EL-16-1776 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-261885 PermitN mber: EL-6-16-1776
Scheduled Inspection Date: September 21, 2016 Permit Type Electrical- Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: FRANZOSA, LYNN Work Classification: Addition/Alteration
Job Address:520 NE 102 Street
Miami Shores, FL Phone Number
Parcel Number 1132060171060
Project: <NONE>
Contractor: LONGMAN ELECTRIC INC Phone: (305)758-1211
Building Department Comments
RE MODEL BATHROOMS AS PER PLANS. Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed /C
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 20,2016 For Inspections please call: (305)762-4949 Page 5 of 23
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Miami Shores Village M
S4' 10050 N.E.2nd Avenue NE y sm'fieation ) � tl�•:.,,
Miami Shores,FL 33138-0000
to � Phone: (305)795-2204 x
Expiration: 01/0212017
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Project Address Parcel Number Applicant
520 NE 102 Street 1132060171060 LYNN FRANZOSA
Miami Shores, FL Block: Lot:
Owner Information Address PhoneCell
LYNN FRANZOSA 520 NE 102 ST I
MIAMI SHORES FL 33138-2455
Contractor(s) Phone Cell Phone Valuation: x,$1,000.00
LONGMAN ELECTRIC INC (305)758-1211
Total Sq Feet: 0
Type of Work:RE MODEL BATHROOMS AS PER PLANS. Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Final
Scanning:1 Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
Underground
W.W.
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# EL-6-16-60343
DBPR Fee $2.25 06/27/2016 Check#:4085 $50.00 $109.10
DCA Fee $2.25
Education Surcharge $0.20 07/06/2016 Credit Card $ 109.10 $0.00
Permit Fee-Additions/Alterations $150.00 II
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL wor!c.
OWNERS AFFIDAVIT: I certify that all the foregoing information i a urate and that all work will be done in comr)liance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-n or to do the work stated.
Juiy 06, 2016
Authorized Signature:Owner / Applicant / ont ac / Agent Date
Building Department Copy
July 06,2016 1
Miami Shores Village
Building Department Ju l 2 7 16
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 20
BUILDING Master Permit No.� VQ fO
PERMIT APPLICATION Sub Permit No. — l �: G
❑BUILDING XELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSIO ❑RENEWAL
❑PLUMBING MECHANICAL PUBLIC WORKS CHANGE OF CANCEL TION SHOP
� CONTRACTOR DRAWINGS
JOB ADDRESS: �� )f�
City: Miami Shores County: Miami Dade Zip: 2 - k3%,
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: CAFE: FFE:
OWNER:Name(Fee Simple Titleholder): Phone#:
Address: ZE=' � 1 k2)Z
City:��'C_L��� ` 5��� State: �) Zip g
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Z{/AI,11✓14,4'.41 Phone#:
Address: f-5— Fxe- IA6�1* -5-ne,--E7—
City: /A;?/A//"/ State: Zip:
Qualifier Name: 1 166w�- Phone#: 30-5-"
State Certification or Registration#: �G�3�d 3 7/� Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
a�
Value of Work for this Permit:$ l i tea^ Square/Linear Footage of Work: /60A
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: /L� ��b�L 13.4TW.(&a�S G` 5 2�. � ���•.S
Specify color of colorthru tile:
Submittal Fee$ ;( , 06 Permit Fee$ A- 0 ®® CCF$ CO/CC$
Scanning Fee$ CKi Radon Fee$ DBPR$ Notary$
Technology Fee$ ® :90 Training/Education Fee$ 00 Double Fee$
Structural Reviews$ Bond$ u Q
TOTAL FEE NOW DUE$ V ®q e ��
(Revised02/24/2014)
1'•"
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 appr9vec and a reinspection fee will be charged.
Gtr
Signat re Signature
VVv
OWNS or AGEN CONTRACTOR
Theforegoinginstru nt was acknowledged before me this The foregoing instrument was acknowledged before me this
day of tJ Kf— 20 (( by t7bl'l/e- 14 of 20 V,=, .by
te
S who is personally known to �r�144CI�0Th s personally n wn tor who has produ ed as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY P LIC: NOTAR;PUC.
Sign: Sign:
Print: 's�e— �`� ��`� Print:
Seal: tioa+Y Pus Seal: Notary Public State of Florida
ro t...�o�, tAURAFAFUYMichelle Perez
* * MY COMMISSION A FF 1881127
Lj,�
MyEXPIRES:Match 18,2019 Exphes o4�oaRot t
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)