EL-16-2745 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-269980 PermitNumber: EL-10-16-2745
Scheduled Inspection Date: October 31,2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: SANDOVAL, RICARDO Work Classification: Alteration
Job Address:610 NE 105 Street
Miami Shores, FL 33138-2054 Phone Number
Parcel Number 1122310120160
Project: <NONE>
Contractor: MOODY ELECTRIC INC Phone: (305)758-2000
Building Department Comments
SERVICE REPAIR NEW DROP BY FPL SECURED Infractio Passed Comments
EXISTING RISER INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-268993. REBECA 12:18 PM
E�r CANCELLED INSPECTION
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 28,2016 For Inspections please call: (305)762-4949 Page 27 of 31
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Miami Shores Village �f�NB trioai 1 4' 0f1 ( W
10050 N.E.2nd Avenue NE
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Miami Shores,FL 33138-0000
h- Phone: (305)79x2204 ��
Expiration: 04109/2017
Issue,Di
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Project Address Parcel Number Applicant
610 NE 105 Street 1122310120160
Miami Shores, FL 33138-2054 Block: Lot: RICARDO SANDOVAL
Owner Information Address Phone Cell
RICARDO SANDOVAL 610 NE 105 Street
MIAMI SHORES FL 33138-2054
Contractor(s) Phone Cell Phone Valuation: $ 120.00
MOODY ELECTRIC INC (305)758-2000
_._.
Total Sq Feet: 0
Type of Work:SERVICE REPAIR NEW DROP BY FPL SECU Available Inspections:
Additional Info:SERVICE REPAIR NEW DROP BY FPL SECU Inspection Type:
Classification:Residential
Review Electrical
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# EL-10-16-61600
DBPR Fee $2.25
DCA Fee $2.25 10/11/2016 Credit Card $109.10 $50.00
Education Surcharge $0.20 10/11/2016 Credit Card $50.00 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERSall the fo information is accurate and that all work will be done in compliance with all applicable laws regulating
constructiIn
g ut rm re,1 authorize the a ove-named contractor to do the work stated.
October 11,2016
A thorize�epartment
nature:Owner / Applicant / Contractor / Agent Date
Building Copy
October 11,2016 1
_Oep ` Miami
Mlal Shores Village OCT 112016
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949 to I
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: Electrical
OWNER:Name(Fee Simple Titleholder): l zId � l Phone#: 454r�® �
Address: 610
!� Zip:
City: State:�L�/..P✓//'� �`_�F��.J� '
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: [/8(.rc I FI fl If I Li2(. Phone#: %�;s - zlc��
Address: 7 N . 7_(J1 fy q t'm 1 c_
City: ��� Y I i Wel"Yj State: Zip:
Qualifier Name: )(11(1 ��Crf_\ i Phone#: 3CS"7:-�,'�- 26r-r-1
State Certification or Registration#: F C-occ d l q Certificate of Competency#:
Contact Phone#: Email Address: /`,'t1 n YY C I ff tr ,C C-C:On
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ I ) Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New epair/Replace ODemolition
Description of Work:
Y � I �
v
Submittal Fee$—,50• Permit Fee$ 16'2;'e'PU CCF$ CO/CC$
Scanning Fee$ ®® Radon Fee$ �e Z� DBPR$ Z • Z f5Band$ �
Notary$ _4q7� Training/Education Fee$ 2® Technology Fee$ •
Double Fee$ Structural Review$
10
TOTAL FEE NOW DUE$ ! •
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 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 cop��s
he otic of commencement and construction lien law brochure will be delivered to the person
whose property is subject to alta Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection wi7igh even O days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approv and reinspe ion fee will be charged.
r
Signature Si
Owner or Agent Contrac r
The foregoing instrument was acknowledged before me this +The foregoing instrument was acknowledged before me thissn
day of OC}OLX ,20 jam,by�:e. I(0 r U �IY1C��V�I day of��G�:'tl- ,20�,by JC��`n � M ,
who isXSrsonaJ1yJ=wn to me or who has produced who is person ly 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:
M Commission Expires: M Commission i Ret>eca Munoz
My $fir Notary Public state of F1otida y Qty � lyy commisaion FF 918344
+� Rebeaa Minn FFF 918344 `or n F-�Ila 09/08x1019
ExPft909M=19
APPROVED BY 1164 1 1- ��� �
� � Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)