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EL-15-2513 Inspection Worksheet Miami Shores Village S - to6 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756.8972 Inspection Number: INSP-244815 PermitNumber: EL-10-15-2513 Scheduled Inspection Date:April 08,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: CARLA GRISONI,CANOR PATO Work Classification: Addition/Alteration Job Address:162 NW 109 Street Miami Shores, FL 33168-4317 Phone Number Parcel Number 1121360100220 Project: <NONE> Contractor: ATLANTIS ELECTRICAL CORP Phone: (305)551-4043 Building Department Comments ELECTRIC WORK FOR GARBAGE CONVERSION TO Infraetio Passed Comments INCLUDE(6) LIGHTS,(8)OUTLETS,(7)SWITCHES INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed ❑ l� Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid April 07,2016 For Inspections please call: (305)762.4949 Page 1 of 27 Miami Shores Village 10050 N.E.2nd Avenue NW �t ••^ Miami Shores,FL 33138-0000 j Phone: (305)795-2204 Project Address Parcel Number Applicant 162 NW 109 Street 1121360100220 CANOR PATO CARLA GRISONI Miami Shores, FL 33168-4317 Block: Lot: Owner information Address Phone Cell CANOR PATO CARLA GRISONI 162 NW 109 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 3,200.00 ATLANTIS ELECTRICAL CORP (305)551-4043 Total Sq Feet: 0 Type of Work:ELECTRIC WORK FOR GARBAGE CONVERSIO Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:3 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W.W. Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# EL-10-15-57299 DBPR Fee $3.38 10/02/2015 Credit Card $50.00 $197.16 DCA Fee $3.38 Education Surcharge $0.80 10/162015 Credit Card $197.16 $0.00 Permit Fee-Additions/Aiterations $225.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $247.16 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: Icert' hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. F re,I authorize the above-named contractor to do the work stated. October 16,2015 Authorized Sign re:Owner J Applicant / Contractor / Agent Date Building Department Copy October 16,2015 1 Miami Shores Village N Building Department OCT o2 05 I 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20(0 BUILDING Master Permit No. 2C- I5- IDZ6 PERMIT APPLICATION Sub Permit No. F_L I5- 2-5 45 BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL r-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:. 1 WL MLo ldct slrne-A City: Miami Shores County: Miami Dade Zip 231 lD$ Folio/Parcel#: l 1 213 0 CV) t�126 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type`` --: Flood Zone: BFE: FFE: f OWNER:Name(Fee Simple Titleholder): 0_apaQ� Phone#:_ 32( 9c_4H Address: ` g Z. M UU lag 51-reeA- City: �_kllQ.UVtle,°.-:�1 State: Zip:n(A Tenant/Lessee Name: Phone#: 3UG 321 900q Email: CONTRACTOR:Company Name: �� S 'T fz�C Phone#: Address: ki" SLO Qc 'Le'a City: State: Zip: Qualifier Name: f Z Phone#: 42(0 A95b State Certification or Registration#: EQ.- Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State Zip: Value of Work for-this Permit: zroo Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration /+❑ New ❑ Repair/Replace ❑ Demolition Description of Work: C4G (Q GcJ�/ P_)C- &Z_ G&24&& CC,l J�QW 7n Specify color of color thru tile: Submittal Fee$ Permit Fee$ o®� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ II TOTAL FEE NOW DUE$ 1 �� • t (Revised02/24/2014) w " 1 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signat a Signature OWNER or AGENT CONTRACTOR The foregoing instrument -was acknowledged before me this The foregoing instrument was acknowledged before me this day of I 1�1e� .20 15 by �day of (7 ►QA ager .20 IS ,by c" Po�� .who is personally known to :�c+o P�le2 who i ersonally know—p--Ib me or who has produced n0,FNr as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign:'- Sign Print: 2)wlA ► Print: Seal REBECA M.PASTRANA Seal: REBECA M.PASTRANA MY CQMMISSION N BE872624 nsv<,vN1SSION 0 EE872624 ` � SIRES:Febteary O7,2017 " A` �?t!'SKES:F�rasry O7,2017 *� m�xs��a�e�ra��s�sr+��x*�x�x�r APPROVED BY /.$'Plans Examiner Zoning Structural Review Clerk (Revisedo2/24/2014) 1 007 or 31 7IC! I & V Law R 1�-� t (Nr ovum" SEC.TYPE OF 8VOWess' PAYaABNr 1MCE11ER ATLA"S ELECTRICPORP . 196 ELEG�:1 BY rnx COUBCrDFf CONTRACTOR WO S) ,. EC13t914 + IECK2115-t�5n9 Aia tae� ,�. Tas mit �i�a tm�i Tax.i�Ike to�rt a tom;, be ark., gull 's � N�taaret ru�aa�tt� Tie r:, Co�89aBs • M Y�