EL-11-705Inspection Number: INSP - 158613 Permit Number: EL -4 -11 -705
Scheduled Inspection Date: May 10, 2011
Inspector: Devaney, Michael
Owner: GONZALEZ, ROBERT
Job Address: 9120 NE 8 Avenue 4G
Project: <NONE>
Contractor: LONGMAN ELECTRIC INC
Building Department Comments
INSTALL CIRCUIT FOR FRIDGE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
77) Kt,/
May 09, 2011
Miami Shores, FL
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060440330
Phone: (305)758 -1211
Page 13 of 23
dtsA - LY\
BUILDING
PERMIT APPLICATION
FBC 20
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
Permit No.
Master Permit No.
Zip: 33 13$
TOTAL FEE NOW DUE $ tun,
d I
771
IpRZ I2011 a,
Permit Type: Electrical L �^
OWNER: Name (Fee Simple Titleholder): RobeRT COIN`ZALZ- Phone #: 'D 5Z'7 c OM
Address: 1 12- Sii" Ave L J i A- 4 (-K-
Cit M l/41/`� 1 � el--
State: L
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: 9 12.0 1 E 0 A` e Lit 4k Q
City: Miami Shores County: Miami Dade Zip: 35 1 3 S
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Ni Flood Zone: N D
CONTRACTOR: Cpmpany Name: ON MAN L l tC.Tf 1' W.-Pi/
Phone #: 3
Address: Mil 14 6 1 V 'Ire c;
City: (1AW ' ' io f e 5 State: i— Zip: 33136
Qualifier Name: _ 1 G'hCL(( / 49-7,-674v9-2.-- 7 Phone #: 6 77 9----)36/
State Certification or Registration #: / e. i 3j ex>,3 7 /3 Certificate of Competency #:
Contact Phone #: '7 t' 97 ) 3 / Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 3 Co. 6® Square/Linear Footage of Work:
, Type of Work: ❑Address ❑Alteration ,STew DRepair/Replace ❑Demolition
Description of Work: -ii l C,
54/ 9 4 7L 6,k 2 i% l k941rrxW
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ ! C wow CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
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 be approved and a reinspection fee will b charged.
Signature // Signature
Oy ner or Agent
Contractor
The foregoing instrument was acknowledged before me this I The foregoing instrument was acknowledged before me this 2/
day of fieh / , 20 1/ , by
day of 461 ,20 L, by
NOTARY PUB ; C:
r
who isCersonally knownjto me or who has produced
As identification and who did take an oath.
�+ir Nip, t. Notary Public state of Florida
• Michelle Perez
At My Commission EE002609
ar d` Expos 04/08/2013
Sign:
Print:
CAN.
My Commission Expires:
� r/
APPROVED BY �� /� Examiner Zoning
(Revised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09)
who isrsonally known o me or who has produced
as identification and who did take an oath.
NOTARY PUBLI •
Sign:
Print:l,A.
My Commission E
Structural Review Clerk