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PW-14-2791 ® qLc- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231035 Permit Number: PW-12-14-2791 Scheduled Inspection Date: March 27, 2015 Permit Type: Public Works Inspector: Rodriguez,Jorge Inspection Type: Final Owner: CENOZ, EFREN Work Classification: Public Works Job Address:51 NW 110 Street Miami Shores, FL 33168-4318 Phone Number 3051751-5274 Parcel Number 1121360030600 Project: <NONE> Contractor: AMPSTRONG ELECTRIC INC Phone: (305)468-7988 Building Department Comments EXCAVATION TO UNDERGROUND ON ALLEY Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-225688. No cut on asphalt ,% � ' 03-26-15 Cancel by Christina. Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. March 27,2015 For Inspections please call: (305)762-4949 Page 19 of 29 mss �;-r -7 H rAMPS w 1t_��w ►�r�3Ce TEIF� C l f C l A t 4 PERMIT CANCELLATION REQUEST Date: 03 / 03 ! 2015 Reference: Contractor Name: Ampstrong Electric,Inc. Permit Number: PW-12142791 Jobsite Address: 51 NW 110 St. Cancellation Reason: No work has been performed Contact Name: Osvaldo Cardoza Phone Number: 305 468-7988 Work has: [ x l not taken place; [ or,taken place. Please be advised that this is a request to cancel above referenced information. Should you need any further information please contact the above referenced contact at the phone number indicated. Sincerely; y Signature of Applicant Applicant Signature Notary Osvaldo Cardoza Printed Name of Applicant State of Florida.County of Miami-Dade ft S,w3 and subscribedthis: p G LG Signature of Notary Public Day Year Personally Kno n or Identification: Notary Public t " MARIA DEL PILAR ROBLEDO MY COMMISSION#EE220559 (Type or 10D and expiration date) •. EXPIRES August 13.2016 6965 NV1'43rd St.Ba)#31Aliami.Fl.33166IPli:(305)468-79881 Fam(305)468-7989E-mail:ini'o�a ampstrong.com 'N' Miami Shores Village Building Department �J 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 ®�C 2„ 014 V� Tel:(305)795-2204 Fax:(305)756-8972 ^' INSPECTION LINE PHONE NUMBER:(305)762-4949 FB `C 20 BUILDING Master Permit No,-E),__ PERMIT APPLICATION Sub Permit No.'P ❑BUILDING EBIELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLICWORKS ❑ CHANGE ❑ CANCELLATION ❑ SHOP L 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): Phone#: ���- '/z3'Zyo_3 Address: 5C!5 5- N. W. ile off City: "12221 State: FL- Zip: 333/26 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: '\C Phone#: Address: (AtaS ICU.) �J S City: k (J�m,k State: Zip: Qualifier Name: C Sams,\ C.® Cor- D z c\ Phone#: L( State Certification or Registration#: E C -s oo *%-1 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: 1 City: State: Zip: Value of Work for this Permit:$ /, ®© Square/Linear Footage of Work: Type of Work: ❑Addition ❑ Alteration ❑New ❑ Repair Replace ❑Demolition `,Description of Work: 2 Specific color of color thru tile: Submittal Fee$ Permit Fee$ i 00 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 suc per notice, the inspection will not ap rovedand a reinspection fee will be charged. Signature Signature or or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me thiso�day of ' /s V 20 L by 4F 21 0, day of 1 L *J by c'q �� who is personally known to me or who has produced who is personally known to me or who has produced EL- 1)L, As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: yy 1 jj��QQ Print: J Print:( Xr/��t CSC AllMARIA DEL PILAR ROBLEDO M Commission Ex i RAG C MMISSLLNmEEM My Commission Expi Y p =.; r�+y c +flssioN I«�6a�s2a f4YCOMMI3SION E EE220S58 EXPIRES:October 15,2016 Sade+,Trou Nagy Public uWvWift,s I'• ,y� .. EXPIRES August 13.2018 407)399-0163, FloMdaWota�ySaviaaxn APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012))(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)