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ELC-16-705 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-256189 PermitNumber: ELC-3-16-705 Scheduled Inspection Date:April 05,2016 Permit Type: Electrical-Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: , Work Classification: Addition/Alteration Job Address:9823 NE 4 Avenue Miami Shores,FL Phone Number Parcel Number 1132060170330 Project: <NONE> Contractor. MOODY ELECTRIC INC Phone: (305)758-2000 Building Department Comments REMOVE ROMEX IN 18 CLASSROOMS REPLACE WITH Infractio Passed Comments MC CABLE ADN 1900 BOXES PROPER SPLICES INSPECTOR COMMENTS False Inspector Comments Passed D �0 Failed Correction /7--� Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid April 04,2016 For Inspections please call: (305)762-4949 Page 21 of 32 Miami Shores Village : 10050 N.E.2nd Avenue NE , Miami ShoresFL 33138-0000 w Phone: (305)795-2204 Expiration: 09/191201 Project Address Parcel Number Applicant 9823 NE 4 Avenue 1132060170330 MIAMI SHORES COMM CHURCH Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MIAMI SHORES COMM CHURCH INC 9823 NE 4 AVE MIAMI FL 33138-2402 Contractor(s) Phone Cell Phone Valuation: $ 11,200.00 MOODY ELECTRIC INC (305)758-2000 -- — Total Sq Feet: 0 Type of Work:REMOVE ROMEX IN 18 CLASSROOMS REPLA Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $7.20 Invoice# ELC-3-16-59055 DBPR Fee $5.04 03/22/2016 Credit Card $368.28 $0.00 DCA Fee $5.04 Education Surcharge $2.40 Permit Fee $336.00 Scanning Fee $3.00 TeChnolo$y Fee $9.60 Total:',-;':( $368.28 L..i CJI 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 pertainin"ereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting fAis permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required f&ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNER&-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 zo ' . uthermo ,I authorize the above-named contractor to do the work stated. March 22,2016 A44horized Signature:Owner / Vpplicant / Contractor / Agent a e Builcling Department Copy March 22,2016 1 Miami Shores Village g - 'b'�� Buildin Department ' ` D � g p LBY: MAR 1:7 2o�s 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2014 Ste` BUILDING Master Permit No. F—L J(--70S PERMIT APPLICATION Sub Permit No. F-1 BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ?go-13 �� � � - City: Miami Shores County: Miami Dade Z)g: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Phone#: c Address: City: Stante: Zip: Tenant/Lessee Name: /(/�f7 Phone#: Email: CONTRACTOR:Company Name: / �/i /&Phone#: � S�JdI�C fG/ Address: City: State: / Zip: Qualifier Name: //��—,,—_�� Phone#: 1565-758R06)0 State Certification or Registration#: [�6010 1199 Certificate of Competency#: DESIGNER:Architect/Engineer: /i//� Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 0 0 Square/Linear Footage of work: Type of Work: ❑ Additi n ❑ Alteration ❑ New Repair/Replace/ Q ❑ Demolition Description ork:f&A,1042 ,� 2'i / U _fir/ qz- Specify color,of color thru tile: Submittal Fee$ Permit Fee$ CCF$ Pj CO/CC$ Scanning Fee$ C Radon Fee$ dS-()y DBPR$ 0�0� i Notary$ Technology Fee$ LS Training/Education Fee$ c2, qO Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ � ) •sfV (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 on-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. 1 Signatur e&" Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day �of)��/r�rC ,20 ,by _L�day of M(-C I ,20 1(0 ,by K wl ,who is personally known to 'uh1i S• MC T who is personally known to 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: —+U/Vv� Print Print: Seal: Seal: �yr4rry X40 gN Notary Public State d Plaids °kr� NOM Pubft State dFbrMe Reber plhlnp� Rebeca Munoz My CO MMut+ron Rf 818344 ' My COmmle m FF 818344 APPROVED BY ,�� � Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)