EL-11-704Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 158605 Permit Number: EL -4 -11 -704
Scheduled Inspection Date: January 23, 2012
Inspector: Devaney, Michael
Owner: LONGMAN, JOHN
Job Address: 333 NE 92 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: LONGMAN ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number O_-
Parcel Number 1132060136370
Phone: (305)758 -1211
Building Department Comments
INSTALLATION OF HIGH HATS AND SMOKE
DETECTORS
Passed
Et'
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
January 20, 2012
For Inspections please call: (305)762 -4949
Page 3 of 47
14 -
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 7952204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: ( 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit No.
APR 2 1 2011 119)i
BY:
Master Permit No.
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): Lui q AI e h Phone #: 3Q�r�.�,�— 60/
Address: 333 tiE ���►/� �/
A�1 IL . 3.r /.�7
City: � .aL/ -! f � �/ -.// State: �• Zip•
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: "'it (37 4-46t4 ,
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: 1494/ 6- 41,,�j -✓ r)<c 79 G Phone# 7i� ) ?//
Address: ,, � y �4 q, ,� i� e/
zip: 33.3
city: ,t?� `°�M/ - �� �"`'� 1 / State: l
Qualifier Name: "42J"1Id Ie '6- .474-r, - Phone#: 11,6 — q7a- /3 4)
State Certification or Registration #: et... )3 2C' 37 )3 Certificate of Competency #:
Contact Phone#: 3 7i — /91/ Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 2, ®®®. 00 Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration New ❑Repair/Replace ❑Demolition
Description of Work: T.�." )/' ?� ✓ PAC ) 3 4 6.6 4- ,. k.L
el See‘1,5
Submittal Fee $ Permit Fee $ % 6 zee CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ \NO
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 ' (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will ection fee will be charged
Signature
inspection w - occurs rev �z
not ved an
/
er or Agent
The foregoing instrument was acknowledged before me this 9 1
day of 4P117 ,20 I/, by
who personally kno ' to me or who has produced
As identification and who did take an oath.
NOTARY P _ t t LIC:
My Commission Expires:
Signature q2714.41-----/
Contractor
The foregoing instrument was acknowledged before me this 0f
day of 4fi / , 20..4, by
who ' ; sonaily known me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
a *a **s * * *e*********e*a* * *** * ***** ** a** ********* **eea*** ** * * ** a******** ****** ******* * *e * * **e+a***** ******
APPROVED BY /
/A/7i Plans Examiner
Structural Review
(Revised 07/10/07)(Revised 06 /1012009)(Revised 3 /15/09)
Zoning
Clerk