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EL-12-2413
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 185280 Permit Number: EL -12 -12 -2413 Scheduled Inspection Date: February 06, 2013 Inspector: Devaney, Michael Owner: ABARCA, JULIO Job Address: 166 NW 98 Street Miami Shores, FL Project <NONE> Contractor: SOUTH DOM ELECTRIC INC Permit Type: Electrical - Residential Inspection Type:h Work Classification: Alteration Phone Number (305)733 -2893 Parcel Number 1131010260040 Phone: (305)626 -5904 Building Department Comments ELECTRIC SERVICE REPAIR AND RELOCATE NEED WORK WITH FPL Infractio Passed Comments INSPECTOR COMMENTS False Passed ,/ Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments February 05, 2013 For Inspections please call: (305)762 -4949 Page 20 of 22 Miami Shores Village 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 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 1 ( (3 Nn‘-) DEC 202012 FBC 20 10 Permit No. F-f--'L--t9N, Master Permit No City: Miami Shores County: Folio/Parcel #: l A O / " 074 00 lo Is the Building Historically Designated: Yes NO .>c Miami Dade Zip: "6' ! ro, OWNER: Name (Fee Simple Titleholder): Jvk 1 0 Address: 16 b i" W q City: `' * a LA-; is State: 11... Zip: 3 3 is- 0 Tenant/Lessee Name: Phone #: ttloo, Flood Zone: (■JO Phone#: ��� + 3 — Email: c\ Q (i Qr®p . Lo#k CONTRACTOR: Company Name: Z d7 / ith/% EIt"r.71. C,ik Phone #: Address: gfo c00 I (Q7 sr City: 1.4/09- /y/ State: 7 L- Qualifier Name: MO 70_1 e Phone #: Zip: ;/ a `C State Certification or Registration #: e J Certjficate of ompetency #: imIA#40 mail Address: i/1 / ii.�I /iw!i /4 � �%.: /// 4 Contact Phone #: ,�0� ,'<�P 3 9/0 u E DESIGNER: Architect /Engineer: Phone #: Value of Work for this Permit: $ ®' ® ® Square/Linear Footage of Work: Type of Work: °Address °Alteration Description of Work: °New ]Repair/Replace °Demolition F L ** * **a ****** ** *** * *** *** * * ************* Fees**** ****** ******* * ** * * ***********+xa:+x ****** ** Submittal Fee $3— - Permit Fee $ at t CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 1S, 2 c 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 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 berg roved and a reinspection fee will be charged. Signature \`Oder or Agent 2 The foregoing instrument was acknowledged before me this 1 ✓ day of a`t-C-- , 20 a, by ��Ali Pr3P'l/2 -6 who is personally known to me or who has produced 1 As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: k`\`‘ 0uun My Commission Expires: *** * * * **** ** ** * * * ** APPROVED BY E . J ^ o '� `�� ; W .,// / - L Plans Examiner 2e.,/� Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 IQ, by' Yt 1t- &3) , who is personally known to me or who has produced ��t D as identification and who did takolg >mat40 #i, NOTARY PUBLIC: ��� 0-?. .... •... ��•,. Sign: = ,, �^- Print: ° '� E ' ',, �•• ' tom` J . `\ Structural Review (Revised 3 /12/2012)(Revised 07/1 0 /07)(Revised 06 /10/2009)(Revised 3/15/09) My Commission Expires: III/111111o, + Zoning Clerk I. 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