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EL-10-26 N �f33 �r r 9' a ��) Miami Shores Village . . �} R l 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 33 3 �� Phone: (305)795 -2204 Expiration: 07/1412010 Project Address Parcel Number Applicant 117 101 Street 1131010220150 Miami Shores, FL 33150 Block: Lot: KATHRYN HAMILTON Owner Information Address Phone cell KATHRYN HAMILTON 117 101 Street MIAMI SHORES FL 33150 - Contractor(s) Phone Cell Phone Valuation: $ 600.00 IDIK ELECTRIC INC 305 -552 -0150 Total Sq Feet: 127 Type of Work: INSTALL 8 OUTLETS For Inspections please calk Additional Info: (305)762.4948 Classification: Residential Available Inspections: Inspection Type: Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $0.60 DBPR Surcharge $0 EL -1 -10 -36756 $ 305.88 $ 305.88 $ 0.00 Education Surcharge $0. Check #: 1035 Permit Fee - Additions/Alterations $150.00 Radon Surcharge $0.64 Scanning Fee $3.00 Technology Fee $0.80 Work without Permit Fee $1 50.00 Total: $305.88 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. February 05, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy February 05, 2010 1 Miami Shores Village Building Department JAS 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 0 5 RECD Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: f305).762.4949 BUILDING Permit No iwo ' ;4 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type ELECTRICAL Owner's Name (Fee Simple Titleholder) KATIA I,N H Phone # 30S 3 - 1 1 — 37 8 5 Owner's Address ( SO ',f ZND I-y II q City State FL Zip 3 7 � 3 1 Tenant/Lessee Nam u Phone # Email � Job Address (where the work is being done) IA VJ t 0 City Miami Shores Village County Miami -Dade Zip 3 1 ' 3 kD FOLIO / PARCEL # t ` — `Sk ®1 ° ® 2.2. -- 01 Is Building Historically Designated YES NO )�_ Flood Zone Contractor's Company Name _ .�:'� 1 2 _zC_ U C_ Phone # 6�01!?� 4-vi — ®Ses Contractor's Address 1 k 3 ® SL.;,) - 2- (® S,T City State T:'L rl� Qualifier Name ::�_ ®1S - 1 - 12il q Phone # _ State Certificate or Registration No. r--Q— C C > 151 Certificate of Competency No. 9 R G Ca00 24 Contact Phone &? S� SS's — ® k E -mail ±rj G �\kS OA t IN- 1_A44 - _ Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ - 41 60D Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑ Demolition Describe Work: 1 N`2T M ( n L. k&14r ®() — N�t� ®I'n G F��S TZA1 KIT ew KF D k T1467 FNCI DAT} V")M Submittal Fee $ Permit Fee $ 14&?4M® CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ 0, Scanning $ 3 "V Radon $ DPBR $ Bond $ ,Double Fee $ Violation date: Structural . $ Total Fee Now Due $ M4'w See Reverse side I Bonding Company's Name (if applicable) (� Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) k-4 f� 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 c mmencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In absence of such posted notice, the inspection will not be approved and Vre-i nee 11 be charged. R' Signature Agen Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Z2 day of f lNl� , 20 U), by p /RY1J 1 1/AW/fA,/�/L0 day of NX cew.�p�r 20 O , by I" �V , who is personally known to me or who has produced ) who is personally known to me or who has produced X .bA . t— iidex's& As identification and who did take an oath. — as identification and who did take an oath. NOTARY P NOTARY P LIC: " l�jandro Aguado Sign: Sign: rntssion #DD582703 --� p►re . AUG. 08,2010 Print: C/�.d�l�� p Z Print: ' F � FF �' © o °° AARONN .com M Commission Ex �r � Eneida Lopez Y p' @;'' -� My Commission Expires: •- : *= - Commission # DD547762 1 T $'.in Msso1e APPROVED BY Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) C OR D CERTIFICATE OF LIABILITY INSURANCE OP ID DX DATE(MM/DD/YYYY) IDIRE -1 1 08/19/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Customers Rule Ins. Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1830 S.E. 4th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Ft. Lauderdale FL 33316 Phone: 954- 759 -7171 Fax: 954- 759 -7170 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA *Canal Insurance Compan IDIR Electric, Inc DBA Data INSURERS: *Travelers I ridemni ty Company 25666 and Wires Electric INSURER C: 11370 SW 26 Street INSURER D: Miami FL 33165 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR N R S DATE M TYPE OF INSURANCE POLICY NUMBER POLICY M/D POLICY EXPIRATION LIMITS M/DD DATE MM/DD GENERAL LIABILITY EACH OCCURRENCE $1 B X COMMERCIAL GENERAL LIABILITY 660- 9119N83A 08/16/09 08/16/10 PREMISES (Ea occurence) $100,000 CLAIMS MADE � OCCUR MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 X POLICY PRO LOC Ben EXCLUDED PRO - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR El CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WC STATU- WORKERS COMPENSATION AND X TORY LIMITS ER A EMPLOYERS'LIABILITY WC 1 11911 5 02/21/09 02/21/10 E.L. EACH ACCIDENT $100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L. DISEASE -EA EMPLOYEE $ 100,000 If yes, describe under SPECIAL PROVISIONS below E.LDISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Electrical Work - Within Building. CERTIFICATE HOLDER CANCELLATION MIAMI S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Miami Shores Village NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Building Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 10050 NE 2nd Ave Miami Shores FL 33138 REPRESENTATIVES. AUTHO REPRESENTATIVE ACORD 25 (2001/08) © ACORD CORPORATION 1 ---- - - - - - -- a ' � i`NC CC :# 99 ECTRiC t h DAB TIC Tom; 1ff} f � 'fl1X AE8:�7tt' � R8Y1RS • X!F DO NOT FORWARD IDIK ELECTRIC INC a xe IVAN TRIFF PRES rA OF 11370 SW 26 ST MIAMI FL 33165 ~ SEE OTHER SIDE 2010 MRST"CLASS CONTRACTOR'S U.S. PPOAGE 2009 AST MUNICIPAL TAX RECEIPT MIAMI, FL MIS COLLECTOR E COU gTATE OF FLORIDA pERMIi No. 231 MIAMI "DADS COUP " CODE SEC• 10'24 1 W pl ACLER ST. PURSUANT TO GO 1st FLOOR EXPIRES SEPT. 30, 2010 MIAMI' FL 33130 DO NOT PAY THIS Is NOT A BILL 9E000247 30- 4336459 CC N0' RECEIPT HOLDER MAY DD OR RECEIPT NO. A S PEC F ED HEREON BUSINESS NAME I LOCATION IDIK ELECTRIC INC 11370 SW 26 ST OWNER DIK ELECTRIC INC ELECTRICAL CONTRACTOR P C�PpLITIES DO NOT FORWARD PARTICIPATI Receiptho►dermust IDIK ELECTRIC INC register in the city. I V AN T sW P ST where work is to be M done. IAMI FL 33165 done. RoGOVED c0'j y gyt g (6 !! p AA q q 3366 j j {7 ti{ ] . pJpU � J �� bti7678 � { i} i 715 lgll}ii179S177ti77696777Mgi14Y X0 23 006 1 'eaa 17774 STATE OF FLORIDA D�;PART rybF` LR00151-64 it /�� 0$$009 REG ELECTRICAL CQNdR TRIFF, IDIR BLECTiC I13C$+ Ate; "w (INDIVIDIIAYr.:,:_.ST LICENSING 'R IaR TO CONTRACTING_IN -.1Y AREAS MW. REGISTERED.._ under the prov3s;Lous:.bf � 499 X010. a0 5o15S' F'' SxpS stion date. ADG 31,. =a CTQB. Construction Trades Qual�fft Board BUSINESS CERTIFICATE OF COMPETENCY' 99E000247 x , IDIK ELECTRIC INC D.B.A.: DATA AND WIRES ELECTRIC T FF� RI Is certified under the provisions of Chapter 10 of Miami -Dade County � �•� e mi la ° � 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 137487 Permit Number: EL- 1 -10 -26 Scheduled Inspection Date: March 10, 2010 Permit Type• « Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: HAMILTON, KATHRYN Work Classification: Alteration Job Address: 117 NW 101 Street Miami Shores, FL 33150- Phone Number Parcel Number 1131010220150 Project: <NONE> Contractor: IDIK ELECTRIC INC Phone: 305 - 552 -0150 Building Department Comments Inspector Comments Passed Ez Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 09, 2010 For Inspections please call: (305)762 -4949 Page 20 of 24