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EL-10-956Scheduled Inspection Date: July 01, 2010 Inspector: Devaney, Michael Owner: THOMAS, MARIE Job Address: 470 NE 103 Street Project: <NONE> Contractor: MIZPAH ELECTRICAL INC Building Department Comments June 30, 2010 Miami Shores, FL 33138 -2457 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 144546 Permit Number: EL -5 -10 -956 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132060170720 Phone: 305 -620 -2701 UPGRADE SERVICE FROM 100 TO 200 AMPS. TALKED TO MIKE OVER THE PHONE ON 5/28/10. HE APPROVED TO RELEASE THE PERMIT W /OUT HIS SIGNATURE. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments `A-9 9 ��� 9, - F ; Y(/ y /6 For Inspections please call: (305)762 -4949 Page 10 of 26 Project Address 470 NE 103 Street Miami Shores, FL 33138 -2457 1132060170720 Block: Lot: MARIE THOMAS Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 MARIE THOMAS Contractor(s) MIZPAH ELECTRICAL INC Phone 305 - 620 -2701 Cell Phone Type of Work: ELECTRICAL Additional Info: SERVICE UPGRADE Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.20 $0.40 $150.00 $3.00 $1.60 $156.20 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 May 28, 2010 Address Parcel Number 470 NE 103 Street MIAMI SHORES FL 33138 -2457 Phone Pay Date Pay Type Invoice # EL -5-10 -38010 05/28/2010 Cash 05/27/2010 Cash Amt Paid Amt Due $ 106.20 $ 50.00 $ 50.00 $ 0.00 Date Expiration: 11/24/2010 Applicant Cell Available Inspections: Inspection Type: Final May 28, 2010 1 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) Owner's Address 5‘70 Al' ,123 City /1ihi ," 6. State Tenant/Lessee Name E -MAIL: Job Address (where the work is being done City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES 0 Contractor's Company Name Contractor's Address n2 /� u) 1511 , � - D City Pi/X/-4/ �s,�k. S' .. State , Qualifier Name 4S h&5 State Certificate or Registration Ni : 000a./ jr E -MAIL: Architect /Engineer's Name (if appigcable) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 zip 33'3, Phone # NO Phone # .'Structural Review. $ Total Fee Now Due $ Permit No. EL -5- FO ` 9S10 Master Permit No. Phone # '726 — Y ^ 9027 County Miami -Dade Zip Phone # . 03,0 S / ( 9 Zip 33056 Phone # o 5 ) 0 2 Certificate of Competency No. Value of Work For this Permit $ /3 0 �7 ' e , Square / Linear Footage Of Work: Type of Work: ['Addition ['Alteration ['New Repair /Replace ❑ Demolition Describe Work: ()o 4.t d�o SP.,Pvi ie es Fit /o0,Q,y," 7 1 , p ,,a00,4 4/ Submittal Fee $ �`o' (34 Permit Fee $ CCF $ CO /CC • `FA Notary $ Training /Education Fee $ Technology Fee $ Scanning $ a Radon $ DPBR $ Zoning $ Bond $ ` Code Enforcement $ Double Fee $ 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 b approved and a reinspection, fee will be charged 1 ! Signature / ✓ i j O. � > c may: Signature Ow, er or /gent The foregoing instrument was acknowledged before me this day of ��j , 20 113 by' who is personally known to me or who has produced — 56 5 /- A )As identification and who did take an oath. NOTARY PUBLIC: Sign;; Print My Commission Expires : (3 0 I Z1 ! \ 2) APPLICATION APPROVED BY: (Revised 02/08/06) z a:x dtrxxxxxa e' g**IcU *x &xxxxxxrxxxx'xaYdc9r*** . zx* xxraci:xz xxxx xx Contractor The foregoing instrument was acknowledged before me this ?_,b day of 0 , 20 10, by who is personally known to me or who has produced ID 2U3 1 I identification and who did take an oath. NOTARY. PUB ,re/rs- "p My Commission Expires: (2), Z, x, ,",**tcxz aYx *xatxt u*fY arZxacxxw�FKai a:,,xz xxxxz xxx Plans Examiner Engineer Zoning ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO RE 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 07/02/2008 EXPIRATION DATE 07/02/2010 / PINISONt DIAS 650485336 FAIN: BUSINESS NAME AND ADDRESS: NIZPAH ELECTRIC INC 508 RICHMOND AVE N LEHIGH ACRES FL .33872 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED ELECTRICAL CONTRACT° IMPORTANT: Pursuant to Chapter 440 . 11e(14), F.S.. an officer of a corporation who elects item Ms chapter by Meg a certificate of election ender this won may not recover benefits or compensation under this chapter. Pursuant to Chapter 449. 1? F.S., Certi'cotes of election to be exempt... apply only within the same of the badness or trade listed on the notice of election to be exempt. Pursuant to Chapter 440. 1 , F.S., Notices of election to be exempt and certificates of election to he exempt shall be subject to revocation 0, at any time after the filing of the notice or the Issuance of the certificate the person aid on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shalt revoke a certificate at any time for failure of the person named no the certificate to meet the requirements of this section. QUESTIONS? 1850) 413 - 1809 1 WC -252 CERTIFICATE OF ELECTiON TO BE EXEMPT REVISED 096 -06 iMPOR'TANT F Pursuant to Chapter 440061141 F.S., at officer of a corporation who elects exemption from this chapter by films a certificate of election L tattler this section may not recover benefits or compensation raider this D chapter. pursuant to Chapter 440.05112}, F.S., Certificates of election to be H tempt- apply only within-the scope of the business or trade listed on ,the notice of election to - be exempt. R • E Pty to Chapter 440.16413), F S„ Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the tam 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. 0.UESfIONS? 18511? 413-1809 STATE OF FINANCIAL SERVICES DIVISION OF COMPENSATION CONSTRUCTION INDUSTRY CMITIFICATE OF ELECTION TO BE EXIEWT FROM FLORIDA WORKERS' COMPENSATEW LAW EFFECTIVE 07/02/2008 PERSON ALST0N DIAS FEIN: 850485338 BUSINESS NAME AM) ADDRESS: MIZPAH ELECTRIC INC SOB RICHNOr6) AVE N LEHIGH ACRES, FL 33972 SCOPE OF BUSINESS OR TRADE i - CERTIFIED ELECTRICAL CONJRACTO PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE EXPIRATION DATE: 07/02/2010 at Carry bottom portion on the job, keep ter portion for your records. ALSTON CUT i• • Oct 15 O9 U1:34p rtizpan tiectirau arl.:e Dew . Your 2009 -2010 Lee County Local Business Tax Receipt is attached below. Please detach receipt and display it in a place that Is visible to the public and available for inspection. The County Local Business Tax Receipt is in addition to any other license or certificate that maa required by law and does not signify compliance with zoning, health or other regulatory req This Lee County Local Business Tax Receipt is non- regulatory and is not an endorsement qu nay. Your 2010 Local Business Tax Receipt is valid from October 1, 2 ,.` through 30 2010. Annual account notices are mailed In August to the address of record at that ti Please follow the instructions on the back of this letter to transfer your Local Business Tax dui to a change of business name, ownership, physical address or you are closing your I h cps. you have a successful year. Lea County Tax Collector Lac 50a RICHMOND AVE LEH MI ACRES FL 33972 WPM ELECT= ps ALSTINV W 909 AVE LOUGH ACRES FL 33972 my Tax Coll 2480 Thompson Street Fort Myers, Florida 33901 www.teetc.com Tel: (239) 533 -6000 Detach and display bottom pawn and keep upper when for you mends LEE COUNTY LOCAL BUSINESS TAX RECEIPT - 2010 t ., " Local Business Tax Account t ACCOUNT RUNNIER: 0611820 ACCOUNT EXPIRES SEPTEMBER May engage In tl:e: bwtneaa of ELECTRICAL CONTRACTOR nes LOCAL moans TAX TRECEIPT IS NON mists TINISISMTANI,Le PAID 286484-t-1 1 ,ns1 98.193 I Permit No: Job Name: ? 4 5 t'Y /® ELECTRIC Critique Sheet /6eyl°' M iami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Mike Devaney 305 - 795 -2204 o H Z 1 t t c ct-e c_p p co n Se_ RA/ is.conlied c 0(0 n1 fictf.--.,c,P, akove.4,e PoDc. f rk w LE- t.7/ M Shores VI Ilene ACED ZONING DEPT BLDG DEPT SUBJECT 10 OCIVIPLIANCE \MTH ALL FEDERAL STATE AND CCIJN I rkULES AND REGULATIONS ,dp Hiz IP t 1 C±-1 k7C H-18 C-P0 C.orrt 0 Se, RN L -iscorro e ci - CrO Rri? akove, Po . V, 4 4 ; ' • 1 M. at/1i Shores VillRge AFPROVED ZONINIG DEPT I j BLDG DEPT SUBJECT i0 CCMPIJANCE WITH ALL FEDERAL L STATE AND cr..,UN,Y HUES AND REGULATIONS