EL-15-3201 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-250149 Permit Number: EL-12-15-3201
Scheduled Inspection Date: May 17,2016 Permit Type: Electrical- Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: PERAGALLO, DINO&IRENE Work Classification: Pool - Private
Job Address:55 NE 97 Street
Miami Shores, FL 33138-
Phone Number (305)995-5224
Parcel Number 1132060130990
Project: <NONE>
Contractor: MESA BROTHERS INC Phone: (305)345-1974
Building Department Comments
ELECTRICAL FOR NEW POOL, SPA 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
May 16,2016 For Inspections please call: (305)762-4949 Page 7 of 32
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Miami Shores Village
10050 N.E.2nd Avenue NE yi£
iS #fGar ) tl�
Miami Shores,FL 33138-0000
Phone: (305)795-22043
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Expiration:€
Project Address Parcel Number Applicant
55 NE 97 Street 1132060130990 DINO&IRENE PERAGALLO
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
DINO&IRENE PERAGALLO 55 NE 97 Street (305)995-5224
MIAMI SHORES FL 33138-
55 NE 97 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 900.00
MESA BROTHERS INC (305)345-1974
... ._ ::._........__.M Total Sq Feet: 00
Type of Work:ELECTRICAL FOR NEW POOL, SPA Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning:3 Light Niche
Bonding
Review Electrical
Alarms
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# EL-12-15-58183
DBPR Fee $5.25 12/29/2015 Check#:13229 $50.00 $315.10
DCA Fee $5.25
Education Surcharge $0.20 02/03/2016 Check#:13299 $315.10 $0.00
Permit Fee-Additions/Alterations $350.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $365.10
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 AFFIDAVIT: I certify that all the foregoing inform 'on is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the abov n ° d contractor to do the work stated.
C February 03, 2016
Authorized Signature:Owner / Applicant 1 Contractor J Agent (1 13515-
Building
a eBuilding Department Copy
February 03,2016 1
iami Shores Village 7 M15
Building Department I DEC 292015
–1-0050 N.E.2nd Avenue;-Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 —
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2®/ CM-
BUILDING Master Permit No.
PERMIT APP OCATION Sub Permit No.L� /•
❑BUILDING ELECTRIC ❑ ROOFING (--j REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS F-� CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Cn St'
City: Miami Shores: County: Miami Dade Zir): 3'J►3`b
Folio/Parcel#: ► ► 3a®e n .:;A D—tCi Is the Building Historically Designated:Yes NO
Occupancy Type: Load. Construction Type:_ Flood Zone: BFE: FFE:.
OWNER:Name(Fee Simple Titleholder): 13,1 nbPhone#:
Address: 4515 tJt C17 �
City: 1.�1'� rhR� �aaS State:, FL_ Zip., �i3t
Tenant/Lessee Name: t l Us Phone#:
Email: llt
CONTRACTOR:Company Name: Ing i Z � _Phone#:
Address*: S LL) aa;2, yam
° Zip: 33/1.S
City: W1•l..L State:��
Qualifier Name:+ /�J ,�l'� o,IA--) Phone#:��r3z/S-"
State Certification or Registration#; Certificate of CompetencyM
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 1:57'Od "a. Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: nj Ilk;
Specify color of color thru tile:
Submittal Fee$ DQ� Permit Fee$ � oa CCF$ d -(00 CO/CC$
Scanning Fee$ ;5` W Radon Fee$ DBPR$ � Notary$
^�
Technology Fee$ r
Training/Education Fee$ 'O� Double Fee$ _
Structural Reviews$_ Bond$
TOTAL FEE NOW DUE$
(RevEsed02/24/2014)
Bonding Company's Name(if applicable) tJ I t-
Bonding Company's Address w 6 1► -
City State ZP
Mortgage Lender's Name(if applicable) t►! rA -
Mortgage Lender's Address 1 A
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 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. ——
' 1
Signature Signature_
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
2`il day of 1 :ZQ15 by 7_day of 20�_,by
whis personally k n to w is perso ally known to
me or who has produc as me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
a
Sign:
Sign•
Print: -IMfft-V- - �A– -
77— Print: ut'�" CYTEJADA
Seal: EXPIRES:JAN 21,2018
COMMISSION PFFUSTW
Seal: ;� :" MI'J3COS MARTINEZ Band®d ftugh lot 8121®In9UMClo
MY COMMISSION 0 FF 008989
EXPIRES:May y 15,2017
&coded Thru Notary Public Undenv'
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)