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EL-15-1210 �A�/K Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-235118 Permit Number: EL-5-15-1210 Scheduled Inspection Date: June 04,2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: CENOZ, EFREN Work Classification: Temp for Test Job Address:51 NW 110 Street Miami Shores, FL 33168-4318 Phone Number 305/751-5274 Parcel Number 1121360030600 Project: <NONE> Contractor: AMPSTRONG ELECTRIC INC Phone: (305)468-7988 Building Department Comments 30 DAY TEMP FOR POWER Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed 1:2 Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 03,2015 For Inspections please call: (305)762-4949 Page 12 of 28 e rrtait NP. EL-646-1210' Miami Shores Village Permit Tie:f_ t�i &Lns1 10050 N.E.2nd Avenue NW ', Work ClaSsifictisait:TOM p for Test Miami Shores,FL 33138-0000 Phone: (305)795-2204 Permit Status:APhROVd) F R� Issue vaw5t27126j� Expiration: 11/23/2015 Project Address Parcel Number Applicant 51 NW 110 Street 1121360030600 Miami Shores, FL 331684318 Block: Lot: EFREN CENOZ Owner Information Address Phone Cell EFREN CENOZ 51 NW 110 Street 3051751-5274 MIAMI SHORES FL 33168-4318 51 NW 110 Street MIAMI SHORES FL 33168-4318 Contractor(s) Phone Cell Phone Valuation: $ 500.00 AMPSTRONG ELECTRIC INC (305)468-7988 Total Sq Feet: 00 Type of Work:30 DAY TEMP FOR POWER Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:3 Review Electrical Fees Due ]AMn �Date Pay Type Amt Paid Amt Due CCF DBPR Fee Invoice# EL-5-15-55651 05/27/2015 Check#:7157 $64.60 $50.00 DCA Fee Education Surcharge 05/21/2015 Check#:7148 $50.00 $0.00 Permit Fee-Additions/AlterationsScanning Fee Technology Fee Total: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AF (DAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructi uthermore,I authorize the above-named contractor to do the work stated. May 27, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy May 27,2015 1 Miami Shores VillageCEIV D Building Department MAY 2.1..2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 20 10 BUILDING Permit No. PERMIT APPLICATION Master Permit No. �c - / - I®xl� Permit Type: Electrical // JOB ADDRESS: '�/ N• W. Ila S?' City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes i1Q0.) Flood Zone: OWNER:Name(Fee Simple Titleholder): li Y lt,6�A1/ Z /li Q 7 Phone#: Address: 5/ ;A i w Ile s City: H/(0-7 s'Aore-S State: FL- Zip: l Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: i� 17fp� Phone#: Address: QA�3 �� �� T A -2. City: `G State: JI Zip: Qualifier Name: ` Phone#� State Certification or Regis ation#: tC k 3 GO 41� L/ Certificate of Competency#: Contact Phone#\ 30 �� LiGLIQ$ Email Address: 1 �� �5 Un -(ze" DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ Soo -OQ Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteratiion ❑New ❑Repair/Replace ❑Demolition Description of Work: O L,-A le- t-I&K Submittal Fee$ Permit Fee$ aO 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 which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approve a reinsp ction fee will be charged. - 0 Lin Signature Signator wner or Agent Contractor ° The foreZ* inst7rument was acknowledged before me this ZO The foregoing instrument was acknowledged before me this day of PkIl ,20—6by 6C1eA Ce naZ_ day of Aq a ` .20 by who is personally known to me or who has produced who is p<onally known me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: > Sign: Print: Print: My Commission Expires: CHERYLLANDPADE My Com &!'"�,' gu MY COWAISS"N t EE 843924 xPRIA DEL PILAR ROBLEDO .rz ' EXPIRES:ucicber 15,2D16 ;' MY COMMISSION#EE220559 '18r Banded Thro Noldy Pubec under EXPIRES August 13.2016 APPROVED BY �� �/I!e& Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Building MIAMI•DADE 11805 SW 26th Street Miami, Florida 33175-2474 786-315-2100 miamidade.gov AFFIDAVIT FOR 30 DAY TEMPORARY ELECTRIC SERVICE ELECTRICAL CATEGORY 26 ELECTRIC SERVICE WILL BE DISCONNECTED"WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED OR CERTIFICATE OF OCCUPANCY OBTAINED. It is understood thatthe temporary electrical approval by the Miami-Dade Building Department is given in connection /2G J2 i with the building being constructed under the Building Permit # �/1/1 and Electrical Permit# ataddress 51 " w I/® Sf Mi'e%_7vr/ s4®ras for owner: g re- 6eA10_-_r and is being given only for construction purposes or for testing the following equipment in said structure: The owner does hereby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and cancellation and electric power can be cut off at the discretion of the Building Official and will be disconnected if the building concerned is occupied before final inspections are approved and/or a Certificate of Occupancy or Completion is obtained. I, being first duly sworn, depose and say that I am the owner of the above described property, and that I agree that the structure covered in this agreement shall not be occupied until the building actor has obtained approval of final inspections and/or obtained a Certificate of Occupancy or Co ure comply with the provisions of this affidavit will result in your being unable to obtain future m ra Test p' mits. CItMUAIDRADE S' atur o caner 84 Ocmbsr 15,2016 \ xpires: -�• I Pabicllnaenttre�s being duly sworn, depose andsay that I am th the above-described property an hat the electrical installations as now existing will not ate safety hazard if temporary services on ec d. Signature of Electrical Contractor Siature of Notary ,::•^' ;; MARIA DEL PILAR ROBLEDO M Commission Expires. •*= MY COMMISSION#EE220559 I, /U,/J✓h.41r , �?olrc e being first duly sworn, depose and say that I ar Itinspection ding s"gest 13,2018 of the above described property and that I will not permit occupancy of this building u iWs ectkmmbeen called for by the contractors and sub-contractors concerned and final approval by division obtained and that I have the authority insofar as the owner of said property is concerned to t occupancy until such final inspections are obtained and/or a Certificate of Occupancy or Completion is iss MrsEE 843M Signature of Building Contractor IBEs:oceDRADE rls,2ols *Commrisos�ionExp�ires: ThruN�rywmBcuMerwr�a+s Date: Signature of Electrical Inspector Date released to FPL: 12301-124 6/06 Building 1 11®ADE 11805 SW 26th Street Miami, Florida 33175-2474 786-315-2100 miamidade.gov AFFIDAVIT FOR 30 DAY TEMPORARY ELECTRIC SERVICE ELECTRICAL CATEGORY 26 ELECTRIC SERVICE WILL BE DISCONNECTED"WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED OR CERTIFICATE OF OCCUPANCY OBTAINED. It is understood thatthe temporary electrical approval by the Miami-Dade Building Department is given in connection with the building being constructed under the Building Permit # /�G-1/1 -/o?- 9®14 and Electrical Permit# at address ,�/ tJ.W ll® SJ _54o.rre-5 for owner: 0 re_2I Gezy,-_ and is being given only for construction purposes or for testing the following equipment in said structure: The owner does hereby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and cancellation and electric power can be cut off at the discretion of the Building Official and will be disconnected if the building concerned is occupied before final inspections are approved and/or a Certificate of Occupancy or Completion is obtained. I, .nDfy)� being first duly sworn, depose and say that I am the owner of the above described property, and that I agree that the structure covered in this agreement shall not be occupied until the building,.contractor has obtained approval of final inspections and/or obtained a Certificate of Occupancy or Corr; a e*_ ' ure comply with the provisions of this affidavit will result in your being unable to obtain future Tem ra Test p mits. CHERYLLANDM S' atur o wrier y�� 643sz4 n OcUm 15,2016 xpires: taotndod �s I, D lJA , being duly sworn, depose and say that I am th ful the above-described property and that the electrical installations as now existi g will not create safety hazard if temporary service is conn ct -`—Signature of Electrical Contractor Signature of Not A9.1 le. MARIA DEL PILAR ROBLEDp My Commissio Exp ir MYCOMMISSInti EE2205559 I, N6,-, cT �i7�(�crc�e being first duly sworn, depose and sa that I rit gild' t 13,2018 of the above described property and that I will not permit occupancy of this building t3inSDe ' ,00„ been called for by the contractors and sub-contractors concerned and final approval by th' inspection division obtained and that I have the authority insofar as the owner of said property is concerned to prit occupancy until such final inspections are obtained and/or a Certificate of Occupancy or Completion is is CHERYLLANORADE s 4392 � 4 � MY COMMISSIM @ EE 86 October 15,201 Signa u o uilding Contractor I F40A R ftM TWU Nfty ftfic UMOMRM My Commission Expires: - - Date: Signature of Electrical Inspector Date released to FPL: 123_01-124 6/06