EL-16-209 IV
( � �'
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-251626 Permit Number: EL-1-16-209
Scheduled Inspection Date: February 08,2016 Permit Type: Electrical- Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: PINO,ALEJANDRO Work Classification: Temp for Test
Job Address:9105 NE 5 Avenue
Miami Shores, FL 33138-
Phone Number (305)302.5770
Parcel Number 1132060141210
Project <NONE>
Contractor. ELECTRICORP INC Phone: (305)525-6299
Building Department Comments
30 DAYS TEMP FOR TEST Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed U1
Failed
Correction a
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
February 05,2016 For Inspections please call: (305)762-4949 Page 24 of 46
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6Su `
Miami Shores Village
10050 N.E.2nd Avenue NE
Y
Miami Shores,FL 33138-0000
Phone: 30 795-2204 ; E
M
� 51
Expiration: 0712 2016
Project Address Parcel Number Applicant
9105 NE 5 Avenue 1132060141210
ALEJANDRO PINO
Miami Shores, FL 33138- Block: Lot:
Owner information Address Phone Cell
ALEJANDRO PINO 9105 NE 5 Avenue (305)302-5770
MIAMI SHORES FL 33138-
9105 NE 5 Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 100.00
ELECTRICORP INC (305)525-6299 Total Sq Feet: 00
Type of Work:30 DAYS TEMP FOR TEST Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning:1 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# EL-1-16-58453
DBPR Fee 2.
DCA Fee $2 0000 01/28/2016 Credit Card $58.60 $50.00
Education Surcharge $0.20 01/26/2016 Cash $50.00 $0.00
Permit Fee-Additions/Alterations $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
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,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS 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 nin Futhermore,I authorize the above-named contractor to do the work stated.
January 28,2016
Aid orized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
January 28,2016 1
0\ko\* Miami Shores Village
Building Department 7JAN 344 2 1
`v 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 BY:
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC 20
BUILDING Master Permit No. IRf ` —/
PERMIT APPLICATION Sub Permit No. 4r-k- -/6— 221
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING F-1 MECHANICAL PUBLIC WORKS f--] CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: f1®5 A19 0,fiolg
City: Miami Shores Coun : Miami Dade Zip: 313l ao
Folio/Parcel* `� ® � Is the Building Historically Designated:Yes NO _
Occupancy Type: Load: Construction Type: il> Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): ;0*7 Rl/t/? Phone#: AZr- ?"00-47-70
Address: 9��� o✓E .6
City: /UI/AA State: 41404 Zip: 3-10P/IAB
Tenant/LesseeeName: t� ,� t -` i`� Phone#:
C��
Email: 1P ky l" ` SQ V $
CONTRACTOR:Company Name: Phone#: 'T2
Address: Sz'-o G/ v Z46 d-vw
City: dt�C .L 4 e. r State: G- Zip:
Qualifier Name: t 6 /6—X _ :� -i� Phone#:,���SZ6'GZ�i�i
State Certification or Registration#: le/L l O/ 31/ ? / Certificate of Competency#: 0/ 6'00 z j G
DESIGNER:Architect/Engineer: R6110�7 /Vly e- Phone#: Ot<-V2— Zlv-'T"
Address: /7-2?7 IV � 'T-�2,�- City: XI,4w( State: P�' Zip:
Value of Work forthisPermit:$ � Square/,Unear Footage of Work: 101,E
Type of Work: Iii Additlo'W '_El"A1te`t d6tf"--071'f ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of clolor/t`�hru tile:
Submittal Fee$ S u,6 v Permit Fee$ _10,0/'4C5 40 CCF$ 0 a (00 CO/CC$
Scanning Fee$ 3 .1Cb Radon Fee$ DBPR$ 2- ' Notary$
Technology Fee$ 0 Training/Education Fee$ Cj . 2�0 Double Fee$ 0
Structural Reviews$ Bond$ - e r
TOTAL FEE NOW DUE$ _t
(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 w'1 be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of comment ent st be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in th se of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
O or AGENT NTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
�- day of ,20 1 C .by Z day of _ 20/9f ,by
who is personally known to '441� 1 44 I'�'` `� ,who is personally known to
me o w o has produced as me or who has pro ced —' as
Went``fiica on and who di take an oath. identification and ho id take n
NOTA�tY P BUC: NOTARY P Q '
-�► •••�..►► Nt KA 80TOLONGO
Sign: �°�e••. IURKA SOTOLON,_ Sign: (rotary P •State of Florida
° guic
= Not Public-State of Floiida g • o -
Print: 2018 Print: ••, , A•� ommiss #F FF 141590
Seal C sshm N FF 141590 Seal:
s�*a�s�*�r�a�w��s*�a*****mx�*+�**s*s�*�*�**s�►***�xx��s�**���x�xx��x��**��e�**�xa���a��***�s�s�w*w�sssr�sw*�**e�**a�**e�ww*�a�*asap*
APPROVED BY lans Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)
16—
C7JAN
r
4 (! 2 811805 SW 26th StreetMIAMI• Miami,Florida 33175-2474
17'i'�1W 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.
0,&M(stfaog 5
It is understood that the temporary electrical approval by the ML-wa 4ade-Building De artment is given in connection
with the building be'ng ucted nder the Building Permit # �'— — ! and Electrical
constr
Permit# L °- / -- 14 lqr at address +4 E
for owner: 9�W 0 and is beh2g 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 cutoff 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.
1,�C. . A)912y 1. "01A)0 , 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
Completion. Nota:Failure to comply with the provisions of this affidavit will result in your being unable to obtain
future Te o f Test permits.
Sigp(dtuJ6 of Owner Signature of No X0 LOOMESSANMOPINO
My Commission X comwss10N8E"�
I, being duly sworn, depose and say that �iL `Weazard
for
the above-desc ' d pr perty a that the electrical installations as now existing 4S if
temporary se is 's c ted.
Signature of E66tri ontractor Signature of Nota
My Commission SATER0PINO
I, tjp %t'being first duly sworn, depose and say t lr or
of the above described property and that I will not permit occupancy of this buil iI in i i ' e
been called for by the contractors and sub-contractors concerned and final approv y t e mspectioO•�
obtained and that I have the authority insofar as the owner of said property is concerned to prohibit occu3�. • '���''.
such final ' s ons are ob d and/or a Certificate f,Occu ancy o Completion is issued. Ffl2sosa ?*:
ify'= �. E'���✓����C g: EXPIRES
'9 t o Jun 03.2018
Signature of Building Contractor Signature of 06tary
My Commission Expires:
Date:
Signature of Electrical Inspector
Date released to FPL:
12301-124 6/06