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EL-16-1776 (2) 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 S '46 77�► t :type E) cl RlllidentIr l 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 t �' lf2tt1 p� F. 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 °'t �°~ �WnelAru8�ltNtttlybervioire APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)