EL-16-637 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,Fl. (0— (3�
Phone: (305)795-2204 Fax: (305)756.8972
Inspection Number: INSP-254475 Permit Number: EL-3-16-637
Scheduled Inspection Date:April 11,2016 Permit Type: Electrical- Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner. JULNOR JEAN,JOSEPHINESIMEON Work Classification: Solar
Job Address:375 NW 111 Street
Miami Shores,FL 33168-3303 Phone Number
Parcel Number 1121360010760
Project <NONE>
Contractor: GOLDIN SOLAR, LLC Phone: (305)469-9790
Building Department Comments
SOLAR PHOTOVOLTAIC TIED TO GRID Infractio Passed comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
Apra 08,2016 For Inspections please call: (305)762-4949 Page 18 of 42
Miami Shores Village
10050 N.E.2nd Avenue NWx .
Miami Shores,FL 33138-0000
Phone: (305)795-2204 a �
Expiration:0912112016
Project Address Parcel Number Applicant
376 NW 111 Street 1121360010760 JOSEPHINESIMEON JULNOR JE
Miami Shores, FL 33168-3303 Block: Lot:
Owner information Address Phone Cell
JOSEPHINESIMEON JULNOR JEAN 375 NW 111 Street
MIAMI SHORES FL 33168-3303
Contractor(s) Phone Cell Phone $ 5,000.00
GOLDIN SOLAR,LLC (305)469-9790 Valuation:
Total Sq Feet: 0
Type of Work:SOLAR PHOTOVOLTAIC TIED TO GRID 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 $3.00 Invoice# EL-3-16-58975
DBPR Fee $2'63 03/10/2016 Credit Card $50.00 $141.26
DCA Fee $2.63
Education Surcharge $1.00 03/25/2016 Credit Card $141.26 $0.00
Permit Fee-Additions/Alterations $175.00
Scanning Fee $3.00
Technology Fee $4.00
Total: $191.25
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 AFFID IT: 'aa ore 'ng information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an n Futhennore I e above-named contractor to do the work stated.
March 25,2016
Autho Applicant ! Contractor / AgentDate
Building Department Copy
March 25,2016 1
Miami Shores Village Fy M r�TVI F--,D
Building Department MAR 1 d 2096
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 �.
Tel:(305)795-2204 Fax:(305)756-8972 2, '
INSPECTION LINE PHONE NUMBER:(305)762-4949
F�BCC 20 H
BUILDING Master Permit No. 1"--t -4(0 —6-3�
PERMIT APPLICATION Sub Permit No. Va,16 -,C;s i'
❑BUILDING t ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL
❑PLUMBING ❑MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
c CONTRACTOR DRAWINGS
JOB ADDRESS: 37J 'y A,,`�w I I I T', S�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
r
OWNER:Name(Fee Simple Titleholder): 14113 J ea r Phone#:
Address: ,S W 11111"N
City: S State: �t Zip:
Tenant/Lessee Name: Phone#:
Email: ccp G
CONTRACTOR:Compan Name: '� J a�Gd' Phone#: 30S-VL9�97?0
Address: a4�T De/c il JG., P�V-t–
City: Kia.•,. State: �� Zip:r�
Qualifier Name: /t^ l.� � Phone#: 305 `69--7796
State Certification or Registration#: Certificate of competency#:
DESIGNER:Architect/Engineer: ✓i Phone#: q%_ 736-1W
625 SU.a &2 4 1�ve city: F1 p: 3 yY
Address: ��+• State: Zi
Value of Work for this Permit:$_ � 000 Square/Linear Footage of Work:
Type of Work:
El Alterati n L�/New [� Repair/Replace ❑ Demolition
c
Description of Work: �/® l
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ 3 ' CO/CC$
Scanning Fee$ 3 Radon Fee$ DBPR$—Q I Notary$
Technology Fee$ d Training/Education Fee$ 1- Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014) *L -qoW
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.
Signature Signature
NER or AGENT CONTRACTOR
The foregoing inst mt wasaccknowledged before me this The foregoing instrument was acknowledged before me this
day of 1'/�idA* ,20 ((D .by 41 _day of L4A&4%J^- ,20 1C, .by
0 IL ,who is personally known to 'C'lt.tti efts t i-+^ ,who is personally known to
me or who has produced A)11 p, ,X►twi USA as me or who has produced f:- *Di':%W5, L:-ea-Was
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
�.
Sign: SigI N- It .
Print: Print: At-,c.S Lb
HUMPSeal: Seal:
COMMISSION#FF223731 A�CA6Y.LC
EXPIRES: Jury 17, 20119 No"PI ►�soiF**
A
g'% ,•° www.AARONNOTARY.COM ConnUM FF 140706
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)