EL-14-1371 T.. C )
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-227999 Permit Number: EL-6-14-1371
Scheduled Inspection Date: February 12,2015 Permit Type: Electrical - Residential
Inspector: Devaney,Michael
Inspection Type: Final
Owner: PALMISANO, INGRID$ERIC Work Classification: Low Voltage
Job Address:1035 NE 96 Street
Miami Shores, FL Phone Number
Parcel Number 1132060143730
Project: <NONE>
Contractor: MIKES CUSTOM ELECTRIC SERVICE INC Phone: (305)969-5460
Building Department Comments
LOW VOLTAGE Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comme
Passed
Failed
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
February 11,2015 For Inspections please call: (305)762-4949 Page 19 of 22
Miami Shores Village
Building Department J 2m
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC 120/d
BUILDING Master Permit No./,72--" /"/I -3cllo
PERMIT APPLICATION Sub Permit No.��// _Zz
r-jBUILDING ETIELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION SHOP
C� CONTRACTOR DRAWINGS
JOB ADDRESS: ® � r/1, -e- G �c 5
City: Miami Shores County: Miami Dade zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Oc : c cupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):4 / i'G - Yl Ci( � )SO/10 Phone#: , ' `�'d I F3
ddress: r®3 s /V c' �'� �/
City: A( �l m 1 �hr�rP-� State: F L- Zip: _3313 6
nant/Lessee Name: Phone#:
Email: �/f ! C -` ./ c�/ !,
CONTRACTOR:Company Name:/ t '14e"_S C t s-lo m �tt C�'!��L Phone#:30. l O 2 `�7 166
Address:
City: 04 C a State: \ Zip:
Qualifier Name:_ / r W[�-� l tc4mq-3 Phone#:
State Certification or Registration#: f 2 0 O :Z 9 Certificate of Competency#: Cc C�J,L DO 6 Z7
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ®b (9 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration / 2--New / ❑ Repair/Replace ❑ Demolition
Description of Work: TtA V
Specify color of color thni tile: ffll,�•�0�
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ J
TOTAL FEE NOW DUE$ I •�
(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 O�—�� Signature..
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of Jll 020 by day of�w'� ,20 by
who is personally known to /� �� w who is personally known to
ME or who has producedPy�`��ll� � as me or who has produced������6� 'as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign-
rint
Nal ary Punic Stats of Florida
Seal: JoaM Feliciano Seal:
nna Notary Pink State Fla
My Cornmteabn FF 082753 Joanna JOannB M Feffciarb
E 01112rMa 4 w My Com►►dsNon FF 082753
ENi 01!1202018
Ob 04 A
APPROVED BY o; ✓4/LoKns Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)