EL-13-1406BUILDING Pc PERMIT APPLICATION Master Permit No. l3 `,% 7O5
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
JUN 21 2013
Egli j
Permit No. G / � ? Lipb
Permit Type: Electrical
JOB ADDRESS: /2 70 /✓E 92,v') 3 % .
City: Miami Shores County: Miami Dade Zip: 3343 0
Folio/Parcel#: I/ 3a2D,rO 2 70.7./
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: N a m e (Fee Simple T i t l e h o l d e r ) : J O C /,Y!'U/10g. Phone #:30S 7 ' 7-1C104,
Address: / Z 70 Nom" 92 .y% S'" •.
City: /14/444.e �S/9� ,� State: Zip: .gam /.3$
Tenant/Lessee Name: Phone #:
Email.
CONTRACTOR: Company Name: 2-0, / 6741 4,1., k.-/ t"�Te l L Phone #: 3 -7.3s— /c2l/
Address: ,y1 /i/- gg 5.94
City: , T/hJ 5/k e ) e / 9 State: fl-'-' Zip: 33 / 3S'
Qualifier Name: MI/ TA q . / %,,,, GA 34-,,,- Phone #: 3 —%5 9 —Jai/
State Certification or Registration #: f C ) 3 UO 3 72?Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 3,, c-'e G C,') Square/Linear Footage of Work:
Type of Work: °Address Alteration p ,, �ONew ORepair/Replace °Demolition
Description of Work: d i .0. 4 L ��'- P'c`�c.� � ®l.L �•(� ratioioo
* **** * * ***** ***,*** ***** ************ * *F ******** *** ** * *** * **** * **w** *****,r* ** *****
Submittal Fee $ Permit Fee $ 2 7'' 'r be;' CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 41�(•1
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
constraction•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 reinspec s n fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this `g
day of-3 20 NI by le
who is personally known to me or who has pro aced (/
As identification and who did take an oath.
NOTARY PUBLIC:
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of U 2013 , by
who is perso y known to me or who has produced 1r I
(.Q VIce./• as identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires%,
PRISCILLA PEREZ
'OMMISS!ON *'c F007866
c:YPIRES Apra 1 ..2017
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APPROVED B
/ iI Plans Examiner
Zoning
Structural Review Clerk
(Revised 3 /12/2012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
06/28/2013 10:22 FAX 1 800 685 7530
DATA SCAN FIELD SERVICES
ei 0 01
* * * * * * * * * * * * * * * * * * * **
* ** TX REPORT * **
* * * * * * * * * * * * * * * * * * * **
TRANSMISSION OK
TX /RX NO 3759
RECIPIENT ADDRESS 93057579806
DESTINATION ID
ST. TIME 06/28 10:21
TIME USE 00'46
PAGES SENT 1
RESULT OK
Mam Shores Vmage
Building Department
1OObO N.E.2nd Avtmue
khan Short s, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
June 21. 2013
Permit Na: RC 13 -1405
Electrical Critique — Michael Devaney
1. NEED CIRCUIT#
2. ADD SD TO MAIDS AREA PUT D/W RECEPTACLE UNDER SINK SHOW
LOCATION OF ELECTRIC SERIVCE AND PANEL.
4(705-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 194044 Permit Number: EL -6 -13 -1406
Scheduled Inspection Date: May 15, 2014
Inspector: Devaney, Michael
Owner: FISHER, JOCELYNE
Job Address: 1270 NE 92 Street
Miami Shores, FL
Project <NONE>
Contractor: LONGMAN ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number 305 - 757 -1006
Parcel Number 1132050270510
Phone: (305)758 -1211
Building Department Comments
ELECTRICAL WORK FOR INTERIOR REMODEL
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
May 14, 2014
For Inspections please call: (305)762 -4949
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