EL-15-79 0
I
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-226481 Permit Number: EL-1-15-79
Scheduled Inspection Date:January 16,2015 Permit Type: Electrical- Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: PALMISANO,INGRID&ERIC Work Classification: Temp for Test
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
Infractio Passed Comments
TEMP FOR TEST INSPECTOR COMMENTS False
Inspector Comments
Passed 1E 0��
Failed ''
c �
Correction `—
Needed ❑ `�� /������' �
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 15,2015 For Inspections please call: (305)762-4949 Page 17 of 24
Miami Shores Village ���., _
Building Department JAN 13 2014 �
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
BUILDING Master Permit No. I;c )-sof
PERMIT APPLICATION Sub Permit No. 0/ �- --
BUILDING J�J'ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I DSS N t 9� Sr
City Miami Shores County: Miami Dade Zip: .j 5158
b
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): E I L I A/6 PC ?A1,A414 4,i/6 Phone#: vis —7n
Address: Pbg AFS
City: /til1Xw/ :!ukle-cj Stater Zip:
Tenant/Lessee Name: Phone#:
Email: �A-&AA[j AA)(1 A41 J, A41 CQU JO .Z0
CONTRACTOR:Company Name: 1 I/I k' (S Ax4 t&t4 rG Phone#: .T6 f ON-5 K
Address: ti) 15"k1lk k '57/--ft /9
City: <<G? / State: Zip: 7
�`oS /�r
Qualifier Name: �( 60'e/ � C� f Phone#: 36.- x-97.71 7
State Certification or Registration#: IZ ®a&:2 Certificate of Competency#: 7—7
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
lue of Wdrk for this Permit:$ � � Square/Unear Footage of work:
Type of Work: ❑',Additiign Atieeration New ❑ Repair/Replace El Demolition
Description of Work:, '
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ too'®wp 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.
4XCZ&1Z
Signature _ Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
3 day of�lct�. ,20 by _�_day of 3(1 L Y ,20 l ' ( .by
/4 A/b R 10,40 ,who is personally known to M l00ha r"19 145=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.
F
NOTARY PUBLIC: NOTARY PUBLIC: - Stat W FloWa
Robeft Murphy
MYCanmisaEE 201086
Exploss 05/2212018
Sign: A04A NA
Print: �" MOW Print: O — s24 P/
Seal: Seal:
Notary Public Stata of Florida
Robert Murphy
My Commission EE 201066
APPROVED BY f / ��� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)