EL-16-1000 Inspection Worksheet
Miami Shores Village (?)FP i
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-256904 Permit Number: EL-4-16-1000
Scheduled Inspection Date: June 29,2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: PUENTES,ANDRES Work Classification: Pool - Private
Job Address:354 NE 91 Street
Miami Shores, FL 33138-3130 Phone Number (786)606-9930
Parcel Number 1132060190220
Project: <NONE>
Contractor: YORK ELECTRICAL CONTRACTOR CORP. Phone: (305)962-0759
Building Department Comments
ELECTRICAL ROUGH 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
June 28,2016 For Inspections please call: (305)762-4949 Page 9 of 40
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Miami Shores Village
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10050 N.E.2nd Avenue NE Ifi} + OJI POLI aft
Miami Shores,FL 33138-0000
leeh fi � Phone: (305)795-2204
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011 a� /�1 Expiration: 11/0512016
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Project Address Parcel Number Applicant
354 NE 91 Street 1132060190220
Miami Shores, FL 33138-3130 Block: Lot: ANDRES PUENTES
Owner information Address Phone Cell
ANDRES PUENTES 354 NE 91 Street (786)606-9930
MIAMI SHORES FL 33138-
354 NE 91 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
YORK ELECTRICAL CONTRACTOR C, (305)962 0759
Total Sq Feet: 0
Type of Work:ELECTRICAL ROUGH Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning:1 Light Niche
Bonding
Review Electrical
Alarms
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee Invoice# EL-4-16-59407
$4.50 05/09/2016 Credit Card $265.20 $50.00
DCA Fee $4.50
Education Surcharge $0.40 04/14/2016 Check#:13343 $50.00 $0.00
Permit Fee-Additions/Alterations $300.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $315.20
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 certify that all the foregoing info accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the a e-na co r to do the work stated.
May 09,2016
Authorized Signature:Owner / Applicant / ontra / Agent Date
Building Department Copy
May 09,2016 1
Miami Shores Village -
Building Department I Fix APR 14 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 i
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 S
FBC 20(
BUILDING Master Permit No. (0-c1q 7
PERMIT APPLICATION sub Permit No. iEL (& 71006
❑BUILDING [YELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[]PLUMBING F-1 MECHANICAL MPUBLICWORKS M CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 2614 5t
City: Miami Shores County: Miami Dade Zip: 2015%
Folio/Parcel#: I 3eZO(0 •(ZI q •Q2 LQ Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: ^
OWNER:Name(Fee Simple Titleholder):_ Ar1d res �ipf +CS Phone#: (XQ(0•-1-11,1 C',3c-,3
Address: 3S�
City: 1.A►gr1n1 15')Ofe.S State: rL Zip: 33 31
Tenant/Lessee Name:_®j 14K Phone#:
Email: I, ( (�� (-'
CONTRACTOR:Company Name: ®✓�" ��O-�,`Ca-` �=QAaC` 00 Phone#: ° S �c2 2-O�SL
Address: (o 0� \ C 4? -S_- ,j4- ZS7
City: State: Zip: ( 15:4
Qualifier Name: , _Tv f �e-S Phone#: �01`0%4 —2-4 91�
State Certification or Registration#: t� f 3 d® S(p ScQ Certificate of Competency#:
DESIGNER:Architect/Engineer: -F_rr I I i a na CI=2,C to o?5. 4 P Phone#: -7$(40 • -115 .'1
Address: I ga 4zk City: I Omi Stateq. _Zip: t;�31q
Value of Work for this Permit:$ r3no- Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: no-Si4c.
Specify color of color thru tile:
Submittal Fee$ JPO 0�) Permit Fee$ 3.00"®G' CCF$ CO/CC$ Y�
Scanning Fee$ - Radon Fee$ (4- %�() DBPR$ Ll- Notary$ C7a
Technology Fee$ e) Training/Education Fee$ C)° q O Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ Q G 2-0
(Revised02/24/2014)
Bonding Company's Name(if applicable) IJ
Bonding Company's Address N I
City State Zip
Mortgage Lender's Name(if applicable) 1J
Mortgage Lender's Address N
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 on 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 CONTRA R
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
30 day of x'C�► Lerso=nallyknow>to
201 to by � dayof I - ��rc,X.. .20 t l-o by
whois ,who is ersonally know 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.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign• Sign ..Ia(A 10&-Oaia� F�'J
Print: Print: M 'h s�2
Seal: Seal: ----
MARCOS A.MARTINEZ j MARCOS A,MARTINEZ
MY COMMISSION#FF 008989 ' * : = MY COMMISSION#FF 008989
EXPIRES:Msy 15 2017 -_ EXPIRES:Niay 15 2017
Bonded Thru Notary Public Underwriters %„ ;°' Bonded Thru No
APPROVED BY 1 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)