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ELC-16-3236 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 00 Inspection Number: INSP-272013 PermitNumber: ELC-11-16-3236 Scheduled Inspection Date: December 07, 2016 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: MIAMI,ARCHDIOCESE OF Work Classification: Addition/Alteration Job Address:10690 NE 5 Avenue Miami Shores,FL Phone Number (305)762-1033 Parcel Number 1122310430010 Project: <NONE> Contractor: MOODY ELECTRIC INC Phone: (305)758-2000 Building Department Comments INSTALL NEW CHARGING STATIONS IN CLASSROOMS, Infractio Passed Comments INSTALL NEW FIXTURES. INSPECTOR COMMENTS False TO REPLACE PERMIT NUMBER ELC-15-1756 Inspector Comments Passed f Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 06,2016 For Inspections please call: (305)762-4949 Page 19 of 29 `�x Fps it Miami Shores Village T Ele+�� > erciat k �g s 10050 N.E.2nd Avenue NE •••• Miami Shores,FL 33138-0000 Phone: (305)795-2204F, - n� � Expiration: 06/03/2017 Project Address Parcel Number Applicant 10690 NE 5 Avenue 1122310430010 ARCHDIOCESE OF MIAMI Miami Shores, FL Block: Lot: Owner Information Address Phone Cell ARCHDIOCESE OF MIAMI 415 NE 105 ST (305)762-1033 MIAMI SHORES FL Contractor(s) Phone Cell Phone $ 15,000.00 MOODY ELECTRIC INC (305)758-2000 Valuation: Total Sq Feet: 0 Type of Work:INSTALL NEW CHARGING STATIONS IN CL Available Inspections: Additional Info: Inspection Type: Classification:Commercial Final Scanning:1 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 $9.00 Invoice# ELC-11-16-62199 DBPR Fee $37.04 12/05/2016 Check#:54068 $470.79 $50.00 DCA Fee $6.75 Education Surcharge $3.00 11/29/2016 Credit Card $50.00 $0.00 Permit Fee $450.00 Scanning Fee $3.00 Technology Fee $12.00 Total: $520.79 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT* I ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructi d zonin ermore,I au the above-named contractor to do the work stated. December 05,2016 ffithorded Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy December 05,2016 1 Miami Shores Village Tv"r Building Department 17Ni � o )nic 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 LO Y"4--( ' INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING Permit No. PERMIT APPLICATION Master Permit No.W 7—/,6--1705' FB C 20 F1_C 7-- 754 4 Permit Type: Electrical OWNER:Name(Fee Si Titleholder): Phone#: Address: tal City: State: F:��,O_C C),4- Zip: I Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: I U(9 0 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR: Company Name: lG tom, Phone#: � 7 ' Address: �� ® - City: State: ELPee,ZA Zip: Qualifier Name: o 4Phone#: q 86 °236.06SO State Certification or Registration#: Certificate of Competency#: Ed ! il'?l Contact Phone#: 00,153 Email Address DESIGNER:Architect/Engineer: AJ11A Phone#: As Value of Work for this Permit:$ —�' '� Square/Linear Footage of Work: Type of Work: ❑Address DAlteration ONew 21kepair/Replace UDemolition Description of Work: A j Z®® FU A rAj ��:xxxxxx��xx��x�x�x�x��xxxxx�x�xxxxxFees��xx�xxxxn�xx�xx�x��xxxxx��xx��xx��xx Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ Bonding Company's Name(if applicable) N f 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 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. Signature6Signature er or A-gent Contractor Z� The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this g ' g g ,� day of o if p ,201!2.,by �r. Ef ya,b day of N()lII'M W1',20&,by JLJ11V) 1. Mo U who is personally known to nor who has produced who is personally 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 PUBLI r Sign: Sign: Print: kaA Print: � KATHLEEN M BOST M . Rebice Munoz My Commission Expires: : ' " y Commission Expi s ` My Common FF 919344 MY COMMISSION#FF216626 aao� EXOMS 091=019 EXPIRES APM 02,2019 !4117 3b0 0'53 PIm�OW01e +k+kskkkak9kakkakkkNskaknkkakakls 4ekik:kkakkkkR+k�akk�:ktkskakkskakHskkkakakeksIaakkakskakskIsa#�aakk=kknkslakkkkHkskakakak APPROVED BY r�PA�my/4 Plans Examiner Zoning Structural Review tna a ew Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)