EL-12-761 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)785-2204 Fax: (305)756-8872 R C_ iA_ 20to 9
Inspection Number INSP-172900 Permit Number: EL-4-12-761
Scheduled Inspection Date:June 11,2012 Permit Type: Electrical- Residential
Inspector. Devaney,Michael
Inspection Type: Final
Owner: BUTLER,JACQUELINE Work Classification: Addition/Alteration
Job Address:1461 NE 102 Street
Miami Shores,FL 33138-2621 Phone Number
Parcel Number 1132050240140
Project: <NONE>
Contractor: LONGMAN ELECTRIC INC Phone: (305)758-1211
Building Department Comments
TEMP POLE FOR CONSTRUCTION
Inspector Comments
Passed F. P. &L. notified to disconnect residence and connect temp.for
1E construction.
FailedEl
-
Z-
Correction
Needed ❑
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
June 08,2012 For Inspections please call: (305)762-4948 Page 8 of 28
Miami Shores Village ASR j o c62
Building Department '
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY.eseo®e__aee_em__e___
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
BUILDING Permit N..-Y—,�
PERMIT APPLICATION Master Permit No. 01 —2A6
FBC 20
Permit Type: Electrical ^^��
OWNER:Name(Fee Simple Titleholder): CQuf L I W f, 9UM2. Phone#:
Address: o(4(P I N f, 10 Zs+- Y" -CA40C o-,
City: ill !4 M d S H6kA,5 State: -t- - Zip: "
Tenant/Lessee Name: Phone#:
Email:
JOBADDRESS: �4(QS t0► 1 Ca2S}
City: Miami Shores County: Miami Dade Zip: 3'Z 13`�
Foho/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: "z ,,3e!f r.1 ee*At— Phone#:,3—--Y—Ae V1
Address: �1 ✓I/2 17 15
City: &/f/-*w4e&.� State:
'� ���� l' zip:.33�3.5
Qualifier Name: �'Li r./i, ea �nits7�/�'•o/' Phone#:A—7"e-m)'941
State Certification or Registration#. AC, 139AP3 7J 3 Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ 5;0,ps d p SquareAUnear Footage of Work:
Type of Work: DAddress OAlteratio/n ANew ORepair/Replace ODemolition
Description of Work: �G�j n �Dlfs ✓� �L� os�
Submittal Fee$ Permit Fee$ 14y40,,,0 d CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
,.
f e
9
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 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 reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this a?c-, The foregoing instrument was acknowledged before me this
day of OW "J20)2—.by day of 4&7 7 ^,202=,by
who' nally kno o me or who has produced who i orally kno to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:' Z Sign: ^�
Print: ! Print '
My Commi t otary Pubic State of Ffortde My Co s ires:
e PerezMY Commission N
@"o Expires 04/08/2013�2� 4&,, 4000
ffr�sNotary Pubftc State of Floft
WOWS Perez
8/2013 ### #######
� AG/L
APPROVED BYr'� i' s�6a�/ Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07XRevised 06/10/2009XRevisod 3/15/09)