EL-16-3204 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-272148 Permit Number: EL-11-16-3204
Scheduled Inspection Date: December 01, 2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Rh
Owner: GANDUR,ALAIN Work Classification: Addition/Alteration
Job Address:9039 NE 4 Avenue Road
Miami Shores, FL
Phone Number
Parcel Number 1132060460200
Project: <NONE>
Contractor: METRO ELECTRIC SERVICE, INC Phone: (305)945-1991
Building Department Comments
CHANGE THREE PENDANT LIGHTS WITH THREE HIGH Infractio Passed Comments
HATS INSPECTOR COMMENTS False
Inspector Comments
Passed /
Failed
Correction A
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 30,2016 For Inspections please call: (305)762-4949 Page 29 of 33
Permit N0. EL-11i-16-3204
�SgottEs iii Miami Shores Village Permit Type: Electrical -Residential
a 10050 N.E.2nd Avenue NE ' '
WarkCfassifieation.�Addition/Alteration
Miami Shores, FL 3313&0000 permit Status:APPROVED
Phone: (305)795-2204
NY 5tH
FLORIDA`
W,11/2912016 Expiration: 05123!2017
Project Address Parcel Number Applicant
9039 NE 4 Avenue Road 1132060460200
ALAIN GANDUR
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
ALAIN GANDUR 9039 NE 4 Avenue Road
MIAMI SHORES FL 33138-
9039 NE 4 Avenue Road
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 150.00
METRO ELECTRIC SERVICE, INC (305)945-1991 (305)945-1991
Total Sq Feet: 0
Type of Work:CHANGE THREE PENDANT LIGHTS WITH TH Available Inspections:
Additional Info:CHANGE THREE PENDANT LIGHTS WITH TH Inspection Type:
Classification:Residential
Scanning: 1 Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
W.W.
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# EL-11-16-62161
$2.25 11/29/2016 Check#: 122 $ 109.10 $50.00
DCA Fee $2.25
Education Surcharge $0.20 11/22/2016 Check#: 117 $50.00 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
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 AFFI T: I certify tha 11 the for going information is accurate and that all work will be done in compliance with all applicable laws regulating
constructionydzing. Fut rm I author a the bove-named contractor to do the work stated.
November 29, 2016
uthorized Si.
:Owner / Applicant / Contractor / Agent Date
Building Department Copy
November 29, 2016 1
Miami Shores Village NOV 22 2016
Building Department BY: -
i 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
V Tel: (305)795-2204 Fax:(305)756-8972 y�_
INSPECTION LINE PHONE NUMBER:(305)762-4949
GFBC 201Y
BUILDING Master Permit No. C I ( � — 3 W
PERMIT APPLICATION Sub Permit No.
❑BUILDING X ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING 7 MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
90339 ,{ CONTRACTOR DRAWINGS
G�/ [ 9
JOB ADDRESS: '? V 'v L 1 Q'
City: Miami Shores County: Miami Dade Zip: 33/30
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: �Construction Type: � tr?�Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): y'T t i, I ) 604 Z)2 Phone#:
Address: _ qe�� _IA'16' � /��
City: 91�Ae,&S State: 14� Zip: 32�1 3/
Tenant/Lessee Name: _ _ Phone#:
Email: ACOA
CONTRACTOR:Company Name: C-' 1C" _594rJi(
Phone#:
Address: a� ,
Cit I C Vot I State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition E:1 Alteration n❑ New ❑ Repair/Replace ❑ Demolition
9/
Description of Work: 0 6e /ffR.Q� f -)A ''�'� d 6,?5 (0/7-4 ZfJIt�
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ / 5✓� <L'U CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ tOPw
(Revi sed02/24/2014)
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 estimat ad- be exceeding$ 00, the applicant must
promise in good faith that a copy of the notice of commencement and construction ren law brochure will be elivered to the person
whose property is subject to t ent. Also, a certified copy of the recorded notice of commencement mus e po t}he job site
for the first insp tion whi h occ rs seven (7) days after the building per is issued. In the absence f su pos d notice, the
inspection will no be appr ved and reinspection fee will be charged.
Signature Signatu
OWNER r AGENT CONTRA 0
The foregoing instrum t was ackno ledged before me this The foregoing instrument w acknowledged before me this
day of �dMoi 60/ ,20.//� by i>> day of V 20-- — y�.
tfio O RIUDO .. who is personally known to ��''tu� SAW is'personally known'
me or who has produced ��r �� V// ��/ a3 me or who has produced _ --"l as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: I Q �'� Print:
MISS
o c.'•
Seal: MAHARAIK.GONZALEZ Seal: _# `�"•= Notary Public -State of Florida
;;�YP�'•. Commission # FF 989121
' '- MY COMMISSION#GG 044602
EXPIRES:November2,2020 ?,;F opt M Comm. Expires May 4,2020
rP? "°�
Y
e•• o Bonded Thru Notary Public Underwrite
APPROVED BY '^� Y Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)