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DEMO-16-2660
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 -DEQ i O (%._ 2232 Inspection Number: INSP-273302 Permit Number: DEMO -9-16-2660 Scheduled Inspection Date: December 21, 2016 Inspector: Devaney, Michael Owner: Job Address: 800 NE 91 Terrace Miami Shores, FL Project: <NONE> Contractor: LEWD! ELECTRIC Permit Type: Demolition Inspection Type: Final Work Classification: Electric Phone Number (786)241-6627 Parcel Number 1132060050390 Phone: 954/782-0006 Building Department Comments REMOVAL OF EXISTING LIGHT SWITCHES AT GARAGE CONVERSION. Infractio Passed Comments INSPECTOR COMMENTS False Passed lz Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid Inspector Comments CREATED AS REINSPECTION FOR INSP-268084. Garage receptacles to be G. F. I, protected and dryer receptacle to be 4 wire. December 20, 2016 For Inspections please call: (305)762-4949 Page 27 of 46 BUILDING PERMIT APPLICATION WELECTRIC ❑ BUILDING I PLUMBING ❑ MECHANICAL 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 REc r SE28 2016 BY: FBC20(4 Master Permit No.'1mrr6 I �o --R 3 2 Sub Permit No.Thnl G' 2GGb S��l ❑ ROOFING ❑ REVISION ❑ EXTENSION PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR JOB ADDRESS: <> /j=- 1-/112--, ❑ RENEWAL ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Zip: >� NO FFE: Load: Construction Type: . ,/! OWNER: Name (Fee Simple Titleholder): 1 �� i�)��lC� r ,),y.K j / bone#: Flood Zone: BFE: Address: 7{f S�' 5AC-126-;) /2C/ State: �� City: ",t Tenant/Lessee Name: Phone#: !/;E� 7 2 7 Zip: �( Email: il77,t'.t:442i /611' -t-'xi �•� CONTRACTOR: Company Name: Address: ---2,::7--j_51" City: of Qualifier Name: &"tr..J .c C-- Phone#: 1Jr4 5th' State: t.. �'�.$ 1r7h/t State Certification or Registration #: C -t ` Pi Zip: 3 j(i6C3 Phone#: `j3# 'Lit ci c"‘i Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: State: Address: City: Value of Work for this Permit: $ 1` iff' Square/Linear Footage of Work: Type of Work: ❑ Addition 1 Alteration n New Description of Work: Zip: . 50 n Repair/Replace (Jiemolition Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ L.r (Revised02/24/2014) • Permit Fee $ Radon Fee $ 00. et96 CCF $ ° (a 0 CO/CC $ Training/Education Fee $ DBPR $ Z Notary $ oto Double Fee $ Bond $ TOTAL FEE NOW DUE$ '�� r (/0 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 foregoi,ig 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 $2S00, the applicant must promise in good faith that a copy of the notice of commencement and construction.. lien law brochure will be delivered to the person. whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit i 5 issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be char.; ' OWNER or AGENT The foregoing instrument was acknowledged before me this day of 20 i'C- , by Zn�tZ-%rt 1 Fm ,*v 5, who is`personally knowno me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: APPROVED BY - (Revised02/24/2014) CIL SignatureG? CONTRACTOR The foregoing instrument was acknowledged before me this /4 ( day of -N- — ,20 /6 ,by R L 6 ----..SP 4-U t+� , who is personally -444V me or who has produced 'e,/,-; S,0'',% -- identification and who did take an oath. Q Ui NOTARY PUBLIC: Sign:��--- I- C. Seal: Print: ~ .o ava$ W u_ Of LL C 0 * O N C y O_' E °2 0 i Ili Cc E EE 0:°2 Cr z0 Plans Examiner Zoning Structural Review Clerk on uste Ohio Secretary of State Corporation Details your BUSINESS begins here ttt. a—. atIL Corporation Details Entity Number —H 1555208 Business Name BANCROFT INVESTMENTS, LLC FilirL Type DOMESTIC LIMITED LIABILITY CO 1PANY StatusActive Original Filing Date 07/08(2005 Expiry Date Location County State Agent / Registrant Information FDMUND PHILLIPS 224 NORTHWOOD AVE APT 1 DAYTON,OH 45405 Effective Date: 07/08/2005 Contact St atix:' Active Incorporator Information A.NL,HARA Pi IILLIPS filing Type Filings ARTICLES OF ORGANIZA HON/DOM LIMITED LIABILITY CO Date of Filing Document Number/Image 07/08/2005 U0519202)2,1 Return To Search Page Return To Search List Printer Friendly Limited Power of Attorney BE IT ACKNOWLEDGED that I, d11/0 d Full name 5q55f6 2 f4122o7772496he undersigned, do hereby grant a Social security numberD�+'ver icense limited power of attorney to rl g i< )4 z_..3,mg 1)M)€ (5;,2f,,;.r.( / of 47S/ Ol.'L Full Name � /) 4l© l/`�14", /'`�Ziff .11C? '2"� 1�" i7 Address ( Phone as my attorney-in-fact. (CI Said attorney-in-fact shall have full power and authority to undertake and perform only the following acts on my behalf sign for and do all things cessary'tolthis appointment (check only one option): 1. P are q,f Sr ick /alp r 7� 6Zoee5 3":.?/ 2. 3. The authority herein shall include such incidental acts as are reasonably required to carry out and perform the specific authorities granted herein. My attorney-in-fact agrees to accept this appointment subject to its terms, and agrees to act and perform in said fiduciary capacity consistent with my best interest, as my attorney-in-fact in its discretion deems advisable. This power of attorney is effective upon execution. This power of attorney may be revoked by me at any time, and shall automatically be revoked upon my death, provided any person relying on this power of attorney shall have full rights to accept and reply upon the authority of my attorney-in-fact until in receipt of actual notice of revocation. Signed this e,` �' day of 0 6 ,201e . Signature STATE OF FLORIDA COUNTY OF=T ?" (luinl -Deli( 4 T going i r as acknowledged before me this day of , 20/(f, by tarn n 'MI 111 who is6.- rsonally known to me or o who has produced i ification and who did (did not) take an oath. moi Pignature%/ Print or type name Notary Public - State of �" �, Commission No. IV, Commission Expires: ,•`par.... Marie Sandra Pierre 2. .i• .Gn aCommissioa# F F065496 Expires: Oct, 23,2017 'oFFo'" WWW.AAIONNOTAhY,com Dee L6 E{ r-xictio 6x)oey pie' Ildc( -&-AN61,0 414--( Ter-i9A4 iirepeave) a,tA)t aeo it';-aes ge ro# Ag4, pe4g,K) eAd4e- #4Die-1 A14 c#4 le 460 fa dIc1 tt A?tgLoges� l 66eAmia 674-#4,420-se-ot*T-A4 ScAikwi A ke. ,qe ..27. Yaesel (v TL, Mami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exem • tion Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part -tune or full -tune employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature; Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of A4-,± By -Kiril • C ,` m 13 who is personally known to me or has produced ,201{O. Notary: SEAL: as identification. ein My Commission FF 06355E Expires 10/16/2017