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EL-16-228Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Q -C. 15- 2ft/7 Inspection Number: INSP-268173 Permit Number: EL -1-16-228 Scheduled Inspection Date: September 30, 2016 Inspector: Devaney, Michael Owner: Job Address: 175 NW 109 Street Miami Shores, FL 33168-4316 Project: <NONE> Contractor: ALL PHASE ELECTRIC CORP Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number (786)444-2945 Parcel Number 1121360030170 Phone: 305-345-6480 Building Department Comments REPLACE OUTLETS FOR NEW KITCHEN AND CHANGE BREAKER 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 September 29, 2016 For Inspections please call: (305)762-4949 Page 26 of 32 • Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 it Permit NO. EL -1-16-228 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: APPROVED Issue Date: 6/14/2016 Expiration: 12/11/2016 Parcel Number Applicant 175 NW 109 Street Miami Shores, FL 33168-4316 1121360030170 Block: Lot: JCAS FUND CORP Owner Information Address Phone Cell Contractor(s) ALL PHASE ELECTRIC CORP Phone 305-345-6480 Cell Phone • Valuation: Total Sq Feet: $ 2,500.00 00 Type of Work: REPLACE OUTLETS FOR NEW KITCHEN AND Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Amount $1.80 $3.38 $3.38 $0.60 $225.00 $3.00 $2.40 Total: $239.56 Pay Date Pay Type Invoice # EL -1-16-58473 06/14/2016 Cash Amt Paid Amt Due $ 239.56 $ 0.00 Available Inspections: Inspection Type: Review Electrical 1 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 conform' ith the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume res• % ability for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUM .. ' , MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: ; all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and- .nin• i ore, I authorize the above-named contractor to do the work stated. June 14, 2016 rite. ' ignature: Owner / Applicant / Contractor / Agent i ding Department Copy Date June 14, 2016 1 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BY• JAN 27 2016 a - FBC 20/ Master Permit No. g6 2 Sub Permit No.( --I /6 276 0BUILDING 0 ELECTRIC 0 ROOFING ❑ REVISION ❑ EXTENSION 0RENEWAL 0 PLUMBING ❑ MECHANICAL 0 PUBLIC WORKS 0 CHANGE OF CONTRACTOR JOB ADDRESS: / / AM) / 0 9 S 0 CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder): CCA S C( if Address: 0 `7C�i? } ( S •c e -� 1 O 9 City: `(r ` k- n k State: enant/Lessee Name: �\ j �(,,�/► S Email: � ec 2_(.t) (A -o d �� C I I, D," Flood Zone: BFE: CONTRACTOR: Company Name: 1rI Address: f ( l y aki w /2//4-5 z(f__ 4 - NO FFE: Phone#: qv q6I 2 q c1 X31 c ? Phone#: Zip: Phone#: 1 D 2 -m q 2G l' City: ( ' Qualifier Name: Pct State: State Certification or Registration #: �+ 3 ©0 I 5 Z Zip: Phone#: Certificate of Competency #: - - DESIGNER: Architect/Engineer: Phone#: Address: //��y�, City: State: Zip: Value of: Work for this'P�'rmit' $1 Z �VV Square/Linear:Footage of.Work: Type of Work: ❑ Addition n Description of Work: Alteration ❑ New vtw., kut 'At Air any err Specify color of color thru tile: Repair/Replace lc-Ic ❑ Demolition Submittal Fee $ Permit Fee $ $ 1 • EO Co/CC $ Scanning Fee $ 'CZ Radon Fee $ Technology Fee $ 2 "L -f 0 Structural Reviews $ (Revised02/24/2014) DBPR $ SENotary $ p Training/Education Fee $ O • Go Double Fee $ Bond $ TOTAL FEE NOW DUE $ 2-39 • Cr 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 inspe which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will ot be ' pproved and a reinspection fee will be charged. Signature !',, G'! 1/..••-•• Signatur OWNER or AGENT The foregoing instrument was acknowledged before me this The for :oing instrument was acknowledged befor me this day of (7 v , 20 ( �. , by 2day of S Qri N4 rti , 20 A. , by (• On !'who is personally known to POO/JJf(j C4, , who is personally known to me or who has produced as me or who has produced identification and who did take an oath. NOTARY Sign: Print: Seal: tary Public • S to Florida j��'s��, r.i Oct 3, 2016 f •��" ',✓J Co kwff 51 identificati NOTARY Sign: Print: Seal: ar :Nih did take arfti thERTAIN Notary Public - State ot Florida My Comm Expires Oct 3, 2016 Commission # EE 840251 as ***********************************************************************************:sss******************** APPROVED BY (Revised02/24/2014) /P-AiSP2W Plans Examiner Zoning Structural Review Clerk