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EL-13-421Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 187876 Permit Number: EL- 3- 13-421 Scheduled Inspection Date: March 25, 2013 Inspector: Devaney, Michael Owner: PUYANIC, DAVID Job Address: 9259 N BAYSHORE Drive Miami Shores, FL Project: <NONE> Contractor: CONNECTIVE ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Temp for Test Phone Number Parcel Number 1132050270580 Phone: (954)782 -7879 Building Department Comments TEMP FOR TEST ELECTRICAL SERIVCE Infractlo 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 CREATED AS REINSPECTION FOR INSP- 187648. CREATED AS REINSPECTION FOR INSP- 187459. CREATED AS REINSPECTION FOR INSP - 186640. Arc fault breakers, goof rings and step receptacle. rtly Ca77 /c- I r e.c o - S% /ZI.ei% L tip March 22, 2013 For Inspections please call: (305)762 -4949 Page 42 of 48 Miami Shores Village Building Department FEL 2 8 2O13 '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: c2 S 4 1/• City: Miami Shores Dory S Aof County: FBC 20 t° Permit No. (- i 3 ...9 Zl Master Permit No. (2—c 12 'i kr1— Miami Dade Zip: 'i t I Folio/Parcel #: Is the Building Historically Designated: Yes NO l/ Flood Zone: OWNER: Name (Fee Simple Titleholder): 9' %' J Rya^ 6 Phone #: ¶2 /1'. �ysda.c �i� Le Address: 7K' )4S ;55/ City: A1l,6p.I' S: -,aces State: ! 2- Zip: 3313 Tenant/Lessee Name: f V/A Phone#: 0a. /d ejCAryiso)oecree, (1ly.C_ rn Email: CONTRACTOR: Company Name: e0/1/IQ.4 a/e, Cam( '71— 1 it (. Phone#: 9 5''''- T2 -.715-31 Address ::AY/() r� I�' /'L t-161y ZY, ,� City: POty fn.- o l� - (/fit.- /! / State: l - (i Zip: 3 30iU Y Qualifier Name: �%u��..Q Cify0/%19 r�.... State Certification or Registration #: E .-i 30o 3 ?S1 Certificate of Competency #: Contact Phone#: 911-2D (- 7-- SG 1 Email Address: /y1/` k Q- OL0nnccJF-hJ2 ` f eG-'r' L . C ci/ ' DESIGNER: Architect/Engineer: Phone #: Phone #: 5 ((-2,0 3 .-q-S 0 t Value of Work for this Permit: $ 10 0 • Square/Linear Footage of Work: Type of Work: ❑Address Description of Work: Yet" r r ❑Alteration ew DRepair/Replace P3r Test- e(ecf- ; c` 1 Sererc,e, - ❑Demolition 'Ur n Submittal Fee $ Sv' Permit Fee $ / ' ® 4) Scanning Fee $ 19440 Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ �O Bi1nding 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 co >.Won to the suance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that i c py of the ,� ®tice of commencement and construction lien law brochure will be delivered to the person whose property is subject o ttachmen Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection, ' h' h occu s ' ven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b app oved an 9/reinspection fee will be charged. Signature er or Agent The forego g instrument was acknowledged before me this 6 day of rej ,20I3,by Dav Purrs who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 1 My Commission Expi * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Z © '-3 /'Y 2 Plans Examiner Zoning Contractor The foregoing instrument was acknowledged before me this 22— day of Feb , 20 f , by , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commiss Structural Review Clerk (Revised 3 /12 /2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) MIAMI•DADE COUNTY Building 11805 SW 26th Street Miami, Florida 33175 -2474 786 - 315 -2100 AFFIDAVIT FOR 30 DAY TEMPORARY ELECTRIC SERVICE ELECTRICAL CATEGORY 26 miamidade.gov ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED OR CERTIFICATE OF OCCUPANCY OBTAINED. It is understood that the temporary electrical approval by the Miami -Dade Building Department is given in connection with the building bein constructed under the Building Permit # RC--I and Electrical Permit # ; �1.. 1 2 1 at address q 2.'5 oi N. 13 cyjci o �Oa� e %L for owner: .Va %GIP and is being given only for construction purposes or for testing the following equipment in said structure: 4 r ca d 61€,A��c Eie 5-6°,1,4c The owner does hereby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and cancellation and electric power can be cut off at the discretion of the Building Official and will be disconnected if the building concerned is occupied before final inspections are approved and /or a Certificate of Occupancy or Completion is obtained. I, ° toi " °,err Ic , being first duly sworn, depose and say that I am the owner of the above described proper , and tha 4 gree that the structure covered in this agreement shall not be occupied until the building contra' .r has o a'.'ed approval of final inspections and/or obtained a Certificate of Occupancy or Completio o e: Failu comply with the provisions of this affidavit in future T ' por ry for T t,. ermits. the ab• tem, ry s- Signat e My Commission Expires: being duly sworn, depose and say that I am the Electrical Contractor for ve- described property and that the electrical installations as now xi tin U,�ll ��t �rPate a safety hazard if ected. TAYLOR J. SARIOL COMMISSION #r EE1e6804 EXPIRES February 2010 FbtittaNaauyBervle•.ean TAYLOR J. SARIOL '"` MY COMMISSION S EE1eee04 P ✓L: ci'.i l :cam: i.4 L. t. _ _... .. Signature of`Electri ontractor Signa ur My Commission Expires: I,, AA, / 3°f Cicey,4 , being first duly sworn, depose and say that I am the Building Contractor of the above described property and that I will not permit occupancy of this building until final inspecNnh, ve been called for by the contractors and sub - contractors concerned and final approval by the inspe ti n *ON, obtained and that I have the authority insofar as the owner of said property is con rned to prohibit *cupancv t 1 ' %„ such final i ecti• tir `P e obtame • .,a• r a Certificate of Occupancy or . o . o s issu - .. d., .0% My Commission Expires: 0,r'• ��f �, .. %,,, AN,'- , ....... . >' . �f1414 OR I ®rP"�\\\`��. Frarfelareemeaviceacca Signature of Building Contractor ---. -. Signature of Electrical Inspector 123_01-124 6/06 Signature of Notary Date: Date released to FPL: