EL-15-341Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-229618 Permit Number: EL -2-15-341
Scheduled Inspection Date: March 10, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: , STEPHEN C MUMBY JTRS Work Classification: Addition
Job Address: 171 NE 102 Street
Miami Shores, FL 33138- Phone Number (646)246-3448
Parcel Number 1132060131840
Project: <NONE>
Contractor: LONGMAN ELECTRIC INC Phone: (305)758-1211
Building Department Comments
INSTALL 10 RECESSED LIGHTS IN SOFFIT ON OUTSIDE Intractio Passed comments
OF HOUSE AND 2 WALL LIGHTS ON SIDES OF GARAGE INSPECTOR COMMENTS False
DOOR.
Inspector Comments
Passed
ET—
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 09, 2015 For Inspections please call: (305)762-4949 Page 21 of 29
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
FBC 2_0� j
Master Permit No. . I���� 1
Sub Permit No.
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1'71 A/ 1�_ Q a S i+ tt /
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):_ Phone#:
Address
r 11
City: 14,71 �_ %G� State: %�� Zip: 3
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
C�,�!/�M �.✓ � / Phone#: ��--
Address:
City: _
Qualifier Name:
U
F-2- zip: 3 3 l Y.�
State Certification or Registration M )5� C l % 3 Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
90$1_7s4 -'4x"11
Address: City: State: Zip:
Value of Work for this Permit: $^ L��1 420 ® Square/Linear Footage of Work:
Type of Work: ® Addition ❑ Alteration ❑ New F1Repair/Replace ❑ Demolition
Description of Work: -5)0 0 r t tiC) C'` -e 5 /, R .!
7Ar✓ �� �f
0rI-_ 0v f s" 4 /ate h'z'0 L_ a,.,w /e/t i "//
Specify color of color thru tile:
Submittal Fee $50,00 Permit Fee $ i CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revisedo2/24/2014)
DBPR $ Notary $
Double fee $
Bond $ ('�
TOTAL FEE NOW DUE $ LL1., _
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 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 on 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 . ,.-- Signature q"'Z�
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
13 day of J5,eLPfjnArj20 f J , by
5' ,o A , 0 , who is personally known to
me or �-as produced _` ri.a as
identification and who did take an oath.
The foregoing instrument was acknowledged before me this
Ad— day of _ .20.E by
Ul e IVK
a ► o is personally known tic
me or who has produced as
identification and who did take an oath.
NOTARY PUBLI NOTARY PUB t �;
Sign: +� �. Sign: e�t.� .. l k
l
Print. Print:
Seal:Ek*
=Expires
tate of Florida Seal: Notary Public State of Florida
ez Michelle Perez
n FF 000321` MYCommission FF 000321i17 " ate` Expires 04/08/2017
*********************************** *********
APPROVED B /1/� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)