ELC-16-432 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-253082 Permit Number: ELC-2-16-432
Scheduled Inspection Date: March 08, 2016 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael
Inspection Type: Final
Owner: LEONI, TODD Work Classification: Repair
Job Address: 165 NE 96 Street
Miami Shores, FL 33138-0000 Phone Number
Parcel Number 1131010250130-165
Project: <NONE>
Contractor: OHMS ELECTRICAL CONTRACTOR Phone: (954)974-3840
Building Department Comments
REPLACE ELECTRICAL PANEL Infractio Passed Comments
TO REPLACE ELC06-1228 INSPECTOR COMMENTS False
Inspector Comments
Passed a
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
March 07,2016 For Inspections please call: (305)762-4949 Page 23 of 44
I
Miami Shores Village Permit Type:Electrical -,Commercial
�0 10050 N.E.2nd Avenue NE i Work Classification., Repair
r
"�'� Miami Shores, FL 33138 0000 U Permit Status.APPROVED
Fti g«s Phone: (305)795-2204 �3�'
oe: 2122l2016 Expiration: 08/20/2016
Project Address Parcel Number Applicant
165 NE 96 Street 1131010250130-165
Miami Shores, FL 33138-0000 Block. Lot: PALAZZO LEONI LLC
Owner Information Address Phone Cell
PALAZZO LEONI LLC PO BOX 381703
MIAMI FL 33238-
PO BOX 381703
MIAMI FL 33238-
Contractor(s) Phone Cell Phone Valuation: $ 150.00
OHMS ELECTRICAL CONTRACTOR (954)974-3840
Total Sq Feet: 0
Type of Work: REPLACE ELECTRICAL PANEL Available Inspections:
Additional Info: Inspection Type:
Classification:Commercial
Final
Scanning: 1 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# ELC-2-16-58715
DBPR Fee $2.00
DCA Fee $2.00 02/22/2016 Credit Card $58.60 $ 50.00
Education Surcharge $0.20 02/17/2016 Check#: 19066 $50.00 $0.00
Permit Fee $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 ertify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construct n nd Onfria. ermore, I authorize the above-named contractor to do the work stated.
February 22, 2016
u orize Sigat re: Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 22, 2016 1
\� Miami Shores Village
RCEIVED
Building Department FEB 1 � 201s
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305)795-2204 Fax: (305) 756-8972 BY.
INSPECTION LINE PHONE NUMBER:(305)762-4949
F1B�C /201`1
BUILDING Master Permit No.�� t� " 4 3 Z-
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑E ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-]PLUMBING ❑ MECHANICAL [_]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBADDRESS: 165 NE 96TH Street
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): Q ` c1� 2 213 L eO''\ Phone#:
Address: 17 O c�yc �J?3 17d
City: 1AA i v� w� State: �' Zip: 3 L23
Tenant/Lessee Name: �j �a �,Q� "�I Phone#:
Email: (�>C'> (;D L e-0 P-4ccz it P"t 2-5: . C-0
CONTRACTOR:Company Name: OHMS Electrical Phone#: 954-974-3840
Address: 1761 Banks Road
City: Margate State: Florida Zip: 33063
Qualifier Name: Jose R Espaillat Phone#: 954-974-3840
State Certification or Registration#: EC-0001899 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$$150.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Replace electrical panel
Specify color of color thru tile:
Submittal Fee$50 . CD3 Permit Fee$ 11/bm'dd CCF$ CO/CC$ 0
Scanning Fee$ Q3 Radon Fee$ c W DBPR$ ok )C3ZN Notary$
Technology Fee$ J•bD Training/Education Fee$ Q Double Fee$
Structural Reviews$ Bond$ ��3
TOTAL FEE NOW DUE$ `-�C"J '6()
(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 ap&oved and a reinspection fee will be charged.
Signature Signature v
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
-�
day of F_4 7 20 / L by 12th day of February 20 16 by
who is ersonall �own JOSe R. ESpalllat who is ersonall known to
� personally
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
OR
Print: A A) J Lo y C,!'t (;—) Z`. Print: I Win"
Seal: Seal: '• EXPIRES:June 26,2019
Bonded Thru Notary Pubic undawbm
*Z�gADREW VOGEL
SIONMFP919683
APPROVE % %� ,��1 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)