The URL can be used to link to this page

EL-15-1097 r 30-91 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-242787 Permit Number: EL-5-15-1097 Scheduled Inspection Date: September 10, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: LONGMAN, PATRICK Work Classification: Pool - Private Job Address: 1499 NE 104 Street Miami Shores, FL Phone Number (305)677-3046 Parcel Number 1122320320110 Project: <NONE> Contractor: LONGMAN ELECTRIC INC Phone: (305)758-1211 Building Department Comments REPLACE POOL LIGHT INSTALL LOW VOLTAGE LED Infractio Passed Comments STEP LIGHT INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-234330. REpair broken conduits. Add boor alarms. Failed Correction Needed ❑ �' Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 09,2015 For Inspections please call: (305)762-4949 Page 15 of 30 JfTT4j Asx°1S i� Miami Shores Village01 '01'-IZZIW g� 10050 N.E.2nd Avenue NE Miami Shores,FL 3313&0000 ', ` � f ' ta , MVEQ •• Phone: (305)795-2204 ` FLORtD4` Expiration: 12/0"112015 3 Isscie oafs:�14l�1 Project Address Parcel Number Applicant L1499 NE 104 Street 1122320320110 PATRICK LONGMAN Miami Shores, FL Block: Lot: Owner Information Address Phone Cell PATRICK LONGMAN 1499 NE 104 ST (305)677-3046 MIAMI FL 33138-2663 Contractor(s) Phone Cell Phone $ 1,200.00 Valuation: LONGMAN ELECTRIC INC (305)758-1211 Total Sq Feet: 0 Type of Work:REPLACE POOL LIGHT INSTALL LOW VOLT Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning: 1 Light Niche Bonding Review Electrical Alarms Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-5-15-55487 DBPR Fee $2.25 DCA Fee $2.25 06/04/2015 Check#: 1926 $ 110.70 $50.00 Education Surcharge $0.40 05/12/2015 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 In consideration of the issuance to me of this ermit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility r all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,ME ANICAL,WINDOWS, DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certi that all t foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin . Fut h ove-named c ntractor to do the work stated. June 04, 2015 Authorized Sign ure:Ow / Applicant / Contractor / Agent Date Building Department Copy June 04, 2015 1 Miami Shores Village , ; Building Department U� 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY: - INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 10 BUILDING Master Permit Nola `�� PERMIT APPLICATION Sub Permit No.� BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING [—] MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP 1LR(� CONTRACTOR DRAWINGS `[ — JOB ADDRESS: { l"1 NIE I C4 St►'ef�fi 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): R YI& Lavlq YncLn Phone#: 5CS 2.19 4`770 Address: NF_ yyl fit City: M►ary%1 $Mores State: Fil Zip: 3302' Tenant/Lessee Name: n 10— Phone#: Email: poA is P)nq rnari( wl ac. czryW CONTRACTOR:Company Name: L c'' r Phone#: JC2S-7S Address: /V City: /h;�LYJ-t' State: jry Zip: 33i Qualifier Name: - L Phone#: f® State Certification or Registration#: (� J c)63 7/3 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ •z v `� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New 3 Repair/Replace ❑ Demolition c , Description of Work: ('-,a )e'4 �� 01 �1 h 1'J iY 5• ,� v h l��%'l L.� Specify color of color thru tile: Submittal Fee$ Permit Fee$ /�C�' dU CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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 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 a roved and a reinspection fee will be charged. i Signatufe Signatufe `�— OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of� 20 149\by U day of �\/ 20 15 by L.=Ia 146in,who is personally known to LAAi,e-, ",me, who is personally known to — me or who has produced � as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLI NOTARY PUB i Sign: Sign: n Print: l/ Print: N`t16 le treZ_ Seal: �Vn Notary Public State of Florida Seal-. Michelle Perez �.►R'° Notary Public State of Florida My Commission FF 000321 Michelle Perez a Expires 04/08/2017 �( My Commission FF 000321 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 02/24/2014) DATE(MM/DD/YYYY) r CERTIFICATE OF LIABILITY INSURANCE 8001 5/5/2015 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PAYCHEX INSURANCE AGENCY INC PHONE FAX�A/C,No): (888) 443-6112 210705 P: F: (888) 443-6112 E-MAIL ADDRESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAIL# SAN ANTONIO TX 78265 INSURER A: Twin City Fire Ins Co 29959 INSURED INSURER B INSURER C: LONGMAN ELECTRIC INC INSURER D: 844 NE 98TH ST INSURER E: MIAMI FL 33138 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. /NSR TYPE OF INSURANCE ADDL SUER POLICYNUMBER POLICYEFF POLICYEXP LIMITS MM/DDIYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO LOC PRODUCTS-COMP/OPAGG JECT $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOSAUTOS HIREDAUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSA TIONPER OTH- ANDEMPLOYERS'LIABILITY X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1, 000, 000 OFFICER/MEMBER EXCLUDED? A (Mandatory in NH) ❑ NIA $1, 000, 000 76 WEG IX1296 05/01/2015 05/01/2016 E.L.DISEASE-EA EMPLOYEE 1, 000, 000 If yes,describe under E.L.DISEASE-POLICY LIMIT $1000 0 Q 000 DESCRIPTION OF OPERATIONS below I r DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space is required) Those usual to the Insured' s Operations . LIC# EC13003713 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village AUTHORIZED REPRESENTATIVE v 10050 NE 2ND AVEC MIAMI SHORES, FL 33138 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD