EL-15-869 Inspection Worksheet t-11
Miami Shores Village kc
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-232434 Permit Number: EL-4-15-869
Scheduled Inspection Date: May 09,2016 Permit Type: Electrical- Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: OLASO, M CLAUDIA Work Classification: Addition/Alteration
Job Address:55 NE 99 Street
Miami Shores,FL Phone Number
Parcel Number 1132060131290
Project: <NONE>
Contractor: ATLANTIS ELECTRICAL CORP Phone: (305)551-4043
Building Department Comments
ELECTRICAL WORK FOR RELOCATED KITCHEN AND Infractio Passed Comments
LAUNDRY AND NEW BATH AS PER PLANS. INSPECTOR COMMENTS False
Inspector Comments
Passed E�/
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
May 06,2016 For Inspections please call: (305)762-4949 Page 3 of 45
Miami Shores Village �rr
`r
10050 N.E.2nd Avenue NE
:
Miami Shores,FL 33138-0000
` Phone: (305)795-2204
Project Address Parcel Number Applicant
55 NE 99 Street 1132060131290
M CLAUDIA OLASO
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
M CLAUDIA OLASO 55 NE 99 ST
MIAMI SHORES FL 33138-2338
Contractor(s) Phone Cell Phone Valuation: $ 3,100.00
ATLANTIS ELECTRICAL CORP (305)551-4043 Total Sq Feet: 300
Type of Work:ELECTRICAL WORK FOR RELOCATED KITCH Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning:1 Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
Underground
W.W.
Fees Due AmountPay Date Pay Type Amt Paid Amt Due
CCF $2.40 Invoice# EL-4-15-55191
DBPR Fee $3.38 08/28/2015 Credit Card $191.16 $50.00
DCA Fee $3.38
Education Surcharge $0.80 04/14/2015 Credit Card $50.00 $0.00
Permit Fee-Additions/Aiterations $225.00
Scanning Fee $3.00
Technology Fee $3.20
Total: $241.16
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 rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin uthermore,I authorize the above-named contractor to do the work stated.
August 28,2015
Autho gnature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
August 28,2015 1
Miami Shores Village �C --- D
Building Department IP 1 0015 "
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Bim_
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2016
BUILDING Master Permit Noll I S"
PERMIT APPLICATION Sub Permit Na�L
❑BUILDING FA ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: SS E 5Ly ee-
City: Miami Shores County: Miami Dade Zip: 33
Folio/Parcel#: tj c >aOL2 613_2 17-90 Is the Building Historically Designated:Yes NO_ Q
Occupancy Type: Load: Construction Type: Flood Zone: f BFE: FFE:
OWNER:Name(Fee Simple Titleholder):M• Q t(�o ( ]�a_Sa Phone#:_�W(0`2'00' �R �
Address: S5 �E S-Qq eek
City:Micwni sy\ck&s State: I=' Zip:
Tenant/Lessee Name: Phone#:
Email: n �,
CONTRACTOR:Company Name: Phone#:
Address: 12 n3 —W) 2-n k rr-
City: 4.. "e?Mi t State: -�� Zip: 331 5
Qualifier Name: ro►�1(�_iSPn �te2 _T Phone#: 4
V
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: �(�� � City: State: Zi
Value of Work for this Permit:$3,�o .-- Square/Linear Footage of Work: ?06
Type of Work: 0 Addition r❑ Alteration ❑ New / EJRepair/Replace F-1Demolition
��
Description of Work: 0t19%C-*L- cusa`_ 116 It �Cai'lcMXA_) 4 fZ -f
jq+,o njMW &#'i+ i� 0452 p6�S
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ s' �id6 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ �
(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 approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrum nt wa�acknowledged before me this The foregoing instrument as a knowledged before me this
day of i 1 201!5 by 114 ,day of_
'201S ,by
[_IGIX�i�A D(Cts1/�� ,who is personally known toa(1�iS� Z ,who is personally,known to
me or who has produced D C, � do '7:::r'*14e as me or who has produced111
Q/1'�'( as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sig Sign:
Print: Print:
Seal: Seal: `"" REBECA M.PASTRMA
�REBECA M.PASTRANA
My COMOSSION&EEM24 MY COIMIWIISSION#EEVM24
EXPIRES:Fy07,2017 'AW MAPS:Fy07,2017
*********** ************************************ *** *********
APPROVED BY � r� Aerld Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)