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ELC-15-3038 a � Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-248932 PermitNumber: ELC-12-15-3038 Scheduled Inspection Date: December 23,2015 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: SLMB LLC, UNG LLC C/O CJI LAW Work Classification: Addition/Alteration Job Address:651 NE 88 Terrace Miami Shores, FL 33138- Phone Number (305)200-8696 Parcel Number 1132060120020-651 Project: <NONE> Contractor: HENRY RODRIGUEZ ELECTRICAL CONTRACTOR,INC Phone: (305)218-7878 Building Department Comments FIRE ALARM REPLACEMENT Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments PassedEa ,- Failed (> Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 22,2015 For Inspections please call: (305)762-4949 Page 26 of 59 Pe � � -'l 4038 fr X0, yMiami Shores Village Permit Tye:Electrical,-, �rQC IC) . 10050 N.E.2nd Avenue NE � �dl i^:6s51ftbhr1ti011:ActditionrAlteratian Pe, Miami Shores,FL 33138-0000 Phone: (305)795-2204 Permit Status:APPROVED issue DTp1 Expiration: 06/14/2016 Project Address Parcel Number Applicant 651 NE 88 Terrace 1132060120020-651 LFNG LLC C/O CJ LAW SLMB Ll . Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell LFNG LLC C/O CJ LAW SLMB LLC 651 NE 88 Terrace (305)200-8696 MIAMI SHORES FL 33138- 651 NE 88 Terrace MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 7,500.00 HENRY RODRIGUEZ ELECTRICAL CC (305)218-7878 ' _. Total Sq Feet: 0 Type of Work:FIRE ALARM REPLACEMENT Available Inspections: Additional Info: Inspection Type: Classification:Commercial Final Scanning:1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Review Electrical Underground W.W. Fees Due AmountPay Date Pay Type Amt Paid Amt Due CCF $4.80 DBPR Fee Invoice# ELC-12-15-57979 $3.38 12/17/2015 Check#:3359 $ 197.56 $50.00 DCA Fee $3.38 Education Surcharge $1.60 12/07/2015 Credit Card $50.00 $0.00 Permit Fee $225.00 Scanning Fee $3.00 Technology Fee $6.40 Total: $247.56 In consideration of the issuance to me of this permit, I 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 informati accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-na a contractor to do the work stated. December 17,2015 Authorized Signature:Owner / Applicant / ontractor / Agent Date Building Department Copy December 17,2015 1 Miami Shores Village ME Building Department10050 N.E.2nd Avenue,Miami Shores,Florida 33138 � Tel:(305)795-2204 Fax:(305)756-8972 ON NIt INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20c-0 BUILDING Master Permit No. CG d I — I\5. . q $ y PERMIT APPLICATION sub Permit No. iQZ- (5- W-3T ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP Q n CONTRACTOR DRAWINGS JOB ADDRESS: 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): 8P 1 r31 SCA%%yim H CkA 5Grr%c4+ (Y%C.- Phone#:.306' O O 6(,14 Address: 1395 ')4P r(d4A Ave, 4 City:J_�I part( State: Pt zip: 3 31 Tenant/Lessee Name: Ftu=-#-u,- lA- Aigay.i "c-� Phone#: ebb' � Z®7� rrS• Email: cA1 r Q c-4-1 a h 1'Y'GK�t Lir IviC�'f GR lPd M f May CONTRACTOR:Company Name: 14 o2/i 7,078 Address: If 2, City: M6/_A•r c*,P4 State:—_� Zip: Qualifier Name:��B yul�! Phone#: State Certification or Registration#: c9 k 1 Certificate of Competency M DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ dS& V Square/Linear Footage of Work: Type of Work: ElAddition ElAlteration ❑ New F-1Repair/Replace ❑ Demolition Description of Work:1, S LL V`ft LIMM Specify color of color thru tile: Submittal Fee$ 5600 Permit Fee$ j zs ®� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ C S G (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 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 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." 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 such posted notice, the inspection will not be a ro7andeinspection fee will be charged. Signature Signature OWNER or AGENT CONT CTOR The foregoing inst ment was acknowledged before me this The foregoing i trum^� was acknowledged before me this 'Z day of CSL ,20—) , by day of !JTL C ,20 S by cue ve�ct�oSP.eM¢,.Je,<�Lc g� tiFi�(LY I� W\a who is personally known to �� VIS-,who is personally known to me or who has produced r1 ( as me or who has producedI�r, l�el.rly�- as identification and who did take an oath. identification and who did take an oath. NOTARY P Q NOTARY PUBLIC: Sign: Sign: Print: Print: Seal: Seal: t1RY P,, SHARON ANN COX �% •• .•q� ��• MY COMMISSION#FF124989 D(PIRE*S•V �'oii�`erough 1st State Insurance APPROVED BY iPG/� Plans Examiner Zoning Structural Review Clerk (Revlsed02/24/2014)