EL-08-879Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 06/25/2008
Inspector: Devaney, Michael
Owner: FERNANDEZ, ALBERT & LIZA
Job Address: 999 99 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor: LONGMAN ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (786)564 -9152
0814*? Parcel Number 1132060340271
Lot:
Building Department Comments
ELECTRICAL WORK FOR AC
MC08 -710, AND ELECTRICAL
RC08 -870
HOOK UP PERMIT
WORK FOR KITCHEN
QQ®
�Co
PIA! 2 5 PAID
Passed
Inspector Comments
cc
Failed
/1'/-
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Wednesday, June 25, 2008
Page 2 of 2
i 15101 Arprw.
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Miami Shores Village
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Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33 138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATI NKruvrED
FBC 2004 MAY 9, 2008
IYIo(e y
Permit Type: Electrical
Owner's Name (Fee Sim le Titleholder) /f4 1 ? h �iclshone #
Owners Address 9
7✓`� Zip 35 T. 6
Permit No. 08- r
Master Permit No.
0660 56V- Y /iT
City it-(rbeitm ,i,e,„?
State
Tenant/Lessee Name Phone #
E -MAIL: '1- F 'JC. 'JDZ -z Y Q ' *J�i�d ' rewi
99 ' ,
County Miami -Dade
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
Zip 33/3g
Is Building Historically Designated YES NO
Contractor's Company Name % 4/611/ ep,�
Peciki, ,c. Phone # 305-- 75.E — / ?l/
Contractor's Address 6 qq
/?i
City C 2 (
` ✓ke_3 State Zip 3-2)3g
Qualifier Name 421'C-bee / 1......6)./7„/
9;-,� Phone # ��� � 7-54E—b1/
State Certificate or Registration l�o. f ) e9P `713 Certificate of Competency No.
Architect /Engineer's Name (if applicable)
E -MAIL: 2 Zj.'y.4v
Value of Work For this Permit $ �D
Type of Work:
Describe Work:
❑Addition
A- /L
Phone #
Square / Linear Footage Of Work:
Alteration ['New c ❑ Repair /Replace ❑ Demolition
beer v'
** * * * "'x %x x Xx X* *Y. XX Xx *Y. *Y. Y. Y. %Y.XxY.X *X X X X Y. X* Fees Y. X X X W XY.XY. X Y.
Submittal Fee $ Permit Fee $2 'O
Notary $ 5 fb
Scanning $
Training /Education Fee $
Radon $
(50
DPBR $
Y. Y. Y.X Y.XY.xx xY.XXXXX *Y. Y. Y. % %Y.XXY. Y.X
CCF $ I.10 CO /CC
Technology Fee $ 5.0D
Zoning $
Bond $ Code Enforce a$ Double Fee $
Structural Review. $ Total Fee Now Due $
MAY 15 2C18 ._
Axk42 , /t02
MIAMI SHORES VILLAGE
See Reverse side ->
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) da after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and are e will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this /7
day of Y , 20 O by AIbt x..604
who is personally known to me or who has produced �. JDfl'Arts'
L(C (,'•'t '3b 0 As identification and who did take an oath.
NOTARY PUBLIC:
Sign: +'
Print: k
My Commission Expires:
************** xxxxxrxx *xx * * * * * * * * * *r. * * * * * * * *xxx. ** * *xxxxxx
`rq �'
tlg e$'••. MONICA LISSETH DIAZ
d.: MY COMMISSION # DD 483995
iaipt
Jt p f °p Bonded Thru Notary Public um:ft: wrilers
Signature
(7.),?,(4,"
Contractor
The foregoing instrument was acknowledged before me this /G
day of Ay , 20 X16 , by /►IWQCr/ W bide/ /4/ ,
who is personally known to me or who has produced FX J�ip ivtj
L1C.7H3b0 as identification and who did take an oath.
NOTARY PUBLIC:
APPLICATION APPROVED BY
(Revised 02/08/06)
Sign:
Print:;" MONICA 4$3995
SIGN #DD
My Commission``
*rxxxx *r* *4:* :8Q
e EXPIRES:OctPbeerCUndewrters
BondedThru Notary
:zx r. xxxxxx *WW
Mans Examiner
Engineer
Zoning