EL-12-1063Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
C- l z- 10`-15
Inspection Number: INSP - 174697
Permit Number: EL -6 -12 -1063
Scheduled Inspection Date: July 24, 2012
Inspector: Devaney, Michael
Owner: MONTERO, CARLOS
Job Address: 1245 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 (786)282 -4809
Parcel Number 1132050270280
Phone: (305)758 -1211
Building Department Comments
A/C HOOK UP
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
t74/ 7011 2iZ-
July 23, 2012
For Inspections please call: (305)762 -4949
Page 5 of 25
BUILDING
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
FBC 20
Permit No.
@r-goTatwa-
m JUN 1 1 202
PERMIT APPLICATION Master Permit No. mC " 6-
Permit Type: Electrical
JOB ADDRESS:
City: Miami Shores
CA
County: Miami Dade Zip:.�
Folio/Parcel #:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholder):
Address: `er--LAC]
City: 'ti1C \ QS State:
NO Flood Zone:
Phone #:
Zip:
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name: L.o416/4,9,,,- ))
Address: ! 11 ,t// ei A l
City: ,111i1' State: FG.-
Qualifier Name: AV c,12 let L 6,00/6 -47eq
State Certification or Registration #: EC, 1 3 O ®3 7/3 Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Phone #: 3 —75, -/P//
Zip:
Phone#:
.3_31 3.g
Value of Work for this Permit: $ tok9,0e2 t®,0 Square/Linear Footage of Work:
Type of Work: °Address °Alteration °New /Repair/Replace °Demolition
Description of Work: 4) G C.12,4":4./ ed -
*x+ ********* ******+ r***** ** ********** **** Fees************ ******* *+ x**** *+ x +x**+x+x******+x*****
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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, BOIT ,RRS, HEATERS, TANKS and MR 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 .. appr#ved and a reinspection fee will be charged.
Signature
SignatureC✓ G 1
Oi, er or Agent Contractor
The fore4i g instrume f was acknowledged before me this i) The foregoing instrument was acknowledged before me this 1/
day of it/U.1, , 20 J.by , day of or414. , 20 42_, by ,
who i o me or who has produced
who i
ersonally kno
A
NOTARY PUBLIC:
Sign:
Print:
to me or who has produced
11"1
0
.1.
take an oath.
,s06% . . Notary Pubic State of Florida
Michelle Perez
My Commission EE002809
oFao ° Expires 04/08/2013
i s tie Ile Pe.)-
My Commission Expires:
as id-
NOTARY PUB
Sign:
Print:
0/ . 1 .
,4''1'
cierg Notary Pubs State of Florida . Michelle Perez
�y vj My Commission EE002006
nor po. Expires 04 /08/2013
Nl��h eI�G 'ere. z-,
My Commission Expires:
ee : ******e *e*e*** *+x**** * *** ****ee *eex:******* * **** * *eee * **** ******eeeee*ee***e*** **+ x+ x**+x*+x*+xa:+x+x****x•****
APPROVED BY - Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /12i2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)