EL-17-2509'iR y!
Miami Shores Village
,yam
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
�.
CORiDA
Phone: (305)795-2204
Permit NO. EL-10-17 2509
Permit Type: Electrical - Residential
Pen ' Worts Classification: Pool - Private
Permit Status: APPROVED
Issue date: 10/26/2017 ] Expiration: 04/24/2018
Project Address Parcel Number Applicant
844 NE 98 Street 1132060142560
MICHAEL LONGMAN
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
MICHAEL LONGMAN 844 NE 98 Street (305)757-9790
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
LONGMAN ELECTRIC INC (305)758-1211
Type of Work: ELECTRIC FOR POOL PUMP HEATER LIGHT
Additional Info: ELECTRIC FOR POOL PUMP HEATER LIGHT
Classification: Residential
Scanning: 1
Fees Due
Amount
CCF
$1.80
DBPR Fee
$4.50
DCA Fee
$3.00
Education Surcharge
$0.60
Permit Fee - Additions/Alterations
$300.00
Scanning Fee
$3.00
Technology Fee
$2.40
Total:
$315.30
Valuation: $ 2,500.00
Total Scl Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-10-17-65422
10/20/2017 Check #: 301863 $ 50.00 $ 266.30
10/2612017 Check #: 301876 $ 265.30 $ 0.00
Avaname I
Inspection Type:
(Final
Light Niche
Review Electrical
Alarms
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.
OWNERS AFFIDAVIT: I certify that all the foregoing
construction and zoning. Futhermore, I authorize the a
Ea hat all ork will be done in compliance with all applicable laws regulating
to o the k stated.
October 26, 2017
Authorized Signature: Owner / Applicant
Building Department Copy
October 26. 2017
Miami Shores Village
Building Department
RECEIVED
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 p T 2 0 1017
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (WS) 76Z-4949 5 j„
FBC 201(4
BUILDING Master Permit No. i%�pp �'ZS�
PERMIT APPLICATION Sub Permit No. c'-A R `Z 5U` f
BUILDING 2] ELECTRIC 0 ROOFING 0 REVISION 0 EXTENSION RENEWAL
PLUMBING 0 MECHANICAL PUBLIC WORKS 0 CHANGE OF 0 CANCELLATION 0 SHOP
QQ CONTRACTOR DRAWINGS
JOB ADDRESS: y N AF CY /J 5�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): M/ L h q L I L-G4 Ai / Phone#: 30 - 7 5%, ! —7 lD
Address: 03 V /)/ /Z q'j S
City: .4n 4:q,!21' 2i 45AIL 5 State: �'�� Zip: 33 l 3.9
Tenant/Lessee,Name:
Email
CONTRACTOR: Company Name: /b/Zr-e!4 g4i YL Ii Phone#: 313j--
Address: -/ .s A-Z51
City: q State: l Zip:
Qualifier Name: /l�,l s/i`j C"_l /I9 �/1/ Phane#
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address
Certificate of Competency M
hone#:
City: State: Zip:
Value of Work for this Permit: $ 9 , -5 b 0 Square/Linear Footage of Work:
TypeofWork: .0 Addition 0 Alteration W New 0 .Repair,/Replace 0 Demolition
Description of Work: e I tz' f ,L L `6- ey'o l 9"Ye! 1j e_ q�t
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $ %0'0, mooCCF $, CO/CC $
(\
Radon Fee $ q V DBPR $ Notary $
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ ` •
(Revised02/24/2014)
k
16onding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 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.
Signature i ! 1✓ Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
(� day of �— C-�I�� . 20 1-1 by
n rVk=), a o is personally known to
me or who has produced as
identification and who did t e an,oath.
NOT R PUBLIC:
Si \\N Olwd0Z/ z
g........ •. J �i
Print: "'y�e �, •. �>
Seal:
APPROVED B16�1'�
:Re
•�i�+�,,.W31d�S
4". 3TO .
CONTRACTOR
l i The foregoing instrument was acknowledged before me this
/ i f4 d f OUOJPiY 20 /7 by
who is personally k nr
me or who has pro uced as
identification and who did take an oath.
NOTARY PUBLIC:
S
Print:
• - Seal
;Q_
►Q4WP46k Steoswt Fbft
MIG"le Verez
d My Commission GO 0t40e9
m Expires 04MM21
Plans Examiner Zoning
(Revised02/24/2014)
Structural Review
Clerk