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EL-06-607Issue Date: 3/28/2006 Expires: 03/09/2007 Owner's Name: ALBERT & KRISTINE ANDERSON Permit Type: Electrical - Residential Work Classification: Addition /Alteration Job Address: 1217 100 Street NE Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Contractor(s) Phone ALL QUALITY ELECTRICAL SERVIC 305/968 -7832 Yes Primary Contractor Commen : UPGRADE ELECTRICAL SERVICE 200 AMP Additional Information Type of Work: ELECTRICAL SERVICE Additional Info: Classification: Residential 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. Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $1.20 $0.40 $5.00 $150.00 $3.00 $3.75 $163.35 Building Department File Copy Applicant Signature Parcel #: Block: Section: Total Square Feet: Total Valuation: Required Inspections Permit Status: APPROVED Permit Number: EL -3 -06 -607 Phone: 1132050090631 Lot: PB: 0 $ 1,500.00 Alteration Underground Rough WW Service Change Meter Box Fire Alarm Relocation Final Invoice Number EL - 3 - 06 - 24258 Total: , Amt Due $163.35 APR 1 o PAID c. c Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. \N‘c.\- DRIP LOOP F0 BE 3 0' (,1 CAIN) 1 2' ABOVE ROOF 200A { ;hi E TER , • w • • Fll11S11ED rRA])E • iolni I u ul4 } PLAS'iIC 4Lea eN4 • •.i • HA]N CD PANEL • • NMI 11a104a _!1 • • • SUB C 13 ' PAN EL • ,co N R n...L t�, �.r.. _.... c= D oc , °4:23 S I (ilATO RE I F $ 1 TOR NOTARY t le-1:s Lk Nuis'1' • Conductor sirr ,_„ a _ • Conduit stir____ Conduit iype- ��.,.� Thru roof, Y ES r ound W s-c 1.117: liAU1. DIS7OIJldECT R atlnO Muir Sub Breaker-a' SUB FEED New ,._._� Typ Size Bond Z»1z [NS EDE PANEL • " • AnpS cv _Amps Ai p --- R atwig 0 Arias Bond BL,s s ds t• es _._._ -.. _No PER S.F.R.C, 4506,21D) et • Existing /CO_ BUILDING PERMIT APPLICATION FBC 20 Permit Type: ELECTRICAL / Owner's Name (Fee Simple Titleholder) / Owner's Address /o2./ 2 /i/ /00 LS— j ? fli . J,4/5 State F/ Tenant/Lessee Name 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 Email /l a/Y1h 39p A8 / /s0 'i e/ Job Address (where the work is being done) Al/ 7 4/ /7o Sf‘ell City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 8 LCIMPF,En .111,0 f ity Permit No. � _ ( 60 -4- Master Permi No. 4,501 Phone# r, - 3 /ff-S'6 0 Zip 3.x/3 25' Phone # Zip 33/3 3 Is Building Historically Designated YES NO Flood Zone Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Phone # Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: DAddition DAlteration :New ❑ Repair/Replace ep ❑Demolition Describe Work: TC 4 'Z N CWt. -AL L-3-n(0-60-7 ****** * **** * * * * * * *** * * * * * * * * * * * * * * * ** * Fees************* * ** * * * * * * * * * * * ** * * * * * * * * * * * * *** Submittal Fee $ Permit Fee $ 15 - CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ .,C.0 ( D 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 approved and a re- inspection fee will be charged. Signature (Owner or Agent The foregoing instrument was ac owledged before me this C 8 day of SU L- , 20 (,J b V-(L‘,) fI eve . 4 t who is personally known to me or who has produced CL- t As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) \\` O : oo. - z': = 0) � „ � r rrr/ . a C \` Plans Examiner Zoning Engineer Sign: Print: Contractor cP The foregoing instrument was acknowledged before me this day ofs� , 20 , by5GArrI1/4)CLL Lite 1-1760/ who is personally known to me or who has produced PC. 1 p as identification d �d•4id r take an oath. � \‘`�∎�®l d d0 NOTARY PUBLIC: .; .a0 •......• o ►T, A (6\ 89 • tol /90/£0 My Commission Expires: /./S+ ' � ii irr►r►11 i n0 Clerk checked A` °!�° CERTIFICATE OF LIABILITY INSURANCE DA o D `) PRODUCER Annette VMIIIs Insurance 18401 NW 27 Ave Miami, FL 33056 Phone (305)625 -2403 Fax (305)625 -6472 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT#MEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED ALL QUALITY ELECTRICAL SERVICES, INC AND SAMUEL LIGHTBOU RIVE 14750 SOUTH RIVERS DRIVE MIAMI, FL. 33167 INSURER A: WESTERN HERITAGE 00601 INSURER B: AEQUICAP INS CO 00741 INSURER c: PROGRESSIVE EXPRESS INS CO 11760 INSURER D: INSURER E: COVERAGES INSURER F: THE POUCIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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, EXCWSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMinJYY) POLICY EXPIRATION DATE (NQVUDDIYY) LIMITS A ❑ GENERAL V ❑ ❑ ❑ GEML M LIABILITY COMMERCIAL GENERAL LIABILITY ❑ CLAIMS MADE 0 OCCUR SCP0742537 04/16/10 04/16/11 EACH OCCURRENCE 1,000,000 AMAGE TO PREMISES (Ea ce) 50,000 MED EXP (Any one person) 2,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP /OP AGG 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑ PROJECT ❑ LOC C ❑ AUTOMOBILE ❑ n I 5 V ❑ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS 03729940 -6 10/19/10 10/19/11 COMBINED SINGLE LIMIT (Ea accident) 500,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) ❑ ❑ GARAGE LIABILITY ❑ ANY AUTO ❑ AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG ❑ EXCESS/UMBRELLA LIABILITY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ EACH OCCURRENCE AGGREGATE B WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe larder SPECIAL PROVISIONS below WC07077572 08/03/09 08/03/10 � INC STATU- ❑ OTH- TORY UMITS ER E.L. EACH ACCIDENT 500,000 E.L. DISEASE • EA EMPLOYEE 500,000 E.L. DISEASE o POLICY LIMIT 500,000 OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS 2006 FORD ECONOLINE VIN# 1FTRE14WX6HA30873 CERTIFICATE HOLDER ACORD 25 (2001/08) QF MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSJING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAD. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE © ACORD COLORATION 1988 1 ALL QUALITY ELECTRICAL SERVICES INC D.B.A.: LIGHTBOURNE SAMUEL 0001 0004 LO .." AC# 4 2 t1 LOMA DEPARTMENT OF BUSINESS AND;. PROFESSIONAL REGULATION ,.ER13013536 02/26/09 0870492 REG ELECTRICAL CONTRACTOR LIGHTBOURNE, SAMUEL CtIRISTOPHER ALL QUALITY ELECTRICAL SERVICES (INDIVIDUAL MUST MEET ALL LOCAL, ,LJICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) 1!AS REGISTERED under the provi® .oas of Ch 48'' +is xFtraeiori dates AUC 31, 2010 CTQB BUSINESS CERTIFICATE OF COMPETENCY QUALIFYING TRADE(S) • ELECTRICAL FIRE ALARM SPECLT Construction Trades Qualifying Board 05E000478 Is certified under the provisions of Chapter 10 of Miami -Dade County ALID FOR CONTRACTING- UNTIL 09130/2011 < r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone. .- 5)795 -2204 Fax: (305)756 -8972 Inspection Date: 04/11/2006 Inspector: Devaney, Michael Owner: ANDERSON, ALBERT & KRISTINE Job Address: 1217 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: ALL QUALITY ELECTRICAL SERVICES, INC Building Department Comments Monday, April 10, 2006 6 M= Permit Type: Electrical - Residential Inspection Type: W W Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132050090631 Lot: Phone: 305/968 -7832 Page 1 of 2 Passed Inspector Comments k 7 met" Pi Vat- Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone. .- 5)795 -2204 Fax: (305)756 -8972 Inspection Date: 04/11/2006 Inspector: Devaney, Michael Owner: ANDERSON, ALBERT & KRISTINE Job Address: 1217 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: ALL QUALITY ELECTRICAL SERVICES, INC Building Department Comments Monday, April 10, 2006 6 M= Permit Type: Electrical - Residential Inspection Type: W W Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132050090631 Lot: Phone: 305/968 -7832 Page 1 of 2 ms c� '61 300 . Miami Shores Village Sara . Building Department : 3S -Ah1 312.9 Ofo BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) _ Owner's Address I j 7 N E 1 0 0 City Ead -o Vi Shore S State r La , Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES $ Value of Work For this Permit Total Fee Now Due $ (Continued on opposite side) 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 R i Permit No. EL Dio - 60 'Master Permit No. 09 gab lec Ica '` um i inj '1. oc) • Zip 12 - 17 N E. Ro County Miami -Dade NO X Mechanical Roofing Phone # 3 5 7 5 7 11 ,> a 33138 Phone # Contractor's Company Name ALL G .1 i Ek *..r; cal Saw Phone # 3© 5-1- 9 G8-713 L Contractor's Address I ` i 5 N. W. b e t- Cit 4 t Cu , bye- State F j(- %c404— Zip S 3 i C. 7 Qualifier 5 A-Mve_A L ; tx -bo.d 2.0 e 1 State Certificate or Registration No. Certificate of Competency No. 0 S 500 0 '17 8' Architect/Engineer's Name (if applicable) Phone # Zip Square Footage Of Work: Type of Work: [Addition ❑Alteration [New 0 Repair/Re�� ❑Demolition Describe Work: Q e3 i 6 e .. E) f ��- � cam S v ic. -e 2 C9 c rh �► �/ ** * * * * * * * * * *** *** ** * *** *** ** F ees * * ** * *** * * * * * * * * * ***** ****** ** Submittal Fee $ Permit Fee $ /3 4 CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ 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 O WNER: 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 Owner or Agent The fo egoing instrument was acknowledged before me this8 day of MI 20 by )11,-J who is pe1sonlally known to me or who has produced NOT r Y ' UBLIc: Sign: Print: My Comm sion Expir APPLICATION APPROVED BY: chc 05/13/03 ,13114cia., The foregoing instrument was acknowledged before me this �q Cam' I 119 , day of MO i-& 20 b 1 `' atJed U 9 In who is personally known to me or who has produced As identific NtidockWA ( O` as identification and 1-' • y He PUB • �;. ���. �� n #DD47645 J : : Lt'ls� �ndi C Sign: r �k' �� Atlantic 8 Print: * * * * * ** ***********.********** *,**** * * * ** * * *** ** * ** * * * * * * *** * * *,t ** My Coim Contractor o did take an oath. TATE 0 s. tic Bondin **** * * * * * * * * * *; * * * * * * * * * * * * * * * * * * ** **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning ITEM 3ATH TIB UNIT FEE ITEM SWITCH CUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE 31DET LIGHT OUTLETS CENTRAL HEATING 3!SHWASHER RECEPTACLES A/C (WIND) )ISPOSAL SERVICE TEMPORARY A/C (CENTRAL) JRINKIND FOUNTAIN SERVICE SIZE IN AMPS 1 DUCT WORK :LOOT DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TCP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEA1! BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE MRJTDRS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MDTCRS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 1-P VIOLATION INDIRECT WASTES A/C WINDOW RE WSPECTJON WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER 'HEATER GENERATORS TRANSFORMERS -NEW INST. GENERATORS-TRANSFORMERS HEATER- REPLACE . GENERATORS TRANSFORMERS 'SPECIAL LAWN SPRINKLER -WELL PURPOSE SWIMMING POOL OUTLETS COWERCIAL WATER. SERVICE SIGN TUBES SEWER CONNECTIONS .'.SIGN TRANSFORMERS UTILITY-SEWER - SIGN TIME CLOCK UTILITY -WATER F I XTLRES SEPTIC TANK ANTENNA RELAY TELEVISION CUTLETS )RAINFIELD, 4' TILE/RES. 'IJMP VIOLATION It ABANDON SEPTIC TANK RE I NSPECT ION .. 30AKAGE PIT CU. FT. .:ATOM BASIN - IISCHARGE WELL IOMTSTIC WELL AREA DRAIN CIF INLET OLAR WATER HEATER IRE STANDPIPE COL PIPING AWN SPRINKLER SYSTEM AS RANGE TER SET (GAS) IS P IPIT AN A£PLISATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING !l L1 1J 11 Li LJ 111 1 u u l LU 111 V 1iVIi 1 (ll 1 L i V!1 1 1 V11 ELECTRICAL MECHANICAL 4 1 Scheduled Inspection Date: July 12, 2010 Inspector: Devaney, Michael Owner: ANDERSON, ALBERT & KRISTINE Job Address: 1217 NE 100 Street Project: <NONE> Building Department Comments July 09, 2010 Miami Shores, FL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 V Inspection Number: INSP -11670 Permit Number: EL -3 -06 -607 Contractor: ALL QUALITY ELECTRICAL SERVICES, INC For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050090631 Phone: (305)968 -7832 UPGRADE ELECTRICAL SERVICE 200 AMP Passed E' Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments / (2 o Page 1 of 15