EL-14-2362iu-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-225902 Permit Number. EL -10-14-2362
Scheduled Inspection Date: January 05, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: NOVAK, DAVID Work Classification: Alteration
Job Address: 735 NE 91 Street 4-E
Miami Shores, FL Phone Number
Parcel Number 1132060440200
Project: <NONE>
Contractor: LONGMAN ELECTRIC INC Phone: (305)758-1211
dulim ing uepartment comments
ELECTRICAL WORK AS PER PLANS KITCHEN REMODEL I
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.
January 05, 2015 For Inspections please call: (305)762-4949 Page 18 of 21
0 %k
Miami Shores Village„1.
OCT 24 2014
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (30S) 762-4949
FBC 20 10
BUILDING
PERMIT APPLICATION
❑BUILDING (� ELECTRIC ❑ ROOFING
Master Permit No. aL_ 10 — 14- L2203
Sub Permit No.�/ h —
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
� j�G CONTRACTOR DRAWINGS
JOB ADDRESS: �35 III-- 9 -� tl Al
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: — Flood Zone: BFE: FFE:
(
OWNER: Name (Fee Simple Titleholder): Dave- Iyd�ctc-ir\ Phone#: V5
Address: -4 SE 4 'r- 91,5+.
City: "1 IGmI 110 re State: Zip: 3313 $
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: L
Address: -i-44 NFE 9T
ICC
(772— /311
City: same �hG�'� State: ip:
Qualifier Name:___ter 1�unaj �. 0V1gvV1tt� Phone#: $6 - q71 ' 139
State Certification or Registration #: 1<<- i�,3�' 1 �j Certificate of Competency #:
DESIGNER:
Value of Work for this Permit: $y of
Type of Work: ❑ Addition Alteration
Description of Work: KitrJ rear
State Zip:
0 Scq ar%Linear Footage of Work:
❑ New ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $,_��' Permit Fee $ l�vd' CCF $ 0 G ® CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ 7�) Notary $ i
Technology Fee $ c Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
v }
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged beforemethis
day of o c. -� o Lam' 20 � k- by
rxyRo`/r-,( k- who is personally known to
me or who has produced D-/ ivex s V cert se as
identification and who did take an oath.
NOTARY PUBLIC:
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of Oc, 1✓e/- , 20 \A by
_ d Lovlv 0 , who is personally known to
me or who has produc d as
identification and who did take an oath.
NOTARY PUBLIC:
V
Sign:Sign:_
Print: _ Mi< <� p- C Z, Print:
Seal: .40 Notary Public of Florida Seal:
Michelle Perez
My Commission FF 000321
No Expires 04/082017
a coly�
APPROVED BY 2�V 4-4 %` Plans Examiner
Structural Review
(Revisedo2/24/2014)
e re j--
° Notary Public state of Florida
Michelle Perez
My Commission FF 000321
Wow) E,*res 04/082017
Zoning
Clerk