ELC-16-1852 Inspection Worksheet
Miami Shores Village r ��
10050 N.E.2nd Avenue Miami Shores, FL Cc
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-262461 Permit Number: ELC-7-16-1852
Scheduled Inspection Date: November 23,2016 Permit Type: Electrical- Commercial
Inspector: Devaney, Michael Inspection Type: Final
Owner: CHURCH,ST ROSE OF LIMA CATHOLIC Work Classification: Repair
Job Address:415 NE 105 Street CHURCH BLDG
Miami Shores, FL
Phone Number (305)758-0539
Parcel Number 1122310430010
Project: <NONE>
Contractor: ONLY ELECTRIC CO INC Phone: 305-785-6059
Building Department Comments
REPLACE LIGHTS&SWITCHES WITH GFCI &11 infractio Passed Comments
EXISTING ONES INSPECTOR COMMENTS False
Inspector Comments
Passed 121
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 22,2016 For Inspections please call: (305)762-4949 Page 3 of 32
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Miami Shores Village
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10050 N.E.2nd Avenue NE
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"'• Miami Shores,FL 33138-0000 UIn
Phone:
Phone: (305)795-2204 }
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Isssue,Date 71 Expiration 01/0212017
Project Address Parcel Number Applicant
415 NE 105 Street Number: CHURCH BLDG 1122310430010 ST ROSE OF LIMA CATHOLIC C
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
ST ROSE OF LIMA CATHOLIC CHURCH 9401 BISC BLVD (305)758-0539
MIAMI FL 33138-2970
Contractor(s) Phone Cell Phone Valuation: $ 1,500.00
ONLY ELECTRIC CO INC 305-785-6059
__.. _. Total Sq Feet: 0
Type of Work: Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning:1 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# ELC-7-16-60436
DBPR Fee $2.25 07/05/2016 Check#:1184 $50.00 $110.70
DCA Fee $2.25
Education Surcharge $0.40 07/06/2016 Check#:1187 $ 110.70 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $160.70
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named contrgdor to do the work stated.
July 06, 2016
Authorized Signature:Owner / Applicant / ontractor / Agent Date
Building Department Copy
July 06,2016 1
Miami Shores Village
JUL 5 016
Building Department
10050 N.E.2nd Avenue,Miami Shores, Florida 33138 BY�: _
Tel:(305)795-2204 Fax:(305)756-8972 r-
INSPECTION LINE PHONE NUMBER:(305)762-4949 4
FBC 20 M
BUILDING Master Permit No. CGISa— n-sG1
PERMIT APPLICATION sub Permit No. EL _ 16—(852
❑BUILDING X ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F_JPLUMBING F-1 MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION [:] SHOP
� ° `` CONTRACTOR DRAWINGS
JOB ADDRESS: `11s WG (®S' Si^_
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Constru
ction Type: Flood Zone: BFE: FFE:
Cf
OWNER:Name(Fee Simple Titleholder): �t!- � 1/1 Phone#: �$-0�3
Address: z4 I� `v C IOC
City: K't►'a.LAA l �tw y`e 5 State: V Zip:33(�B
Tenant/Lessee Name: Phone#:
Email: / -1
CONTRACTOR:Company Name: 011IV 1EICEfoc G Phone#:C3o,S7
Address:-;q7g IUW 102 —Rackcs
City: )P�DAk'60 n State: zip: 33x4
Qualifier Name: Phone#:
State Certification or Registration#: CCI 300 2313 Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ l tiJoz Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration 1:3U New Repair/Replace ❑ Demolition
Description of Work: E—� �'3 2,V\
—A
Specify color of color thru tile:
Submittal Fee$ ®' Permit Fee$ CCF$ ��' _ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ 4 Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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 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.
Signature
OWNER or AGENT _"�6 CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
2t( _day of �w�_ ,20 1(, ,by kql- day of : y rd- ,20 ,by
-Fr. l�rl41,<� (L-ldl ,who is personally known to ®�S) V ®0 I,i I4 ,who i ersonally known o
_m&or who has produced as me or who has produced as
identification and who did take an oath. identificati
NOTARY PUBLIC: NOTARY P I ����� ®� �
c 11r COMMISSION#FF241795
EXPIRES July.11,2019
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Sign: \v\�OP�NDO•(�c0 r Sign:
Print: ch'La.-I' o L-e& �mbe!19 to Print:
Seal: _ �•� `tet*= Seal:
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APPROVED BY /Jg� Plans Examiner Zoning
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Structural Review Clerk
(Revised02/24/2014)
7/6016 LIABILITY OF INSURMCE MIAMI SHORE VILLAGE 2M7jg
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SCOPE OF WORK:
1. REMOVE EXSTN'G FLOOR AND WALL TILES GENERAL NOTES ••
AND INSTALL NEW ONES SAME LAYOUT. FBC 2014 - - .•
v 2. REMOVE LAYS AND INSTALL NEW ONES, INT. BLDG CODE 2012 E E •
SAME LOCATION. WORK AREA COMPLIANCE GFi •• •
3. REMOVE EXST'NG WATER CLOSETS AND METHOD (301.1.2
INSTALL NEW ONES SAME LOCATION. WORK AREA 230 S.F. T •
4. ADD ONE ADDT'NL WATER CLOSET AND TOTAL AREA: 19,000 S.F. o
6 • •
STALL AT MEN'S AND AT WOMEN'S. ALTERATION LEVEL 2 ,. Idl •.
5. INSTALL NEW STALL PARTITIONS AND OCCUPANCY GROUP A-3 -ewe I
DOORS; CONTRCTR TO PROVIDE SHOP I CONSTRUCTION TYPE III = •
DRAWINGS AND SPECS. " • •• 004 •
6. PAINT WALLS. - •• alt:=r •A�
7. ALL ELECTRICAL SHOWN IS EXISTING.
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1203 4 NATURAL VENTILATION ® 0
1203.4.1 VENTILATION AREA REORD. DEM �.,° F ,•,g�°�
- 4% OF THE FLOOR AREA BEING NEW - - - - - ��• °��` ENS
VENTILATED. EXISTING MENJ BATHROOM PROPOSED MEN'S BATHROOM^ e - '
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MENS BATHROOM IS 110 S.F. WITH
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11 S.F.
110X4% = 4.4S.F < 11S.F. OF � ST
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NATURAL VENTILATION. • °F�� R ft
WOMEN'S BATHROOM IS 120 S.F. _
WITH A JALOUSIE WINDOW 22" X 1'-10" S-2' 1' 9° 5'-10Y° I 1 10' 3 2" S" 5'-10}2 r ,®1 AL
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72' = 11 S.F.
120 X 4% = 4.8 S.F < 11 S.F. OF
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3. REMOVE EXST'NG WATER CLOSETS AND METHOD (301.1.2) FI ••e•• •
WORK AREA 230 S.F. •
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INSTALL NEW ONES SAME LOCATION. a ••••' : •• 9 ••e• •
4. ADD ONE ADDT'NL WATER CLOSET AND TOTAL AREA: 19,000 S.F.
STALL AT MEN'S AND AT WOMEN'S. ALTERATION LEVEL 2 INSTALL NEW •.••; '�� ""
5. INSTALL NEW STALL PARTITIONS AND OCCUPANCY GROUP A-3 DRAW @ Ya" •• •'•' " '
DOORS; CONTRCTR TO PROVIDE SHOP
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DRAWING AND SPECS. WALLS, FLOORS AND •• ••• da• �
PARTITIONS SHALL COMPLY _ � • ••• ,��� •
WITH SEC11ONS 1210.21 VA •a
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