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EL-10-1727BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical Miami Shores Village 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 OWNER: Name (Fee Simple Titleholder): T L(1'nC\ (icee r Phone#: 7 3 (o9) be Address: t1--6 IU 10 i S T = rc City: NA l A f`(1l lS0 S State: F L Zip: 33 13 B Tenant/Lessee Name: ' Phone#: —" Email: CJ mE 9 Ce., l e 9 mai 1 . (Don JOB ADDRESS: 1 d :2 A /01 STtaci ET City: Miami Shores County: Miami Dade Zip: 351 3 fi Folio/Parcel#: Is the Building Historically Designated: Yes i/ NO Flood Zone: CONTRACTOR: Company Name: a l 1 ' 1 e. : C r 1 CJ r- c G.C"f v' • Phone#: Address: C Ia-�� S • kJ' 1I 6 t r, rc ac, (,.,;Q. City: 1 C..411 State: 1 In i Zip: 1.1 f C. Qualifier Name: c l r _„ A. tM Q r s h 4.,,,l 99 1 Phone#: , C 6( 0 ?. 9 (°) State Certification or Registration #: &' b0 0 0 ° 1 t to Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ • 00 Square/Linear Footage of Work: Type of Work: OAddress UAlteration UNew ORepair/Replace ODemolition su / Description of Work: ZNS-f,,// /0 Cc, A n g ie ! r "" EP 3 Permit No. d Master Permit No. ea+xa+a******** *** ******** ** *we*a**** **F **********e*wee***+a*****w**anp** a* *** ****a * ** Submittal Fee $ Permit Fee $ Z Zji ' ' 3 1 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ita 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 gent / Contractor The foregoing instrument was acknowledged before me this .�rk>� The foregoing instrument was acknowledged before me this day of Sg.PT1 ,20 by , day of ,20_,by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identifi NOTARY • JOSHUA G VELASQUEZ •: MY COMMISSION # DD879463 Sign: 1 sign: ? - r EXPIRES April 12, 2013 4-.67,-/- , /H� / Print V! 4 C - 1 ( '1 Print 1/U �Utf i 1 C ( .1 My Commission Expires: 9 (-- z © 13 My Commission Expires: L k2- ) Z rO >I 3 **aa *+i * ***:ti *+r,*e+> *** APPROVED BY Structural Review tRpvirwl 07/10/A7VRevicpri (YJ1N7(N)QNRpvicMA 4 /15!1191 JOSHUA G VELASQUEZ NOTARY PUBLIC: $ ; MY COMMISSION # DD879463 EXPIRES April 12, 2013 07 398-0153 Floridallotarybervtce.00m * *** z * ****+a+a*> Hex*** *are****** * *sena *+xa+a *a ****** ***+six** ****** a *a*** 7? Plans Examiner Zoning Clerk Scheduled Inspection Date: October 13, 2010 Inspector: Devaney, Michael Owner: GREEN, GIL & DEANNA Job Address: 113 NE 101 Street Miami Shores, FL 33138- Project: <NONE> Contractor: B &I ELECTRICAL CONSTRACTORS Building Department Comments October 12, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 151794 Permit Number: EL -9 -10 -1727 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060131910 Phone: (305)607 -2419 INSTALL 10 CAMERAS FOR HOME SECURITY Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments / 3 Page 11 of 23 1 1 'S' . " .""'"'"'"'"*""..""'""" In VJJX.:JJJMOJJX.:4:4:4:44jii:j*:41+1J PRODUCER DISCOVERY 10733 DORAL (305) .-" " 4 : ' ' '' 4 -. Mg44 4 A ' N"'• NJ :' , V7VM:tOrk; ' N .. k ,4 *EMPAV.:V,V C P S ", ACORD. :';'" ' 4 .': 4 ' tOA'ft • • ....:...41. 44. 1 5 A$FJ.,-.240:1*KW:41 , S1:41.j*,:e::eg . ENTR INS AGENCY, INC N. W. 58TH. STREET , FL . 33178 718-8919 FAX: 718-3584 . 4' J ..".$... , , ...,... ::", / . , 4: ' 4' ' -4 *.b, We' ' "''''' ''''''44,6,, n " Q " ." 1 7, DNYl 1: ' + -.' ' '''' ' -.:. ..):4; '''''''' 4. " .. ..".. .4r ' '.. ••• 4 ".. ......' ....), 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 THE COVERAGE AFFORDED BY THE POUCIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A NOVA CASUALTY COMPANY INSURED B. & 1. ELECTRICAL L CONTRACTOR INC 4250 SW 73 AVENUE MIAMI, FL 33155 COMPANY B COMPANY C COMPANY 0 0#1 -,fittealbtathWASSINEI „ WAISRananigtaltagarlinantadebilattlealatian THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION CERTIFICATE MAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, BEEN REDUCED BY PAID CLAIMS. s.I TYPE OP INSURANCE POUCY NUMBER POUCY EFFECTIVE DATE OVIIVIRICITYI POUCY EXPIRATION DATE ILINUDD/TY1 UNITS A owPWs&coP1ThACTow$PEoT GENERAL UASIUTY COMMERCIAL GENERAL umurt I CLAEMS MADE Fri OCCUR $250.00 P. D. 09A.L - 049866 05/06/10 05/06/11 GENERAL AGGREGATE $1,000 000 X PROOUCTS - COMP/OP AGO a , 000, 0 0 0 . 4 500,000 . PERSONAL & MTV INJURY EACH OCCURRENCE $ 500,000 . X mimwmo(kmommlo $ 100,000. DEDUCTIBLE MED EXP (An we pommel 8 5,000 . 8 AUTOMOBILE LIABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT — BODILY INJURY Per prson) $ i BODILY INJURY (Per eceldent) $ PROPERTY DAMAGE 0 GARAGE UABILITY ANY AUTO AUTO ONLY - EA ACCIDENT 0 OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS UABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE $ 7 AGGREGATE 8 4 WORKERS COMPENSATION EMPLOYERS UABIUTY 11-1E PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE AND — INCL EXCL I 7411qtru I 0 11. MITS EL EACH ACCIDENT 1 $ ---. El. DISEASE - POLICY LIMIT EL DISEASE- EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESNWECIAL ELECTRICAL CONTRACTOR ITEMS VILLAGE DEPARTMENT 2ND AVE , FL 33138 SHOULD ANY EXPIRATION 30 DAYS OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE DATE THEREOF, THE ISSUING COMPANY WILL MEDEAVOR TO MAIL WRITTEN NOTICE TO THE CERTIFICATE HOUR NAMED TO THE LEFT, TO MAIL SUCH NOTICE MAU. IMPOSE NO OBLIGATION OR UABIUTY UPON THE COMPANY, cm AGENTS OR REPRESENTATIVES. . i :n s '7 - SttidviSSSISe.iaatiSVStrftfttnkfa4SSMBMINSSSfdatttegitnisa MIAMI SHORES BUILDING 10050 NE MIAMI SHORES FAX #: 305-756-8972 NSW - Mitifigid.64.1-tvtioMmittkamoutaac-Nta*Inimmak---moomIAMINAMIOWNWAt BUT FAILURE OF ANY KIND AUTHORIZED •I • — • ,,