EL-09-2030Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number. INSP- 131226
Scheduled Inspection Date: June 07, 2012
Inspector. Devaney, Michael
Owner: POLANCO, DEYSI
Permit Number: EL -12 -09 -2030
Job Address: 1183 NE 91 Terrace
Miami Shores, FL 33138-
Project <NONE>
Contractor: METRO ELECTRIC SERVICE INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Temp for Construction
Phone Number
Parcel Number 1132050010200
Phone: 305 -945 -1991
Building Department Comments
temp for contruction
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
1///1--- e_
June 06, 2012
For Inspections please call: (305)762 -4949
Page 1 of 24
BUILDING
PERMIT APPLICA.
FBC 2004
il
M ami Si ores Village
lage
J3 ilding J,) e; artrnent
10050 N.E.2nd Avertµ ;''Mialmi Shores, Florida 33138
el: (305) 795.E 04 Fax: (305) 756.8972
gjav
2009 i
Permit No. \M-
R) Master Permit No.?)
Permit Type: CtriCS
Owner's Name (Fee Simple Titleholder)
Owner's Address 1 \ 9_99._ 1
rr
City te-. 1,, State
Tenant/Lessee Name
E- MAIL:.
fl4 4 rrlQ rdezPhone # (, — ( 1
isT Gt
Zip '5 (0.
Phone # —Itb - 3`? 4 —te, 1 l
Job Address (where the work is being done). !' (l ( WE- q Ter-rote
City Miami Shorts Village County
FOLIO / PARCEL # 1 "` ap 0 1 -
Is Building Historically Designat r
Contractor's Company (■ame
Contractor's Address tST,
City .. A-'1 &A.'
Qualifier Name
State Certificate or Reg'
E -MAIL:
Zip -3 /
Phone # "[ let - 5a�,
irkAre FJO. ryWx(y
Zip
Phone #
Certificate of Competency No.
Architect/Engineer's Name (if applicable)
Value of Work For this Peimit$
(pare / Linear Footage Of Work:
Type of Work: ❑Addition ❑AI . ration
0
IN Describe Work: 'h!t P (o u' $ t C) 1. '
❑ Repair /Replace ❑ Demolition
Submittal Fee $
Notary $ Training/Educatio
Scanning $ ` t✓`� Reim $
Bond $ Cod Ldforeem
ar4ro?ra1r*+k*** dr**sYdrar* **aY4eFe eS*drsY***dede& *oY*, t*sY3r3eaYoe3ru etAr, c*4ratr* #**************
Permit F $ /` ®.0
Structural Review. $
CCF $ WO CO /CC
Technology Fee $ 0'
Zoning $
Total Fee Now Due $
See Reverse side -+
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. 1 .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 co
promise in good f% 'th that
whose property I
for the first ins,
inspection will
ion to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
of the notice of mmencement and construction lien law brochure will be delivered to the person
hment. Also, certified copy of the recorded notice of commencement must be posted at the job site
curs seve 7) days after the building permit is issued In the absence of such posted notice, the
d a re' pe tion fee will be charged.
Signature 0 ` .►/�
Ow or Agent ./ Contractor
T �jregoing i trument was acknowledged before me this 3 The foregoing instrument was acknowledged before me this .0 7
da otl -�C'�M 200 el, by day of, eg I C'tY) , 20 b �� U Let y � C� D rrn t.,v
who is personally known to me or who has produced who is personally known to me or who has produced
as identifi , 'on and who did take an oath.
NOTARY oil
\nor
s ide - ification and who did take an oath.
NOTARY P
1
Sign: '— '
Print:
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
41:41N, ASEAN
MYCOMVSSION• MOW
14.0,00* ffinferatuMiget somas
Sign:
Print:
My Commission Expires:
CARAIN ,Ay
n
flli wn01Or $rx da a rit """'^"ry $e es
Plans Examiner
Engineer
Zoning