EL-07-2138Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 01/02/2008
Inspector: Devaney, Michael
Owner: PETERSEN, JHON
Job Address: 893 96 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)498 -1440
Parcel Number 1132060142690
Lot:
Phone: (305)758 -2000
Building Department Comments
NEW UNDERGROUND PIPING FROM EXISTING 200
AMP METER /MAIN TO FPL POLE
JAN 0a200B
Passed
Inspector Comments
cc
/ /7/7
Failed
i /
&-) g
-' ' )Li
.2- J
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Friday, December 28, 2007
Page 1 of 2
Miami Shores Village Tern
Building Department -'k
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING RECEIVED
PERMIT APPLICATION OCT g zuu/
FBC 2004 BY:
Permit No. 1 U
Master Permit No.
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder) �° ,� �- SS:2\('o
Owner's Address 4rc-• ' ' �-(% S- _4
Phone # -
City {'til uo' • ,SkONNI2S State (1-7(0-Y-1
Zip
Tenant/Lessee Name i Ne's Phone #
E -MAIL:
Job Address (where the work is being done) Gam,
City Miami Shores Village County Miami -Dade Zip -�S�
FOLIO / PARCEL #
Is Building Historically Designated YES NO '
Contractor's Company Name Ne i c \nc Phone #
Contractor's Address q
City f GQ /1 _ State ` (GAC 4 Zip
Qualifier Name \j• -_e cx,C Phone #
State Certificate or Registration No. �= (x a � . '59 Certificate of Competency No.
E -MAIL:
-
Architect/Engineer's Name (if applicable) L
Value of Work For this Permit $ t "I OD .UCH
Phone #
Square / Linear Footage Of Work:
Type of Work: OAdditio ❑Alteration ONew
Describe Work: ea) .I,NZ�.
Repair/Replace, O Demolition
******************************** xw.x#.Fees* ** * * * ** * * * * * *** ** **
Submittal Fee $
Notary $
Scanning $ Radon $
Permit Fee $
Training /Education Fee $
((�
/'-4e9/ 6'4'
0 10
DPBR $
CCF $
CO /CC
Technology Fee $ •15
Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 151( -35
See Reverse side -+
Bonding Company's Name (if applicable) \ f
Bonding Company's Address
City State t 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. [ 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 or Agent
The foregoing instrument was acknowledged before me this l The foregoi instrument _was acknowledged before me this#,
day of (add% , 20 V, by ® / r /J , day of , 2c 7 , by -Iii Iia% 9' y ,
who is personally known ro „e or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
xxxxxxxdc*x* *** *Yxx**xx
APPLICATION APPROVED BY:
(Revised 02/08/06)
Notary Public - S4,te o[ Flury
•Wy
Commission Expires May 11, 2010
Commission # DD 531936
*Iffolidetflffiltittohtflaktritilftt
NOTARY PUBLIC:
Sign:
Print:
My Commissi
1 ,/ -ter%■/
****xxxxkic****x
`' J;Y I'ij %i
Notary Public - State of Florida
C xxI'xr 51t5<'
%9,��r °•• mission # DD 1936
•�FQ,A � Bonded By National Notary Assn.
c--`e5>-Plans Examiner
Engineer
Zoning
cf
— a
Q fi
0) .03 VP
(L) N -
to T2-
C.>
Prepared By :
William C. Davis, III, Esq.
2655 LeJeune Road, Penthouse 2
Coral Gables, Florida 33134
Tax Folio Numbers: 1 1- 3206 - 014 -2680
and 11- 3206 -014 -2690
111111111111111111111111111111111111111111111
t4 211 0 DR Bi. 23444 P9 ^1161 F Y
RE-.i:11tsC'E[' 0 ,'fi6;'"005 12r.4710::.
DEED tUt.: Tits 4p390.00
4 Vr R kV ' 4P CLERK i'jF f:(}t }ir
MI +lit—C'ADE COUNTY FLORIDA
LAST PAGE
WARRANTY DEED
THIS INDENTURE made this 1-1 yy of May, 2005, between E.I.I.N.C.O. Limited,
a British Virgin Islands Corporation , whose address is c/o Luiseugenia Johnson, 22 North End Road, Key Largo
Florida 33037 hereinafter referred to as "Grantor ",.and BEVERLY JAMESON and JOHN R. PETERSEN,
Husband and Wife, whose address is 893 NE 96 Street, Miami Shares, Florida 33138, hereinafter referred to as
"Grantee".
Witnesseth that the Grantor for and in consideration of the sum of Ten and No /100 ($10.00) and other good
and valuable consideration to Grantor, in hand paid by Grantee, the receipt of which is hereby acknowledged, hereby
grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the Grantee all that certain following
described land, situate. lying and being in Dade County, State of Florida, to wit:
Lots 3 and 4, Block 74, MIAMI SHORES SECTION THREE, according to the Plat
thereof, recorded in Plat Book 10, Page 3, of the Public Records of Miami -Dade County,
/0 Florida. 3 ,1�.
SUBJECT TO: All easements, lien rights, covenants, restrictions, limitations, dedications,
declarations, reservations, and conditions of record, whether set forth on the subdivision plat,
common to the subdivision or otherwise of record; zoning and other governmental regulations,
and taxes and assessments for the year 2005 and subsequent years.
And the Grantor does fully warrant the title to said land, and will defend the same against lawful
claims of all persons whomsoever.
In 'Witness Whereof, the Grantor has hereunto set its hand and seal the day and year
above first written.
Signed, sealed and delivered in
our presence:
E.I.I.N.C.O., ited
Grantor
( Witless Signature)
Printed Name: MMCI lJL j li?R�
(Witness Signature)
Printed Name:
STATE OF FLORIDA )
COUNTY OF MIAMI -DADE )
Luise
A
genia J e s• , President ---�
ress: 22 North End Road
Key Largo, Florida 33037
(Corporate Seal)
I hereby Certify that on this day, before me, an officer duly authorized to administer oaths and take
acknowledgments, personally appeared Luiseugenia, as President . • of E.I.I.N.C.O., Limited, a British
Virgin Islands Corporation, , well known to me to be the person named as the President of Grantor in the foregoing
deed and who executed the foregoing instrument, who acknowledged before me and twq subscribing witnesses that
he executed the ame freely and voluntarily , and an oath was not taken. (Check one:) Said person is personally
known to me. f Said persons provided the following type of identification ' ( r L , ,
NOTARY RUBBER STAMP SEAL
Mai K.' L Atnotc vei ez
D 0762QQ 6XPLPFr
6, 2006
Witness my hand and offci 1 seal in the County and
State last aforesaid this t3 day of May, 2005.
Notary Signature
Printed Notary Name