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 &!'"�,'
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MY COWAISS"N t EE 843924 xPRIA DEL PILAR ROBLEDO
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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
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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
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*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
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� 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