EL-14-2263Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-222649 Permit Number: EL -10-14-2263
Scheduled Inspection Date: October 31, 2014
Inspector: Devaney, Michael
Owner: , STEPHEN C MUMBY JTRS
Job Address: 171 NE 102 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: LONGMAN ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (646)246-3448
Parcel Number 1132060131840
Phone: (305)758-1211
dunaing uepanment comments
INSTALL 8 RECESSED LIGHTS IN LIVING ROOM Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 30, 2014 For Inspections please call: (305)762-4949 Page 24 of 24
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑BUILDING fM ELECTRIC ❑ ROOFING
0 C T 14 J014Q,a
E
- .1
FBC 20 K-3
Master Permit No. IF (,) 'L-1 —
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: l'_1 ( M Lr ( G -L -Si-
City: Miami Shores
County:
Miami Dade Zip:
31--2112
Folio/Parcel#: �' �a -2-o� - 0 3 A
4 0
Is the Building Historically Designated: Yes
—N O �
Occupancy Type: Load:
Construction Type:
Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder):6 1tt-_ J Q y� Phone#:�� '2 44R
Address: . (_7 ( K' ( Q�)- W
City: ( Kiuk ( !' E-( C) State: Zip: I
Tenant/Lessee Name: Phone#:
Email: j A ,� 2
CONTRACTOR: Company Name: L'04Z Inn Q 4 % ec, t, �G Phone#:
Address:
City: A'Ll0u, -C -4 State:Zip: -313,Y
pp
Qualifier Name: � f/h !Te 4<5,17 Phone#: 3c0 %$ ®1A L/
State Certification or Registration #: E - r_ 1 YCx> 3 7) 3 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address• / City: State:
Value of Work for this Permit: $__ 7 f� f? o C.) Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration] New ❑ Repair/Replace ❑ Demolition
Description of Work: IA�� f� l (� _Ce ,;u zd / ��f $ I
Specify color of color thru Me .
Submittal Fee $ Permit Fee $ �`�' CCF $ '' �® CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ A • Training/Education Fee $ 0' Double Fee $
Structural Reviews $ Bond $ Q
TOTAL FEE NOW DUE $ i IG .
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State Zip
Mortgage Lenders Name (if applicable)
Mortgage Lenders 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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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 - days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appro ee and a reinspecti e will be charged.
Signatu
OWNER
The foregoing Instrument was acknowledged before me this
�_ day of nl".-�n6'y- . 20 14— , by
ShEr� ✓yl u mom— who is personally known to
meor w a as produced L. L as
ide/n" tiiT�aJogand 'ngo did tak &; oat® j
NOTARY PUBLIC:
Sign:_
Print:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
% day of 20 14 by
who is personally knowil to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: =o� Notary Public State of Florida Seal:
Michelle Perez
t My Commission FF 000321
Nor µ Expires 04/0812017
APPROVED BYS/� s'S 4E=I Plans Examiner �--e
Structural Review
(Revised02/24/2014)
P Notary Public State of Florida
Michelle Perez
y My Commission FF 000321
'C1--6. / Expires 04/082017
Zoning
Clerk