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
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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
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'b'�� Buildin Department ' ` D
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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)