EL-18-580 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-300725 Permit Number: EL-3-18-580
Scheduled Inspection Date: April 04, 2018 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: BROOKS,ANTHONY Work Classification: Alteration
Job Address:1100 NE 108 Street
Miami Shores, FL 33161- Phone Number (786)295-0897
Parcel Number 1122320280290
Project: <NONE>
1
Contractor: LONGMAN ELECTRIC INC Phone: (305)758-1211
Building Department Comments
FURNISH AND INSTALL 3 OUTLET AND MOUNTTHREE Infractio Passed Comments
CAMERAS. FURNISH AND INSTALL ONE GFCI OUTLET INSPECTOR COMMENTS False
ON EAST WALL. FURNISH NEW 20 AMP CIRCUIT
BREAKER AND OUTLET IN BACK ROOM. 3 NEW GFC120
AMP ALL RECEPTACLES SHALL BE TR INSIDE AND WP
EXTERIOR.
Inspector Comments
Passed Ile
Failed
Correction
Needed
I
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
April 03, 2018 For Inspections please call: (305)762-4949 Page 18 of 25
Permit No. EL-3-18-580'
Miami Shores Village Permit Type:Electrical -Residential
10050 N.E.2nd Avenue NE Pen
, Work Classification:Alteration
Miami ShoresFL 33138-0000
Permit Status:APPROVED
a-tea` Phone: (305)795-2204
fitor�lvA issue Date:3/1512018 F
Expiration: 09/1112018
Project Address Parcel Number Applicant `
1100 NE 108 Street 1122320280290
Miami Shores, FL 33161- Block: Lot: ANTHON11 Y BROOKS
Owner Information Address Phone Cell
I
ANTHONY BROOKS 1100 NE 108 Street (786)295-0897
MIAMI SHORES FL 33138-
1100 NE 108 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 600.00
LONGMAN ELECTRIC INC (305)758-1211
�_.._....�_..�.. ...___ _ ., .,..._ .. Total Sq Feet: 0
Type of Work:FURNISH AND INSTALL 3 OUTLET AND MO Available Inspections:
Additional Info:FURNISH AND INSTALL 3 OUTLET AND MO Inspection Type:
Classification:Residential
Review Electrical
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due i
CCF $0.60
Invoice# EL-3-18-66695
DBPR Fee $2.25 03/15/2018 Credit Card $ 114.85 $50.00
DCA Fee $2.00 r
Education Surcharge $0.20 03/06/2018 Credit Card $50.00 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $9.00 1
Technology Fee $0.80 I
Total: $164.85
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. 1
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 ano zoning. Futhermore, I authorize the above-named contractor to do the work stated.
March 15, 2018
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department- Copy
March 15, 2018 1
e.,`
Miami Shores Village 's
\G MA 6 20
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY:
Tel:(305)795-2204 Fax:(305)756-8972 44
INSPECTION LINE PHONE NUMBER:(305)762-4949 �p
FBC 20 t
BUILDING Master Permit No:-�1_ te 'j8�
PERMIT APPLICATION Sub Permit No.'
i
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
' CONTRACTOR DRAWINGS
JOB ADDRESS: 1100 NE 108th ST
City: Miami Shores County: Miami Dade Zip:
Folio/ParcelM 11-2232-028-0290 Is the Building Historically Designated:Yes NO X
1
Occupancy Type: SF Load: Construction Type: Flood Zone: BFE: FFE:
t f
OWNER:Name(Fee Simple Titleholder):Anthony Brooks Phone#:786-295-0897
Address: 1100 NE 108th ST
City: Miami Shores State: FL Zip: 33161
' Tenant/Lessee Name: NSA Phone#:
t Email:'
t
CONTRACTOR:Company Name: Longman Electric Phone#: 305-758-1211
t Address: 95 NE 166th ST
City. Miami state:'FL Z;p, 33162
Qualifier Name: 1 /chaseJ LD/16�low A Phone#'_.'5A•44
State Certification or Registration#: EC 13003713 Certificate of Competency#:
DESIGNER:Architect/Engineer: NSA Phone#:
Address: / City: State: Zip:
Value of Work for this Permit:$ 4W��' Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace [:].Demolition
Description of Work: Furnish and install 3 outlet and mount three cameras. Furnish and install one GFCI outlet on east wall.Furnish new 20AMP circuit breaker and outlet in back room.
3n � 6 r6 &4440. Al/ recep"�tes- shz// be re.
IF
avid wFex�er/ r.
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ —Train ing/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised 02/24/2014)
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 1
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.
I
"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
r YOUR NOTICE OF COMMENCEMENT." >
I
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
i 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.
+ r
Signature Signature
OWNER or AGENT CONTRACTOR
TheK7:y
instrument was acknowledged before this The foregoing instrument was acknowledged before me this
of rn 20 , by day of /�/d dG!'/ 20 /9 by
To, tWK5 who is personally known to ✓Yl Lha4l LA1�MQ Alwho is personall k to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign" Sign: 71M
Print: Print:
Seal: Seal: Mn
NADINE BORRERO
' MY COMMISSION#FF154940
ftt
(407)398.0153 FloridallotaryService.com
APPROVED BY 1,4 ,4 Plans Examiner Zoning
r `
I
Structural Review Clerk
(Revised 02/24/2014)