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RC-11-659Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 158400 Permit Number: RC -4 -11 -659 Scheduled Inspection Date: June 06, 2011 Inspector: Bruhn, Norman Owner: BISCHOFF, HERMAN Job Address: 1025 NE 91 Terrace Miami Shores, FL Project: <NONE> Permit Type: Residential Construction Inspection Type: Final Work Classification: Kitchen Cabinets Contractor: EJD CONSTRUCTION CONSTRACTORS & INVESTMENT CO Phone Number Parcel Number 1132050010020 Building Department Comments KITCHEN REMODEL Inspector Comments Passed,(-61 / Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 03, 2011 For Inspections please call: (305)762 -4949 Page 12 of 26 Miami Shores Village PR a 2011 A Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: e. Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit No. 11".. Master Permit No. Permit Type: BUILDING 2 r OWNER: Name (Fee Simple Titleholder): 14 e (wtCl/1 :. c/1,p 'i Phone #: Address:A0.15 NE 91 Te rr. City: M1 W M 1 5110ZGS State: FL. Zip: 3319 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 10.15 iiE 411 . City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel #: Is the Building Historically Designated: Yes NO v" Flood Zone: CONTRACTOR: Company Name: E f_a Cri 0 I Phone #: 305 318 1X178 Address: 1100 NE 143 S+ . City: tiCatIA t- 111A1. tt State: 1F'L Zip: 33181 Qualifier Name: Ea)ct .S +(,}gl2,pso oUGO4 Phone #: State Certification or Registration #:C GC - /5A5 f61 Certificate of Competency #: Contact Phone #: 3os 3r$ 'I 78 Email Address: E.) DCONSTRUC 11 OA) (345t• Ad- DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ -1000. e° Square/Linear Footage of Work: 00 69 4+ Type of Work: ❑Address Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: r t ; h, r n 6 ✓ " fir COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by ******** * * * * * * * * * * * * * * * * * * * ** * * * * * * * * ** Fees***:**:****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ /(2 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Double Fee $ Structural Review $ Training/Education Fee $ Technology Fee $ TOTAL FEE NOW DUE $ 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. � the absence of such posted notice, the inspection will not be droved and a reinspection fee will be charged. Signature C i`., -;----=;-1='-'7 . / Owner or Agent The foregoing instrument was acknowledged before me this 11 day of APR% , 201 t , by EQic, Scar/ho z.0 who is personally known to me or who has produced DL* 'B X%Q 323314.239As identification and who did take an oath. NOTARY PUBLIC: Sign: 2o._ Print: II.A. NON, AMC • MINS 01 My Commission Expi! Coon 100 7l$11 Baidedlbrofty APPROVED BY Signature Contractor The fore i ment wa ackno %ledded be f 1'e me t 's 1`'f /� day of ,20 iI ,by..,t 1G — ersona llyy known to me or who has produced' 'LOZ entification and who did take an oath. PUBLIC: Sign: Print: My Commission Expires: isr fd�' * * ******************************************************* f�7- Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to Certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement 111111111111111111111111111111111111111111111 4Fh1 241110256162 OR Bk 27660 Ps 1336; (1os) RECORDED 04/20/2011 11:12:53 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTY, FLORIDA ,.LAST PAGE Space above reserved for use of recording office 1. Legal description of property and street/address: 1619,5 NE (11 Tee( .U, drvl t S H o /eS I T-( S3131 (3$ 2. Description of Improvement: l�. e�e.10 ✓c.(t�0i.1 3. Owner(s) name and address: �` . P1 s . 9 r r /0/T •... PSG Interest In property: d/P i 3i s $ Name and address of fee simple titleholder. 4. Contractor's name. address and phone number: E. .tD Con 51-(1/6+1 ran 1 7O0 ii/&- 1 GI 3 5r, Ira rte1 F I 3 31$j 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number Amount of bond $ 8. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1Xa)7., Florida Statutes, Name, address and phone number 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided In Section 713.13(1)(b), Florida Statutes. Name, address and phone number: 9. Expiration date of this Notice of Commencement (the ewpiratlon date 191 year from the date of recording unless a different date la specified) WARNING TO OWNER ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) of e,;,:, • ) or Owners ' " ed • : j • Irector/Partner /Manager Prepared By =t�� Prepared By EQ/ ! �CrAL801s;d(.L6,�/ Print Name . ..4.��� �c� Print Name Tale/Office Title /Office /700 01,E / n!. e» �Arr FL 3g4/ STATE OF FLORIDA COUNTY OF MIAMI -DADE The f o r e g o i n g instrument was acknowledged b e f o r e me this 1 I day of /WAIL L . •O!/ By I L SLA 6#I ❑ Individually, or ❑ as for, ❑ Personally known, or pi produced the following type of ides tion: Z 0 Signature of Notary Public: n.,.. Prim Name: (SEAL) Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director /Partner/Manager who signed above: By By 123.0142 PAGES 9110 Book27660 /Page1336 CFN #20110256162 Page 1 of 1 ADD SMOKE/CARBON MONOXIDE DETECTORS ANY AND ALL CLOTH AND RUBBER SULATED CONDUCTORS TO BE REPLACED. NO POINT ALONG COUNTER TO BE MORE THAN 2 FEET FROM G.FI PROTECTED RECEPTACLE. PUT DAN RECEPTACLE UNDER SINK. ALL FIXED APPLIANCES ON DEDICATED CKTS. Install new smoke detectors as per NEC 2009. 802913 OP WOW: Rope= signs athinotawn lea.973* letal tablud, 1.1211 Nu/grads Waft, toyer tooltaphell Courar top odes 1,1 2We rt dar=*42 mamas dotealejares•eul ham In complItraxillINE0 Irterl mot pturnbing eamea satin eeentaCan. hiwogfr "PZ11 VT .......................... to. KOI■I■1•1■1#10,K010,1014; II•19 ,1■4 '40 KIT HEN re-r 12,7 .:7!:VVVViWiTOVVATAMIVANNOVV: rAl r Miami Shores APPROVED BY ZONING DEPT BLDG DEPT DATE SUBJECT TOSONLEICUrn-r-e. FEDERAL N STATE AND COUNTY RULES AND REGULATIONS • • • • iteitiVMON.VVNUNkliniVVV.SMMilitiVVVIVVigee:V03.14 LIVING AREA 2288 8•11 • • • • • • • • • • • • • • • • • • • • • • 11. •• •• • NO POINT ALONG COUNTER TO BE MORE THAN 2 FEET FROM G.EI PROTECTED RECEPTACLE. PUT DAN RECEPTACLE UNDER SINK. ALL FIXED APPLIANCES ON DEDICATED CKTS. SCOPE OF WORK: Replace existing cabinets with new maple wood cabinets. Install new granite counter top w/18" back splash. Counter top outlets to be spaced as required in compliance with NEC 2009 and to be on GFCI circuit. Install new smoke detectors throughout house in compliance with NEC 2009. Install new plumbing fixtures to existing connections. SCALE: N.T.S. 3132DH • ••• •. .• • Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NSP- 158408 it (osci\ Permit Number: EL -4 -11 -660 Scheduled Inspection Date: June 02, 2011 Inspector: Bruhn, Norman Owner: BISCHOFF, HERMAN Job Address: 1025 NE 91 Terrace Miami Shores, FL Project: <NONE> Contractor: BROWER ELECTRIC LLC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050010020 Phone: (954)748 -6236 Building Department Comments ELECTRICAL WORK FOR KITCHEN REMODEL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 01, 2011 For Inspections please call: (305)762 -4949 Page 2 of 8 Miami Shores Village APR i42011 L.) 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 BY: ,!0000060000.0000000,° BUILDING Permit No. .l It --CCa CI O PERMIT APPLICATION Master Permit No.Clt' .0 9 FBC 20 Permit Type: Electrical ` OWNER: Name (Fee Simple Titleholder): A/'/11A/7 /5O%1Oi? Phone #: Address: /0 5 NE 9/ VW. City: mIIrin/ S/%/Z4-5 State: A. Zip: ,3'3/38 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: /OAS- NEr// 7 `7Zec • City: Miami Shores County: Miami Dade Zip: 33)34' Folio/Parcel #: Is the Building Historically Designated: Yes NO 1/ Flood Zone: CONTRACTOR: Company Name: &ow°et EIeC /r. °L Phone #: 95-1l 7981436 Address: 8 6 3 N i3 S r +t��rl�.'!1 L State: F L City: L Zip: 33 ( Qualifier Name: w1 rS A lb Hsu 2{ Phone #: 951 5.78 /Roc" State Certification or Registration #: f C /3 vO Rio / F; Certificate of Competency #: Contact Phone #: i$4.1 Email Address: 6roir.er e /eeirre a 401, Co' DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ .500 .122 Square/Linear Footage of Work: 420 Sit. !/ Type of Work: ❑Address ❑Alteration ❑New *Repair/Replace ❑Demolition Description of Work: ki4O.ier' (Z r oVCr. 1 or * * *** * * ** *Fees * * * * * * * * * * ** Submittal Fee $ Permit Fee $ v "" CCF $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ NMAD O tipp 1TtArl6$ Notary $ Double Fee $ Structural Review $ Training/Education Fee $ Technology Fee $ TOTAL FEE NOW DUE $ i l.) 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 Pit3tice, the inspection will not be approved and a reinspection fee will be charged. Signature caner r Agent The foregoing instrument was acknowledged before me this // The foregoing instrument was acknowledged before me this 13 day of iQpai / , 20 1) , by ecu, f/'./ StgArrOI DGter4 , day of ATM: ` , 20 , by who is personally known to me or who has produced DL i4— who is personally known to me or who has produced f L •2/034233+?433O As identification and who did take an oath. C:7L k-- as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: 84,60 L117 76? ol;© Signature Contractor Sign: Print: My Co APPROVED BY /72--// Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) Sign: Print: My Co Zoning Clerk Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ►1- 105c1 Inspection Number: INSP- 158411 Permit Number: PL -4 -11 -661 Scheduled Inspection Date: June 03, 2011 Inspector: Hernandez, Rafael Owner: BISCHOFF, HERMAN Job Address: 1025 NE 91 Terrace Miami Shores, FL Project: <NONE> Contractor: NELSON G CLIVE PLUMBING INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050010020 Phone: (954)801 -6038 Building Department Comments PLUMBING FOR KITCHEN REMODEL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CL June 02, 2011 For Inspections please call: (305)762 -4949 Page 4 of 7 Miami Shores Village Building Department Ad7Mj L _, I', NPR 1420t1 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No.'- ` 11 " PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: PLUMBING J �- / OWNER: Name (Fee Simple Titleholder): /4'2179,9#) �ISet/ Phone #: Address: /O? NE 9/ . City: /77//9'?71/ £ *IZLS State: /GL Tenant/Lessee Name: Phone #: Email: Zip: 33)3g JOB ADDRESS: /40?3 AI( %/ 7? / • City: Miami Shores County: Miami Dade Zip: 33,3e Folio/Parcel #: NO Flood Zone: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: a u( i t I5CL/ t Phone #: Fs-iv '/ /s/ Address: /.6 S'C7 c000- City: %' / G lWCLA/A� y Stater- Zip: 3�0 '� Qualifier Name: %' /e 6- /���$W) Phone #: State Certification or Registration #: Cf'c CSk® /6 Certificate of Competency #: �3 Contact Phone #: / d'2 4,4 49 Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 300. ° Type of Work: ❑Address ❑Alteration Description of Work: l /'1 IeG Square/Linear Footage of Work: /4 D 45-p• ❑New Repair/Replace ❑Demolition IM, tak ristreiwArta "0611 'alyttg Submittal Fee $ Permit Fee $ /0C) Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ,.4) 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 FI.ECTRICAL 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signatun t er' r Agent The foregoing instrument was acknowledged before me this / / day of Apa / , 20 // , by le''%LI S W #43040il , who is personally known to me or who has produced Di- .010 6.2 / 0,3233.2 'i.,23D As identification and who did take an oath. NOTARY PUBLIC: Sig ! ! - '. SC1S , Print: My Commiss NNW Pals - Slab a. Raab 1144011vallea#*MNt1t 2011 Comminkm • ID M113 *s:* * * ** * * ** APPROVED BY Signature e4,,. 4 f. Contractor The foregoing instrument was acknowledged before me this /Z day of , 20 /1_, by who is personally known to me or who has produced as identification and who did take an oath. NO BLIC: Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Sign: Print: ol]1p].isslp State of Florida 9* °'9 Karla J Carey v. tzil My Commission EE061206 Expires 12128/2014 0 *** **sk**skakaksF*sk*ak3 ,:a$*** Zoning Clerk 2011 -04- 2508 :34 Clive G. Nelson Plum 9544384737 » 1 800 685 7530 P1/1 • ° � CERTIFICATE �7F- .LIABtII�I� INSURANCE OATS (MMfDDKY, � o � PRODUCER Opt Smut 1nwnn a Inc. 10321 N.W. lid Aw MINK FL 3.1169 PIMiv (30E053.71T, NA THIS CERTIFICATE IS IUU!b Ai A MATTER OF INFORMATION ONLY AND CONFEIRN NO MOM UPON THE CERTIFICATE HQIAER. TEM CERTIFICATE ODES NOT AMIP4 EXTEND OR giapt TI4P 001!1 9! AFFORDED BY THE POLIOI BELOW. ImoutuPQ APPIJNI w YirY1stokui t NAM 1 mama CAVE G MOOR Pumhln0 Inc 10218 BW 23 Ct Miramar, FL 33025 I • Nation' IMUranda ©rOU _ sgyREN D. IMEURER !: COVERAGES INSURER r: --WE KWH C . EIELIANI:CL ll311D WA12 IRLL3 ANY IGGARIDENT. TREMOR CONDITION OF ANY MAV P!fTAM. THE FIB .10FOFIDEO as' THE ACCREOATI LENTS SHOWN MAY HAVE ISM TL-11411 :L ; ULttr>163140 "Zf 114E ; G111 01110 ' 1104117101I l I MHO CONTRACT OR OTHER ocKAAMINT WITH Raao1OT TO WHIOM TMW OIR W OAT1 MAY as WAD OR Milan DECCrIMEO HET1EIN IC CUEJECT TO ALL THE T!f MC, MIDLUCIONC /IND L'QlMI�S RRE OF CUM !!M REDUCED EY MO CLARE. FOUOtai. 37 gin TYPi OF INSURANCE POLICY NUEHN �� 02!18/11 11412474 02/18/12 T.- LEM PAM fa IHRPN? O AAAff A movaimM I NMI rry Il7� 0CR+9JERCL?LGEVERSLLMJ IUTY MC 078.3181 717J' . #i , N n Milan... . 4100,000 , MO IMP (My ma pow) 85,000 CLAM WE ® OCCUR ■ pERBoNAL a KW INJURY 8500,000 D GENERAL r GORDEATE 8500,000 D IQATR AMMO PRL PROIAICT$ - CCNIFICP ADO 8500, 000 OEN L A(i13 WAIT MAY 0 PROJECT • LEE P D MOM his - Cli0S+g0 ■ AUTTM8WIJLIASIEW 0 ANY ADO AI 1 Men alma eaieoLLED AUTOe HIED AUTOS NON OWNED AUTOS Q • 1AAOsPftU Writing ui 1 Ma scolded) BMW INJURY tPV pP1 I BODILY INJURY (PerltoRANri$ PROPERTY DARAAo! (Per rooldsnt) • ❑ GARAGE LIME TY ❑ ANY AUTO El AUTO ONLY • EA ACCIDENT amen THAN EA ACC AUTO ONLY: Age EccosaiUMERILLA WWLm ❑ oocUR ❑ DUMB raw 0 DEDUCTIBLE ❑ RETENTION $ ENCH COCURRENCE AAOREGiAT1 B wORltab 00Aa•aelaATIEN Awn 'IUND14S! TLJ1 d/1 LI 11J13/11 Ewan. _ EMPIAY1Re' L IAIILITY oinrnoPPurront PARTNER / EXECUTIVE OFFICER /MEAN E,9CWNW yes I O : �o.-.. Ir El. ENCN AOCIDONT 100,000 C.L. o0 =AC - CA ChEL0YCC !00,00 .1 I MUMS WV V'YJ IM6.6 1110 Ana OTHER oaaaaarnoN OF oramtoNa I =aim I mom / IJICLLWONe ADDi SY INDONSIDENT I aarIWAL INNOVI$IONi Plumbing CERTIFICATE HOLM CANC1wT10N Li 1 T LW MIAMI IitrlVKtl:i 1 OOSO NE 2ND AVE. MIAMI SHORES, FL 33138 1954438.4737 FAX mow) ANY OP THE WWI IICR$io POLEM11611 {TINED WORD TM wpm= maim THIRCOF1 THE Ramo avaIJRIR WILL ENDOW* TO MAL OD Weal MITER OJ NuTW` I T41111 GURTIMATa Flatr.Ell WARR TO TRI<LE % TUT PMILURI TO DO SO etALL. UAPOalt No OILIOATICN OR Maury OF ANV KING UPON THE INSURE, Ra ARAM" OR REFRae11TATNIaa. AITHORLIIm RIPI EMETATNE + <N >:W4IK V :*.b. KM-MO (20011e) Cr 2011 -04.21 15:29 3056540293 ACCORD CORPORATION 190E Page 1 Permit Number: MC -6 -11 -990 I Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 160423 Inspection Date: June 01, 2011 Inspector: Perez, JanPierre Owner: BISCHOFF, HERMAN Job Address: 1025 NE 91 Terrace Miami Shores, FL Project: <NONE> Contractor: MAGIC AIR CONDITIONING CORP Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Kitchen Hood Phone Number Parcel Number 1132050010020 Phone: (305)898 -6044 Building Department Comments REPLACE KITCHEN HOOD DUCT -..--() G"' ( ( i (r Passed Inspector Comments (,\'' IM Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 June 01, 2011 Page 1 of 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33 38 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 20 Permit No. C- d I —91:3/0, Master Permit No. 2 L ',-- I Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) rot rmari e / 6 /i Phone # Owner's Address H i =#+ &f d z / . p Ale- City /1)1 f i _S�// ice={ State (L- Tenant/Lessee Name Email ,i Job Address (where the work is being done) City Miami Shores 'Village Zip 33) 3 8 Phone # k 1C— 3e6-7./ ® County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name /406:11C 414 e0114 �r-'J Cc"2 -p Phone # (305) Ito 044 Contractor's Address 62 1l/ ) 26, r City //lei State Fe- Zip 33/55 Qualifier Name alb( h ,' it>* _ Phone # (052 trl `7,'fo0 Sled State Certificate or Registration No. Cf4C 041Z 703 Certificate of Competency No. Contact Phone Architect/Engineer's Name (i E -mail applicable) Phone I# Square / Linear Footage Of Work: Value of Work For this Permit $ 280 • ®e. Type of Work: ['Addition D:sc 'b ['Alteration /oDAP ['New L7/Repair/Replace Over ❑ Demolition fvo Y�:C�, klt�at�i�'i.,hF. tetaA , — ******* ** * * * ** ******** *****�k�k�k�krk� ***** * **** *** Submittal Fee $ !`�'t i`-+ Permit Fee $ � 6 Notary $ Training/Education Fee $ Scanning $ Radon $ Bond $ Structural Review. $ C4ilC3C C i9 .i aC:* l E•Pi "r CCF $ CO /CC Technology Fee $ DPBR $ Zoning $ Code Enforcement $ Double Fee $ Total Fee Now Due $ 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 commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all IawS regulating construction in this jurisdiction. I understand that a separate permit must be secured for FTFCTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 2 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, COMMCONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF ENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500. the promise in good faith that a copy of g applicant must py f 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 foregoing instrument was acknowledged before me this day of /gay 20 it , by G who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign' � - Ci - adr 'JG Print: My Com resRAO&A. SCARBOROUGH Notary Public • Buts Of fbdda `• WCampion Evan OttIS,X II Contagion R OO 72813 floodedThroma Nand NoHryAten. ***************** ** * ** * * * * *** ** * * * * *** * ** * *** * ** APPLICATION APPROVED BY (Revised 07/10/07) 1 *************************************************** ns xaminer Signature Contractor The foregoing instrument was acknowledged before me this day of f7) , 20 , by who ispersonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: 6- L Engineer Zoning Clerk checked