission Expires: '�,°�,� 1�- My Commission Expire c W Cp J0N
ERM:OCT 02,2017
Bonded through l et Stge hurme
APPROVED BY C /L Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/102009)(Revised 3/15/09)
II