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
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M Shores VI Ilene
ACED
ZONING DEPT
BLDG DEPT
SUBJECT 10 OCIVIPLIANCE \MTH ALL FEDERAL
STATE AND CCIJN I rkULES AND REGULATIONS
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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