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EL-15-3181 )L Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-250671 PermitNumber: EL-12-15-3181 Scheduled Inspection Date:January 13,2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: RABINOVICH, IVAN Work Classification: Low Voltage Job Address:10326 NW 1 Avenue Miami Shores, FL 33150-1270 Phone Number (786)436-0329 Parcel Number 1121360131430 Project: <NONE> Contractor: CARLY ELECTRICAL SERVICE Phone: 305-970-6345 Building Department Comments LOW VOLTAGE WIRING FOR TV OUTLETS. Infractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed Failed 7 V �e/� Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 12,2016 For Inspections please call: (305)762-4949 Page 16 of 31 trr l#tuts EL-12-15-3181 �s o"Its 91 Miami Shores Village Per f#Type Electrical- oeldehbal -�M 10050 N.E.2nd Avenue NW INr�rkOlas alVon;Low Voltage Miami Shores,FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 : �coxv Expiration: 06/27/2016 ..:: Issue nate- 12/301201 Project Address Parcel Number Applicant 10326 NW 1 Avenue 1121360131430 Miami Shores, FL 33150-1270 Block: Lot: JG 10326 LAND TRUST Owner Information Address Phone Cell I JG 10326 LAND TRUST 560 NE 103 Street (786)436-0329 MIAMI SHORES FL 33150- I 560 NE 103 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 500.00 CARLY ELECTRICAL SERVICE 305-970-6345 _ Total Sq Feet: 0 Type of Work:low voltage wiring for tv outlets Available Inspections: Additional Info: Fewection Type: Classification:Residential Electrical Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# EL-12-15-58159 $2.00 12/24/2015 Credit Card $50.00 $63.60 DCA Fee $2.00 Education Surcharge $0.20 12/30/2015 Credit Card $63.60 $0.00 Notary Fee $5.00 Permit Fee-Additions/Alterations $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $113.60 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,MECHANICA ,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that a goi information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermo z e ve-named contractor to do the work stated. December 30, 2015 Authorized Signature:Own Applicant / Contractor / Agent Date Building Department Copy December 30,2015 1 i Miami Shores Village i Building Department DEC 24 2015 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 I't Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2004 BUILDING Master Permit No. 5 r ��I PERMIT APPLICATION sub Permit No. ❑BUILDING ;K ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING F-1 MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOBADDRESS: y)�� !J��m 4 Ava, City: Miami Shores County: Miami Dade Zia: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type:�Load: Construeora Type: Flood Zone: BFE: FFE: 'stow 1(�ot'.C;-.< (i& OWNER: Name(Fee Simple Titleholder): TG C�® l zT Phone#: Address: A��r 6® N 6 � . ` ? City: WAN S�8�� S, State: IFL� Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:CompanyNaame: CA'Kd U6C S6, V(C6 Phone#: 505 Address: (ye® TLARM.k 1!�l\j - City: WAAAA State: Zip: : 3�Yl L�j�q Qualifier Name: CaA:6)5 ak\AaNkaC__Z Phone#: _165 qL)'6�3�� ,,57� State Certification or Registration#: Ecj-,)oosjq Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: ,c� City: State: Zip: Value of Work for this Permit:$ �V Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace F-1Demolition Description of Work: V L� Q�- `es Specify color of color thru tile:'- Submittal Fee$ Permit Fee$ /d47'®4*" CCF$ 0-r50 CO/CC$ Scanning Fee$ �� Radon Fee$ DBPR$ •Cb Notary$ Technology Fee$ Training/Education Fee$ 0 , 20 Double Fee$e�sstt, Structural Reviews$ Bond$ 7lYJ TOTAL FEE NOW DUE$ -3 a GO (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 of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signat� �� Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _day of � rs:/c' U-�� 20 15 , by4rk day of ��a—C 20 IS by t\lfty who is personally known to who is ersonally know me or who has produced �s LIR1 S ; as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY P LIC: NOTARY PUBLIC: Sign: Sign: ,• NANCY HERNANDEZ Print: �I �� _ Print: •� �. Gemntisslen#FF 1601 Seal: OP°V6 Notary Public State of Florida Seal: M ,� Eores February 6.2019 8003 i0Y L- ; • . 8"&d Tluu Tmv Fain hm SMO Sindia Alvarez o� My Commission FF 156750 �oFs�o@ Expires 09/03/2018 APPROVED BY L �/�� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)