EL-11-1795Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 164982
1 1
Jso
Permit Number: EL -9 -11 -1795
Scheduled Inspection Date: August 13, 2012
Inspector: Devaney, Michael
Owner: PENKWITT, PATRIK
Job Address: 520 GRAND CONCOURSE
Miami Shores, FL 33138-
Project <NONE>
Contractor: LONGMAN ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060171430
Phone: (305)758 -1211
Building Department Comments
INTERIOR ELECTRICAL WORK
Passed
C7"
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
410091,*
f/e- /0/
74.0",
S%
August 10, 2012
For Inspections please call: (305)762 -4949
Page 2 of 48
E
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: (305) 762.4949
773 n
BUILDING Permit No. EL -9-11 -1795
PERMIT APPLICATION Master Permit No. RC11 -1500
FBC 20
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): Petrick Penkwitt Phone:
Address:
500 Grand Concourse
City: Miami Shores State: Florida zip: 33138
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 520 Grand Concourse
City: Miami Shores County: Miami Dade Tap:
Folio/Parcel#: 1132060171430
Is the Building Historically Designated: Yes NO X Flood Zone:
CONTRACTOR: Company Name: Longman Electric, Inc Phone#: (305) 758 -1211
Address: 844 NE 98 St.
City: Miami Shores State: Florida zip: 33138
Qualifier Name: Michael Longman Phone#:
State Certification or Registration #: C 1,3' c03 243 Certificate of Competency #:
Contact Phone#: 3 U.f^7 51, l 1 Email Address:
DESIGNER: Architect/Engineer Twenty First Century Design &Build Phonet (954) 522 -6446
Value of Work for this Permit $ ...2 ¥b a 641 Square/Linear Footage of Work:
Type of Work: Address ClAlteration ONew ORepair/Replace ODemolltion
Description of Work: Revision to interior wiring due to floor plan ci a%,.r i ; n . �+
y Yl
.Zr
r` S
***************************************F es****** ****a*a * * ***** ***a* *e* *e****** **
Submittal Fee $ Permit Fee $ 5,, 4,' CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Trai�/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL :tai i 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, 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 W1TH 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
who se property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
fol 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 atncpection fee will be charged
Signature,
Owner or Agent
The foregoing instrument was acknowledged before me this
day of De ,20 i \ ,by io ?ff\Y
who i�personally known to meter who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Contractor
The foregoing instrument was acknowledged before me this 9
day of P , 20 ci , by /he 6/21.??
who is Wally know me or who has produced
as identification and who did take an oath.
r. -V'' H: C -STATE OF FLORIDA
•':.. i ` . �� Anne Blakeman
#DD933300
43: NOV 30, 2013
ec ac��v�aco INC.
Print 'hC.--Vtvv tiN°n`e )\023..edYn 0.
My Commission Expires:
APPROVED BY
* * * * ** * ** * * * * * * * ** * * ** * ***** ******** ********* **** *******t ** ****** **** ****** *
+QC
Plans Examiner
Structural Review
(Revised 07/10/07X Revised 06/102009)(Revised 3/15/09)
Zoning
Clerk
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder):
CCcq_
Permit No.
Master Permit No.�,
SEP 2 92011
Th5
Address:
City:
(IA 111,11
Tenant/Lessee Name: Phone #:
Email:
Sio
�J
Phone #:
3s "77211
State: Zip: -31V
JOB ADDRESS: D C6 A
City: Miami Shores County: Miami Dade
Folio/Parcel #: 1/ -- 3Z 6 °— o (T -- ! (1-0
Is the Building Historically Designated: Yes NO Flood Zone:
Zip: 5301'
CONTRACTOR: Company Name: 1 t y /y� l P� `'��C. Phone #: 3 — 75.g— M/
Address: �))
City: /)1I 44'/1 ' . ' '5
State: pi-
Qualifier Name: A/C, lige/ ic7,y.5 47 9;2,—
State Certification or Registration #: 5 G f 3 '37/ ,3 p Certificate of Competency #:
Ib
Contact Phone #: > � 2--) C l Email Address: � �+ - -.,. - / 1 G
DESIGNER: Architect/Engineer: 1R/C Phone #: Jn�`��..4t l0 4N (0
Phone #:
zip: 33/ 3 A.
Value of Work for this Permit: $ 2 4'
Type of Work: DAddress DAlteration " '�
Description -of Work: „7:007;,/1,;(1/4.? 4aA4
Square/Linear Footage of Work:
UNew URepair/Replace
❑Demolition
** *****+x**************+ + **** * * ** *+xx *** Fees***** *+ x********** ** *************** ****a:*+ * **
Submittal Fee $ Permit Fee $ %4 ' ,6'4'
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
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, 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 approv • and a reinspec charged.
Signature
wner or Agent
The foregoing instrument was ac wledged befo me this
5
day of 5-61\-61' , 20 l , by 1-4v-rote. ,
who is personally known to me or who has produced FLA t
As identification and who did take an oath.
NOTARY PUBLIC: << @►j js/*!
Sign:
Print:
My Commission Expires:
-4 0 R ID P �.\ \‘'
* * * ** :,x�:,x *,x,x�x�x:x�x ***** * ***** x** * *x��x****r4WMa** * * ** * * ** x***** * *** x****+ x+ x* ****** *x:* ***** x,+ x*********,x,x,x*****
APPROVED BY Plans Examiner Zoning
Signature qt'Lit/4/
Contractor
The foregoing instrument was acknowledged before me this2i
day of SCikiet' , 20 .IL, by << e % it54:5' 4 _
who i personally know o me or who has produced
as identification and who did take an oath.
NOTARY PUB
Sign:
Print:
My Co
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)