EL-16-1255 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 EPp 1('2
Inspection Number: INSP-271751 Permit Number: EL-5-16-1255
Scheduled Inspection Date: November 28, 2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: GLINN, MacDAM & DENISE Work Classification: Pool - Private
Job Address:1201 NE 102 Street
Miami Shores, FL 33138-
Phone Number
Parcel Number 1132050250160
Project: <NONE>
Contractor: MESA BROTHERS INC Phone: (305)345-1974
Building Department Comments
POOL ELECTRIC WORK Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-258540.
Faded
Correction 2
Needed
Re-inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 23,2016 For Inspections please call: (305)762-4949 Page 21 of 23
Miami Shores Village
CF
Building Department MA16
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax: (305)756.8972 BY•
INSPECTION'S PHONE NUMBER: (305)762.4949 UU
FBC 20 l
BUILDING Permit No.jF
l —
PERMIT APPLICATION Master Permit No. PT1 16 PI_
Permit Type: Electrical
JOB ADDRESS: 1201 NE 102 St
City: Miami Shores County: Miami Dade zip: 33138
Folio/Parcel#: 11-3205-025-0160
Is the Building Historically Designated:Yes NO X Flood Zone:
OWNER:Name(Fee Simple Titleholder):Macadam Glinn Phone#:
Address: 1201 NE 102 St
City: Miami Shores State: Fl zip: 33138
Tenant/Lessee Name:_ Phone#:
Email:
CONTRACTOR:Company Name: Mesa Brothers, Inc Phone#: 305-630-2549
Address: 5215 SW 103 Ave
City: Miami State" Fl Zip: 33165
Qualifier Name: Raul Mesa Phone#: 305-345-1974
State Certification or Registration#: EC13001870 Certificate of Competency#:
Contact Phone#: Email Address: mesabrothers@att.net
DESIGNER:Architect/Engineer: C)rvz �'Y=. Lo(0--54N Phone#: '7 -•l i« -'7
Value of Work for this Permit:$950.00 Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: S. Pool electric Work
x�x��xxx�xa�����axx�x�xxxx�x�xx:xx��x:�`�`*Fees'�'�'�'�xxxxx�xxxxxxx��xxxx��xx�x�x:�xxwx��xmm���:
Submittal Fee$_ S3 ° Qi�) Permit Fee$ CCF$ ® CO/CC$
Scanning Fee$ 7� a (-i.1 Radon Fee$ ! ' • �c� DBPR$ 4•9® Bond$ �)
Notary$ Training/Education Fee$ Technology Fee$ ® a 0
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$_ ®�� � GO
Bonding Company's Name(if applicable)
Bonding Company's Address Q
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address 1�
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 ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 com_menruffienfatust be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. n the senee o ueh posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature-,'
Owner o gent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged be
'or/e me this
day of 1 ,20 l by day of ,O ,20�,by /�-� ,
who i ersonally known ttOme or who has produced who is perso ally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: �� _ _ . ..... Print: o,...
NANCY TEJADA
MISSION AEE0847
MARCOS A.M/9TINCt PiR ,i� 2018
My Commission Exp' >' c- _ MY COMMIS&ON#FF 008c,189 My Commission E it e �ti,r e Insurance
EXJIRls:MJY 15 2017 v
E cnd d Thru Not3ry Public Underwriters
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APPROVED BY /®illi y Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)