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RC-10-517Project Address 46 96 Street Miami Shores, FL 33150- April 14, 2010 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Fees Due CCF DBPR Surcharge DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Work without Permit Fee Work without Permit Fee Total: Amount $1.20 $0.00 $0.50 $0.40 $150.00 $0.00 $0.50 $12.00 $50.00 ($50.00) $1.60 $0.00 $150.00 $316.20 Building Department Copy Parcel Number 1131010330490 Block: Lot: Approved: In Review Comments: Date Approved: : I n Review Date Denied: Type of Construction: BATHROOM RETILING Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Authorized Signature: Owner / Applicant / Contractor / Agent Pay Date Pay Type Invoice # RC -3 -10 -37420 04/01/2010 Check #: 2458 04/14/2010 Check #: 2464 Amt Paid Amt Due $ 50.00 $ 266.20 $ 266.20 $ 0.00 Applicant DORIS GRIMALDI April 14, 2010 Date Expiration: 10/11/2010 Available Inspections: 7 ruction w tiK?Il__ PROV DORIS GRIMALDI 20700 HIGHLAND LAKES Boulevard MIAMI FL 33179- Valuation: Total Sq Feet: $ 2,000.00 100 Inspection Type: Final PE Certification Shutter Final Window Door Attachment Tie Beam Slab Termite Letter Framing Drywall Screw Shutter Attachment Window and Door Buck Ceiling Grid Fill Cells Columns Declaration of Use 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 work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. 1 Inspection Number: INSP- 141736 Permit Number: RC -3 -10 -517 Scheduled Inspection Date: April 28, 2010 Inspector: Bruhn, Norman Owner: GRIMALDI, DORIS Job Address: 46 NW 96 Street Project: <NONE> Miami Shores, FL 33150- Contractor: HOME OWNER Building Department Comments April 27, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1131010330490 BATHROOM REMODEL. RETILE BATHROOM ONLY. SAME VANITY, TOILET & TUB. Passe -/v Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 19 of 22 Miami Shores Village 1 Building Department r z�� LW 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY- Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. PERMIT AP CATION Master Permit No. /Q -- &J 7 FBC 20 Permit Tie: BUIL DIN ROOFING Owner's Name (Fee Simple Titleholder) 1 6 04 $ K r VV1& Phone # 7 - 2 ^ C Owner's Address y ( 3 k ( (p a'' ST" City I V ` i 41w csfe S State FL— Tenant/Lessee Name Email Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name Contractor's Address Contact Phone iructf raFReview. $ 0 C s+f'u -ei fi. v &b a p f.( Qualifier Name Aleet.awri. r — w.P`i State Certificate or Registration No. C &,C J SD 7 0 State 1 - E -mail Notary $ Trainin ducation Fee $ Scannin , t-_,..`:1.11 Radon $ AO DPBR $ CIO KJ Violation date: zip 3 31 Phone # Phone # Zip 3 3 3/ Z Phone # Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # d Value of Work For this Permit $ Type of Work: ❑Addition 7 Alteration :New ❑ Repair/Replace ❑ Demolition Describe Work: grAnno J e_ 0/.6L- re_ P itke P _ �. 1 truom �((� vt ai r y f, .// /; h f: 1 Square / Linear Footage Of Work: ******** * * * * ** ** * * ** * * * * * * * * * * ** * ** * * ** F * * * * * * * * * * * * * * * * * * ** * * * * * ** * * ** Submittal Fee $ 1 . Permit Fee $ CCF $ I • a CO /CC $ Technology Fee $ t Bond $ Total Fee Now Due $ , (494 See Reverse side 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of com 'ncement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued ' the absence o uch posted notice, the inspection will not be :''d c; reinspection fee will be charged. / Signature oe Signature Ai; t _ Owner or Agent The foregoing instrument was acknowledged before me this - day of 4 'PR,t,'L , 20 4_, by ( PLS(Z L G (1L f C `! who is personally known to me or who has produced PC/19 As identification and who did take an oath. NOTARY PUBLI : Sign: Print: 1I i111111�� i � i „ „ "�: 40 . : Commission # Contractor The foregoing instrument was acknowledged before me this day ofApri t ,201b,by who is personally known to me or who has produced as identification and who did take an o NOTARY PUBLIC: Sign: Print: 1 . 1'• . DDIS5901 • "! � F LU My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Plans Examiner Engineer My Commission Expires: Zoning Clerk checked �fr7 'DODS wArtirap Fcri Nr.,w A 1e(9 W ?H BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) , ? pats Owner's Address 4u L5(.93 C ? City in (Q a. e$ State 1- Tenant/Lessee Name Email Job Address (where the work is being done) 46 Nu) 96 City Miami Shores Village. County Miami -Dade FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name OP:IS Contractor's Address AU tog) 96 City 919 ceafro Qualifier Name State Certificate or Registration No. Contact Phone Architect/Engineer's Name (if applicable) Value of Work For this Permit $ /.50-0 State Type of Work: ['Addition ['Alteration Describe Work: Miami Shores Village Building Department Notary $ Training/Education Fee $ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 c a ni (d( 'ogee -me- b.. 0(1 he it Zip Phone # Square / Linear Footage Of Work: ❑New ❑ Repair/Replace Scanning $ Radon $ DPBR $ ouble Fee Violation date: Strut eview. $ Total Fee Now Due $ IIECERIYIEB MAR 2i 201 BY: Permit No. C J 10-511 aster Permit No. Phone ( i ) _ 0622 3 3/ �� Phone # Zip 33 I3 -0 Phone # Phone # Zip Flood Zone ce of Competency No. ❑ Demolition * * * * * * * * * * * * * * * * * * * ** * ** * * * * * * * * * ** * *Fe * * * * * * * * * * * * * * * * ** * ** * * * * * * * * ** ** * * * * * * * ** Submittal Fee $ PermitFee $ CCF $ CO /CC $ Technology Fee $ Bond $ See Reverse side -* 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 4s 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 IOJ9 64k Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day o .i�}�N , 20 \ (J, by ] }(j.4,s C„ f2.1 frt , day of , 20 _, by who is personally known to me or who has produced 'PL--F) who is personally known 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: (Revised 07 /10 /07)(Revised 06/10/2009) Sign:./ ' VVHIIir,as,. Sign: Print: a�ao�� dO ' Print: • l •'••. • ��'I' My Commission Expires: r t♦0 65 91 v My Commission Expires: 0 a 0/10 YlOk APPROVED BY ° ° ° i� / S 1 41�e ' \ O l ans Examiner Zoning �rJ�illllRt Engineer Clerk checked R BUILDER DISCLOSURE STATEMENT NAME: 'ana DATE: S I Z S (2 ®lO ADDRESS: q(0 M W ( 4, .14 C vn kQ a eS Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor, I further understand That I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied fora permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two-family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with- holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. 5. I understand that, as the owner - builder, I must provide direct onsite supervision of the construction. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder permit under an exemption from the law. The exempfon specl ies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. 3. 1 understand that, as an owner builder, I am the responsible party of record on a permit I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or licen tubers on permits and contracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built o • tantialiy improved it for sale or lease, which violates the exemption. Initial Initial 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. 7. I understand that it is frequent practices of unlicensed persons to have the property miner obtain an owner- builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner- builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who Is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow thesimay suittct to serious financial risk. 9. I agree that, as the party legally and financially responsible for this proposed Corrstructlon activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. 10. I understand that I may obtain more information regarding my obligations' as an employer from the internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or htto://wen,v.mvfloridalicense.com/dborioroicilbiindex.html 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party legally and financiall responsible for the proposed construction activity at the following address: • y . initial eh 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retumed to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. ByTXYZ'L C rYIA-Ub Was acknowledged before me this day of l .,. j 4 , 20 Produced there License or — ViTh who was personally known to me or who has as identification. 0111011111w //// Initial Initial Initial NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. ® "' 5 ` , TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: GO :Cy f. w►� 2. Description of i mprovement: 1 42._ v-t0 oQ¢ k. \k& r0 v •tea e2,4 -e.. v • I ( w 3.Owner(s) name and address: IA(Z.LS l YYI� �. C{�i �d b ,yu) �/9 V' (- rtiO Interest in property: Name and address of fee simple titleholder. 4. Contractor's name and address: Co 3o S w !LOA F4- 3 1 2, - q"�.�ATE OF FLORIDA, CO 5. Surety: (Payment bond required by owner from contractor, if any )HEREBY CERTIFY that this is a tr �, Name and address: /U Pr • ors , f1� in this ,1� 4 0 , , SS . .. her 6. Lender's name and address: A) -; -, [ �. . Amount of bond $ 7. Persons within the state of Florida designated by Owner upon • m not: documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: N/A- 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida S atutes. Name and address: 9. Expiration date of this Notice of Commencement (the expiration different date $ • - cified) ignature of Owner Print Owner's Name b Q (U S 6a ( fll A' d- 1 ` Prepared by Sworn to and subscribed before me this Notary Public Print Notary's Name My commission expires: 123.01 -52 PAGE 4 8102 4In#errejr8A\` � F 3 11111111111111111111111111111111 1111111111111 CFH 201 0R0233424 OR Bk 27243 Ps 0807; Ups) RECORDED 04/08/2010 10:22:48 HARVEY RIJVINr CLERK OF COURT MIAMI -CAGE COUNTY, FLORIDA LAST PAGE / date is 1 year from the date of recording unless a Address: -U C) 0 ---. 0 1 am! Shores Villa 77,--,H---„,., • BY DATE CNING DEPT !._ DG DEPT UBJECT (0 CC,MFIJANCE WITH ALL ATE AND cr_, UN 1 RULES AND REGULATIONS FEDERAL ELL CP11-... GR1NAAL 61 RE75 . 1 beN Ckf- ?egg" iT RC-10 —S L I to L O - c‘ SA NAINA-A*1 S‘,04.( ,L. 3:#i lc 18 LI 1 Go(AGE ... it i'ii 1 ' 2q16 .................... q 41) 29 8 12 - - . 1 1 1 V1 1'`,JVL.G.1 16 Fla.Rm 12 5`o vi ro TT Race .tK Ki t 6k R Br a- Ode e\%,9 -c2 e "I" ,Air/ G' 777, ffz ®r r4'` A-AL ✓ A-4L ,1 ,9 ,Z 2.4,-ceitot `reG c` PA- Left/°' S re Be R1c/94 ,4 MAR (.4 Z.V 9- 9-" Miami Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT �,�` c ` /7ib SUBJECT YO CCMPIJANCE W1TH ALL FEDERAL STATE AND CCUNIY RULES AND REGULATIONS 29 8 12 - - . 1 1 1 V1 1'`,JVL.G.1 16 Fla.Rm 12 5`o vi ro TT Race .tK Ki t 6k R Br a- Ode e\%,9 -c2 e "I" ,Air/ G' 777, ffz ®r r4'` A-AL ✓ A-4L ,1 ,9 ,Z 2.4,-ceitot `reG c` PA- Left/°' S re Be R1c/94 ,4 MAR (.4 Z.V 9- 9-" T T t -------- ---.\. k ' 6 t.„ t INTIACOOM RETILANG 044 • Same vANuri,wit tru6 r011.61 • 1 Inspection Number: INSP - 140132 Permit Number: PL -4 -10 -589 Scheduled Inspection Date: April 16, 2010 Inspector: Hernandez, Rafael Owner: GRIMALDI, DORIS Job Address: 46 NW 96 Street Project: <NONE> Miami Shores, FL 33150- Contractor: VALOU ENTERPRISES Building Department Comments April 15, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010330490 Phone: (786)278 -9698 REPLACE TOILET DRAIN RELOCATE WATER HEATER REPLACE BATHTUB Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 14 of 23 Project Address 46 96 Street Miami Shores, FL 33150- Owner Information April 14, 2010 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Contractor(s) VALOU ENTERPRISES Phone Cell Phone (786)278 -9698 Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Work without Permit Fee Total: Amount $0.60 $0.50 $0.20 $150.00 $0.50 $3.00 $50.00 ($50.00) $0.80 $150.00 $305.60 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Address Pe ;tNO. L- 'tt -5& it T Pl um - id fa a Add " afiraltion PROVED Expiration: /11!2010 Parcel Number 1131010330490 Block: Lot: Phone Type of Work: BATHROOM REMODEL Type of Piping: REPLACE TOILET WATER HEATER Additional Info: PLUMBING Bond Retum : Classification: Residential Pay Date Pay Type Invoice # PL-4-10 -37521 04/14/2010 Check #: 2464 $ 255.60 $ 50.00 04/08/2010 Check #: 2459 $ 50.00 $ 0.00 Amt Paid Amt Due Applicant DORIS GRIMALDI Cell DORIS GRIMALDI 20700 HIGHLAND LAKES Boulevard MIAMI FL 33179- . a Valuation: Total Sq Feet: $ 500.00 100 Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory Underground 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 work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. April 14, 2010 Date 1 BUILDING PERMIT APPLICATION FBC20 Permit Type: PLUMBING i Owner's Name (Fee Simple Titleholder) \loc°.1/4 S I-. m,N Phone # Owner's Address L RO l Jt C j 0 '$ .1-- City Mi�w,� S�o�S State �� Tenant/Lessee Name Email Job Address (where the work is being done) City Miami Shores Village j County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES City M /jL/ Qualifier Name k Contact Phone Architect/Engineer's Name (if applicable) Miai Shores Village Building Department 10050 N.E. nd Avenue, Miami Sh ida 33138 Tel: 05) 795.2204 Fax 305 756.897 INSPECTION'S PIIONE NUMBER: (305) 762.4949 cK s-r NO 1/1:1 jq k'1wgg hue . e� govOls Contractor's Company Name Dig Phone #7 Contractor's Address Stae Zip 3 3/0 11 11 State Certificate or Registration No. e +JC / A ✓ Ale y. Certificate of Competency No. E -mail t77 6 //4j 70- ‘ Value of Work For this Permit $ S00 .00 Square / Linear Footage Of Work: Type of Work: ❑Addition ['Alteration ❑New [epair/Replace ❑ Demolition Descr Work: \ c. � �e� iU. ��C�� r w� - � r 6� wc � .-�—% 4 L , Notary $ Scanning $ Zip j ` "9-1 Phone # Phone # Phone # Total Fee Now Due $ 2516. 1FEUMEWIEn APR 0 8 2010 BY: Permit No. —1 Master Permit No. C 1O 7-O2- Cz(c22 Flood Zone * * * *, * * **** * * * * * * * *n * * *' * * * * *** F * * * * * ** ** * * * * * * * * * * * * * * * * * ** * ** Penult be , v2. .k5 CCF $ 0*(00 CO /CC $ $0 DPBR $ Technology Fee $ ' Bond $ See Reverse side --* 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 approv and a reinspection fee will be charged. Signature i geto Sign: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) 4 21C4 Owner or Agent Contractor The foregoing instrument was acknowledged before me this 6 The foregoing instrument was acknowledged before me this 7 day of A 1t I , 20 I3, by , day of 0(21 L , 20 it 0, byL gS2 t 9 V M/lnrg LA 41/ who is personally known to me or who has produced e VD who is personally known to me or who has produced P2 L As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Print: ',a J p =o: My Commission Expires: - y : ti a y •. ti� S01\.• 14, 4nm * ** **** * ***** * * * * * *** ** *** 10 Plans Examiner Engineer Print: Y�1 C/4 SOO S .SC.r My Commission Expires: `/- Q * * * * * ** Zoning Clerk checked ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: FEIN: BUSINESS NAME AND ADDRESS. VALOU ENTERPRISES INC DBA DBA MR ROOTER PLUMBING 19151 SW 108 AVE # 30 MIAMI FL 33157 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED PLUMBING CONTRACTOR IMPORTANT: Pursuant to Chapter 440. 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. 'ursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed au the notice of election to be exempt. Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation 0, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? {850) 413-160S WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 05/01/2008 EXPIRATION DATE: 05/01/2010 MCMILLAN LESLIE V 650837358 05 -01 -2008 * *. STATE OF FLORIDA DEPARTMENT 01/ BUSINESS AND PROFESSIONAL REGUIJATION CONSTRUCTION INDUSTR LICENSING BOARD 1940 NORTH MONROE ST7ZEET TALLAHASSEE FL 3299-0VW; MCMILLAN, LESLIE VAUENT1W2 M ROOTER PLUMBING' 15980 SW 109 STREET MIAMI Fr..1 33 1:4_!!! i411` :11`40 Al F'1()iii,11:t111:3 li(,cn by thf. , f; t:)tir '.nils )ir-jfAcIs:;(.1:5r1.11 if if: frf111, orcniief Iliirbeqt.it't l'f.v.-italr.lim ifi tho fr.eff;f • flay ;ye work. to , Afify 11'1 I? ;11'! 1J qitortnalion •flpt:)1.1? (Hi p log onto wt.)vv.rnyflariololicorisel.r;orn. find nioro i our t.fivIsi()11; z:n1f111 unpa( 1 you t;u1);c111)0 10 (11. Lind ;11 lirr? oh! of Pro f.)11ror1ilili ior; E lnIIy , ; ( riv , . , r yt)ti brIttot fild! y,)if c;:.11; $f Ronk Y(;'.i fur (I Ding . i; ... t1 STAT. ttistes DEPARTm ELT-RucT-g ON; I 07 8172467'4:: LICENR CFC1425608 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2010 MCMILLAN, LESLIE VALENTINE MR ROOTER PLUMBING 15980 SW 109 STREET /4/AMI FL 33196 GOVERNOR LO TAC.i LII:1-0, OF FLORIDA CHARLIE CRIST LABI BY LAW •8b0 ) 407 1,3':; S II. o 4 OR M • DEPARTMENT OF D118 1:N1/; AND PROVES 0 TONAL REGULATION CFC1.42S00 07/01/08 0/81.7246 CERTIFIED PLUMBING VONTRACTOV MCMILLAN, LESLTE VALENTINE MR ROOTER PLUMBING IS CERTIFIED uiRR, Ltv,, i :In t .469 AND PROFESSIONAL REGULATION UsTRY LICENSING BOARD SEQ# L0807010072 07/01 2008 DATE BATCH NUMBER CHUCK DRAGO INTERIM SECRETARY THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED AI3UVt rvrc Ir.= ruin r rcruvu nw.nvr., �.. ,..,, •... , ......, ...... -- 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POUCIES. AGGREGATE UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LT R TYPE OF INSURANCE P OLICY NUMBER DATE (MMIDDJYYYYI DATE POLICY LIMITS LTR A RM O INBRD GENERAL LIABILITY GL 00090409 05/2612009 EACH OCCURRENCE $4,000,000. $ 05/26/2010 .n ( a c 3 PREMISES (Ea occurrence) $100,000.00 COMMERCIAL GENERAL UABIUTY "J MED EXP (Any one person) $5,000.00 :2 II CLAIMS MADE 0 OCCUR PERSONAL& ACV INJURY $1,000,000.00 0 ■ GENERAL AGGREGATE $2,000,000.00 II PRODUCTS - COMP/OP AGG $2,000,000.00 GEM_ AGGREGATE UNIT APPLIES PER: • POUCY 1 PROJECT • LOC AUTOMOBILE UABILITY COMBINED SINGLE UNIT (Ea accident) • ANY AUTO BODILY INJURY • ALL OWNED AUTOS 1 I SCHEDULED AUTOS per person) BODILY INJURY (Per accident) 1 HIRED AUTOS 1 NON OWNED AUTOS PROPERTY DAMAGE (Per accident) • • GARAGE LIABILITY AUTO ONLY - EA ACCIDENT EA ACC • 1 ANY AUTO OTHER THAN AUTO ONLY: MG ■ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE 1 OCCUR 1 CLAIMS MADE ■ • DEDUCTIBLE • RETENTION $ WORKERS EMPLOYERS' ANY PROPRIETOR OFFICER (Mandatory S PECIAL P ROdf COMPENSATION AND LIABILITY / PARTNER / EXECUTIVE / MEMBER EXCLUDED? In NH) below • WC STATU • OTH- _ u 1 _ 3: EL EACH ACCIDENT EL DISEASE - EA EMPLOYEE EL DISEASE - POLICY UMIT OTHER DESCRIPTION PLUMBING Miami Contract OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS SERVICES Dade County is listed as Certificate Holder AND Additional Insured. Number. CICC -7380, CICC -7040 PRODUCER Angel Assurance Infl, Inc. 12049 SW 117th Ave Miami, FL 33186 Phone (305)235 -4417 Fax (305)235-4428 INSURED Valou Enterprises, Inc. dba Mr. Rooter Plumbing 15980 SW 109 Street Miami, FL 33196- CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TIE COVERAGE AFFORDED BY THE POUCIES BELOW. NAIC # INSURERS AFFORDING COVERAGE INSURER A: Gotham insurance Company INSURER B: INSURER C INSURER D: INSURER E: DATE (MMIDD/YY) 10/15/09 25569 COVERAGES ACO MIani Dade County 111 NW 1st Street Suite 2340 Miami, FL 33128 -1987 Fax: 305.375.1477 CERTIFICATE HO 26 (2009101) QF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN HOME TOTKECE .TE.KOLDEaNA ED TO T I1LEFr, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURE:, ITS AGENTS OR REPRESSIrATIVES. AUTHORIZED REPRESENTATIVE Jenniffer C. Morales 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MIAMI, P1., 33130 if1):6 V • :7 A t4 •:•e 1 y 6 • I • SEE OTHEFI.S1DE • DO NOT FORWARD MR ROOTER PLUMBING LESLIE V MCMILLAN PRES 15980 SW 109 ST MIAMI FL 33196 IA 11 ta11111111111111 1111411Illimk4lip VI I • 4. Inspection Number: INSP- 140925 Scheduled Inspection Date: April 21, 2010 Inspector: Bruhn, Norman Owner: GRIMALDI, DORIS Job Address: 46 NW 96 Street Project: <NONE> Miami Shores, FL 33150- Contractor: WATTS ELECTRIC INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: EL -4 -10 -550 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1131010330490 Phone: 305 -824 -3722 RE- WIRING ENTIRE HOUSE AND UPGRADING ELECTRICAL SERVICE UP TO CODE. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 20, 2010 r/4- Inspector Comments For Inspections please call: (305)762 -4949 Page 19 of 30 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 46 96 Street Miami Shores, FL 33150- 1131010330490 Block: Lot: DORIS GRIMALDI Owner Information Address DORIS GRIMALDI 20700 HIGHLAND LAKES Boulevard MIAMI FL 33179- Contractor(s) WATTS ELECTRIC INC Phone 305 - 824 -3722 Cell Phone Type of Work: ELECTRIC FOR BATHROOM REMODEL Additional Info: ELECTRICAL Classification: Residential Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Work without Permit Fee Total: Amount $0.60 $0.50 $0.20 $100.00 $0.50 $3.00 $50.00 ($50.00) $0.80 $150.00 $255.60 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 work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Permit t[ EL- - -aaa it T e i rilcal = Resident Parcel Number Phone Pay Date Pay Type Invoice # EL-4-10 -37461 04/01/2010 Check #: 2458 04/14/2010 Check #: 2464 Amt Paid Amt Due $ 50.00 $ 205.60 $ 205.60 $ 0.00 Applicant Cell Valuation: Total Sq Feet: $ 150.00 100 Available Inspections: Inspection Type: 1 April 14, 2010 Date April 14, 2010 1 7/111` Miami Shores Village BUILDING PERMIT APPLICATION FBC 20 Permit Type: ELECTRICAL Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 C i t y U a i t r 4 0 State `f Zip 3 3(1 1 Tenant/Lessee Name Phone # Email Job Address (where the work is being done) 1{(, c1..) 4 Se4 City Miami Shores Villa le County Miami -Dade • FOLIO / PARCEL # Is Building Historically Designated YES Value of Work For this Permit $ Type of Work: Describe Work: DAddition DAlteration Notary $ Trainduc on Fee $ Sc nning $ Radon $ Doable Fee $ Structural Review. $ - NO, C: L E C T (Z iC 1.V lat.Phone # Submittal Fee $ `��-J Permit Fee $ 'qr d CCF $ Permit No. Zip 93/3g Square / Linear Footage Of Work: 5 PirtT B S 9! W� it et &.L gg ,x Q p {{ � -- e y��, �r p oo+�n.. (4%A., e s� ev.. -cv 9COYaE'7Y7Y�Y� k �Te 41. **'0,*** +k i vieiY3r .hVtGGJ" t*: Y�1)ve*dr*aY4esY*** Ms 4 12010 2010 • kb ., Master Permit No. 5- L 10 Owner's Name (Fee Simple Titleholder), 0 2 (S 6 f rri ea, Cot I Phone # lap O6 Z Owner's Address L{ ( IV's Q f@ Flood Zone PO Contractor's Company Name i T 1' S Contractor's Address 1.1. w 1 , 15 p L. Cit 141 14 t- c r4 N State pc. Zip 1 0 1'L Qualifier Name ,1, 6 Co oQ 2P I-C1.. Phone # 305 341340 23 04- State Certificate or Registration No. Ea, . 0 0 1.021 Certificate of Competency No. 0000 /t 6 D g Contact Phoni345/ Q 3 7 a-- E -mail Architect/Engineer's Name (if applicable) Phone # ®New [T D Demolition C1. eXt oY4:X 4r *943e*o'e7t'4: *'+Yde:Yk9t&*** 4 L-a e4c1S��n�� CO /CC $ Technology Fee $ 0 otiO Bond $ DPBR $ Violation date: Total Fee Now Due $ 9 bop See Reverse side -* 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 COMIVIENCEMENT 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 approyd and a re- inspection fee will be charged. Signature Sign: Print: fip?,4 Owner or Agent The foregoing instrument was acknowledged before me this go day ofhaa,CA, 20 lo, by des Co2im ALt , who is personally known to me or who has produced cc. As identification and HIHktw oath. NOTARY PUBLIC: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) 0-01' Engineer Contractor The foregoing instrument was ackno ledged re me this / day oft' "th ,20I , G• Tait 2__„ who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: i \A 114 My Commission Expires: iticassea * $01 6 0 0,214 * * * * * * * * * * * * * * * * * * * * * *, *************************************************** ** ********kk*********** ***** * ** Plans Examiner Zoning Clerk checked 2010 -04 -13 08 :23 FROVUM PsIMIDO Altaantse 1906 W. DOM Stag Nark FL 30012 mow 18960890 Fox (306)231 INSOR® WATTS ELCTRIC OF SCUTh FLORIDA 470 W. 38 P1. Wish, Fl 33012 OM 8244722 COVERAGES ACORD mum OF 2010 -04-13 08:15 MIANI SNORES VELRADE DEPT. 10050 NE 2AVE. M AK FL 33138 30582533W 1 600 685 7530 3052319299 CERTIFICATE OF UABIUiY MAW= DATE (LEoYOomr) 04i1310 TPA CERTIFICATE IS ISSUED As A MATTER CF NFCRMA7loN C N L Y AND Maims NO Re = UPON THE CERiFICATE HOLDER. MS C mwicAiE DOES NOT MEM , ME rIm OR ALTER 77! COVERAGE AFFORDED UT THE • -. SEL01N. P 1/1 INSURERS AFFORESTS! COVERAGE NM IF ENStMR1'AA Asaondad UndonsSers EHSIR EE INSURER C- RBURER D: SOURER I: AUTOMMILII LIASILITY ANY AUTO ALL OWNED AUTOS SCHETINNED AMOS KIND AIMS NON CMIIES) AUTOS MIN/ tiligRNIAA mums OOCUR 0 MAUI awe PREMISES Es awnaooa) mu ma (Anyone perm) PERSONAL AADV INJURY OE■ERAL AGATE PRODUCTS - P G PROPERTY allAIAGE (Par amidst* AUTO ONLY EAAOOIDENT cam THAN ave Awn ONLY: AGO EL EACH ACCIDENT EL. DISEASE - EA EMPLOYEE E.L. amuse- POUCY LMEIrI' 5100.000 000,000 $100.000 TMR PCL r m a M MtUURA.= LIMO RAW_ nrE14 M RO7O INMARIO RAMO ABOVE FOR TIN POLICY PERIM NDIDA71<D NOIINDSTANDING ANY REDUIRBSENT. TBAAA OR cCIPANI W or ANT CONTR/AOr OR OTHER OOCISAENT Wml RESPECT TO WHICH T1U8 ceantsc AT! MAY BE ISSUED OR ANY PERU" THE MR/ACE AFFO310E0 DT THE POLO= OE9dlecD Hem to stoma TO ALL Ti! TERM. EXL`uIB10NB A te OOMNTIONB OF BIJCM POLICIES. Aii0iREO ATt oars erioN i WAY NAVE D!EN REDUCED SY PAD WAG. Mime Emotive eumukva, Woe ditstosirm DT L�rE TYrE PCUCY MGM GAMOW USAILITY ❑ OCSNIERONI. CRIVERAL URNI T 00 mum WOO 0 OCCUR DESORPTION OF OPERATIONS! LOCATIONS tvalcuisr mamma= Mow UIDOA®IHITlsiRaut PROVISIONS SHOULD MY OP On M O V E DIRDIUI SD POLICED U CAC lO EE CII THE !lDErATION DATE THIRDOF.O S MUM DIBIME•R WP.L MIDIRVORTO EMAIL 30 OATS worm time TO CORI'IA RCM* HAMM TO OW T, our E TO DO ao NO oIu0�A71oN CPR LM ABLY or ANY ICRID LAtf]N nis ROUE*. i r ORRIRDSB■NTAT U. Olk _ a4 dl The ACoRD COIRPORIMON. AN rights raary d. Logo as rsyisf isd sods aTACORD Page 2/5 470 West 38 Place Hialeah, FL 33012 E -MAIL wattselectric@bellsouth.net April 12. 2010 Doris Grimaldi 46 Miami Shores, FL 33179 Contact Number: 786 - 202 -0623 Project / Reference: Bathroom Remodel & Rewiring House As per your request, we are pleased to submit the fo /lowing estimate on the project mentioned above, for your review and final approval. Only the materials itemized on the attached proposal will be supplied. Please verify all items, sizes and quantities listed on our proposal. Watts Electric, Inc. is not responsible for omissions. Our Price as submitted is based on contract terms being those in the Construction Industry Standards Council Subcontract form. The following work will be preformed according to the National Electrical Code and local ordinances: • Electrical work for bathroom remodel • Rewire entire house to code • Replace panel to 150amp The following items but not limited to, are not included in our estimate: • Permits • Repair of walls or surfaces of any kind WATTS ELECTRIC INC. Due to the instability of construction material costs, the price provided is subject to change, we will notify you once we have been made aware of any change. Authentically, Nlldee L Gonzalez Vice President Electrical Estimate: $4,000.00 Thank you for your consideration, we look forward to hearing from you soon. PHONE (305) 8243722 FAX (305) 825 -3373 rint Name: Signature: Date: Inspection Number: INSP- 141258 Scheduled Inspection Date: April 27, 2010 Inspector: Devaney, Michael Owner: GRIMALDI, DORIS Job Address: 46 NW 96 Street Project: <NONE> April 26, 2010 Miami Shores, FL 33150- Contractor: WATTS ELECTRIC INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 RC-3-10 '511 Permit Number: EL -4 -10 -550 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1131010330490 Phone: 305 -824 -3722 RE- WIRING ENTIRE HOUSE AND UPGRADING ELECTRICAL SERVICE UP TO CODE. Passed mt/ 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- 140925. //740 PiL ,‘" " Page 12 of 29