RC-08-1359Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP - 124372
Permit Number: RC -7 -08 -1359
Inspection Date: July 18, 2011
Inspector: Bruhn, Norman
Owner: YVEL, ARMAND
Job Address: 138 NW 106 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: JDF CONSTRUCTION AND ROOFING INC
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Kitchen Cabinets
Phone Number (407)427 -1657
Parcel Number 1121360080040
Phone: (407)456 -2259
Building Department Comments
KITCHEN AND BATH RENOVATIONS /REPAIR FLOOR,
TILE REPAIR
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 124004. CREATED AS
REINSPECTION FOR INSP- 90468. NO Access NB
Work exceeds permit interior alteration and reconfigure space. NB
L''',�
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
July 18, 2011
Page 1 of 1
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 10/06/2008
Inspector: Perez, JanPierre
Owner: ARMAND, YVEL
Job Address: 138 106 Street NW
Miami Shores, FL 33150-
Project: <NONE>
Contractor: US MECHANICAL SERVICE INC
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New
ULPhone Number (407)427 -1657
Block:
Parcel Number 1121360080040
Lot:
Phone: (305)525 -2618
Building Department Comments
REPLACEMENT A/C UNITS AND DUCTS
®CT -4 ''11
,D ([: 16
Passed
Inspector Comments
,�i�
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Friday, October 3, 2008
Page 2 of 2
I I III I
RECORDED 08/13/2008 10:27 :09
This Instru ant Prepared y:' HARVEY RUVINF CLERK OF COURT, iiIAMI -DADE COUNTY, FLORIDA
Names nel YU 2 I LAST FADE
Address �j�00 j�d,(�r .% sports
13S9. ft 331 Tax Folio No.
Permit No.
STATE OF
COUNTY OF
NOTICE OF COMMENCEMENT
THE UNDERSIGNED hereby gives notice that improvement 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.
1. Description of property: (legal description of property, and st eet address if available)
i uzeL �I— Z136_o®8 -ooto ct38 1,1w L06t it ce..u,6 S1.(4 fres FL)
2. General description of improvement:
L t /(5 r t•4re.p -to re AD vwt -La4.0 •
33/5-0
3. Owner information ^, V � �¢ U • , l� G `>r - 3 �z3
a. Name and address: A w - r
b. Interest in property: D W ■telr
c. Name and address of fee simple titleholder (if other than owner):
Contractor: ���% Ctj' t-' C/ 0 , , 14itf 3 ,1- N w i 3
a. Name and address: /�, � /YA
-
b. Phone number: O f /� „/.' ( Z33Q, g
5. Surety
a. Name and address:
b. Amount of bond $
c. Phone number:
(ofoi f 4CCe
6. Lender
a. Name and address: C,x.,.,ej$-S �eeAs1 E`i
b. Phone number. �J
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(1)(a)7., Florida Statutes:
a. Name and address:
b. Phone number.
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section
7.13.13(1)(b), Florida Statutes:
a. Name and address:
b. Phone number.
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is
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.
tgfi4oing instrument was acknowledged before me thl
authors (name of person) as
authority, ...e.g. officer, trustee, attomey in fact) for
behalf of whom Instrument was executed).
p 1
Sig = Ure of • 7 er or Owner's Authorized Officer /Director
Partner /Manag,,r
$Ignatory's Ti , /Office
Id
i i11'.!'f=ll�lllt�!I'
fie
NOTARY PUBLIC -STATE OF FLORIDA
^. Claudia V. Cubillos
Commission #DD717923
,,,,c Expires: SEP. 23, 2011
B9NDt
TUAtt Aug NOM
249V(year) by
Y11
(type of
(name of party on
Sign =ture of Notary Public - State of Florida
Print, Type, or Stamp Commissioned Name of Notary Public
Commission Number
Personally Known _ or Produced Identification O2010
Verification Pursuant to Section 92,525. Florida Statutes
Under penalties of perjury, I declare that I have read the foregoing and that the F= stated in it are true to the best of my
gar
knowledge and belief.
Signature of Natur
Person Signing Above
Upr »F k tt Le u - '1 b'ewcd.
Miami Shores Village
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING
OWNER: Name (Fee Simple Titleholder): Prw►jp4 F
Address: 1,14 M.. 1014141. 1. 12x1
City: i9e.vta.ur.A State: FL_ Zip: 3 z73 2
Tenant/Lessee Name: I4a A-4 CO..jkrt)Lo Phone#: 3t 5 _ S 1 - 26v j
At FEB 102011
Permit No. g, G -7-08-115/
Master Permit No.
Phone #: 40749 + -96C4
Email: Arut4 s&G 'l..eL at>
C9uArla L • C t W%
JOB ADDRESS: t 1,) w t0 G tk Sfree r
City:
Miami Shores County: Miami Dade Zip: '6 I5 o
Folio/Parcel #: (12.1 3 6 ®o 8 na v 40
Is the Building Historically Designated: Yes NO X' Flood Zone: N/A
CONTRACTOR: Company Name: 3 D f G olastro Gt1 OIL A Qeoh Phone #: 4 07— 45 9
Address: 8 4 3 D 9 t _ittoo "tom J
City: Ortgv1010 State: FL Zip: 3 2. 8 Z5
Qualifier Name: 3 orcle. Fe r re r
State Certification or Registration #: C 8 C 2. G 1 + 4 5 Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Phone#: 4 07-' - L25 q
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑Address
Description of Work:
UAlteration
K Fc..1ney
UNew ORepair/Replace
ter MI L- JI ataL,tzz€,.L (01rlrer )
ODemolition
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
Submittal Fee $ Permit Fee $ c/oC d .50 0 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ .;9
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 be approved and a reinspection fee will be charged.
Signature J Signature
Owner or Agent
The foregoi strument was ackno edged before me,
day of 20 by g gJ c✓
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Print:
y o ss n Fgkvps.
* * * * * * * * * * *
Nctary Public State of Florida
M y Ellen T Cechowski
My Commission DD981329
Expires 06/07/2014
APPROVED BY 4 A 1�--c(-f7'-
(Revised 07 /10 /07)(Revised 06 /1012009)(Revised 3/15/09)(rev6/4/10)
The foregoit
day of ri
Contractor
ent was acknowle. _;ed before mejhis
,20// by re f
who is personally known to me or who has produced
�-- ° ° as identification and who did take an oath.
Plans Examiner
Structural Review
.a{ �xlllji iy Public State of Florida
a ; Mary Ellen T Cechowski
` c° My Commission DD981329
4'0r ,eq. Expires 06/07 /2014
Zoning
Clerk
Friday 02/02/2011
Miami Shores Village
Building department
10050 N.E. 2nd Ave
Miami Shores, FL 33138
RE: permits renewals 138 NW 106th Street
Attn: Eileen/Vivian
Dear Eileen/Vivian,
Find attached two building applications for a renewal and for a demolition of a partition wall.
I have also attached a parcel owner report with the open permits listed, including fees.
The wall permits (RC -9 -09 -1570 and EL -9 -09 -1571) were canceled by letter request on 12/23/2010 and
will now be replaced with new demolition permits (see attached copy ).
I was unable to locate the original licensed electrician for the renewal of residential electrical permit EL -
7 -08 -139, and will submit a renewal as well as a new demolition permit for electrical work as soon as I
am able to find a new contractor to sign the applications.
I have attached a check for $397.50 for the renewal of permit RC -7 -08 -1359 and a check for $110.00 for
a new (building) partition wall demolition permit.
Please call me at my number below for any questions /suggestions you may have
Armand Yvel
407 - 694 -9504
Cc: Antony Floris , Norman Bruhn.
DATE .BATCH- NI,IPABEF
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores , FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Expiration: 02/02/2009
Applicant
138 NW 106 Street 1121360080040
Miami Shores, FL 33150- Block: Lot:
YVEL ARMAND
Owner Irlformation Address Phone Cell
YVEL ARMAND
214 N JUNGLE Road
GENEVA FL 32732
Contractor(s) Phone Cell Phone
JDF CONSTRUCTION AND CONSULT (407)456 -2259
(407)427 -1657
Valuation:
Total Sq Feet:
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Construction: KITCHEN CABINETS
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted:
Certificate Date:
Bond Return :
Occupancy:
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info:
Classification: Residential
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$6.60
$2.20
$5.00
$322.50
$9.00
$8.06
$353.36
Total I Amt Paid I Amt Due
$ 0.00 $ 0.00
Payment Type :
$ 0.00
LA AUG 0 7 2008
MIAMI SHORES VILLAGE
$ 11,000.00
130
Available Inspections:
Inspection Type :
Framing
Drywall
Final
Insulation
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 .
August 07, 2008
Authorized Signature : Owner / Applicant / Contractor / Agent
Building Department Copy
Date
Thursday, August 7, 2008
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 - 124004
Permit Number: RC -7 -08 -1359
Scheduled Inspection Date: September 09, 2009
Inspector: Bruhn, Norman
Owner: YVEL, ARMAND
Job Address: 138 NW 106 Street
Project:
Miami Shores, FL 33150-
<NONE>
Contractor: JDF CONSTRUCTION AND CONSULT SVC INC
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Kitchen Cabinets
Phone Number (407)427 -1657
Parcel Number 1121360080040
Phone: (407)456 -2259
Building Department Comments
KITCHEN AND BATH RENOVATIONS /REPAIR FLOOR,
TILE REPAIR
Passed
Failed ,av9-9s�
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 90468. NO Access NB
teje, e,ee /ae , r
no onno
For Inspections please call: (305)762 -4949
O-,ne 77 ..s 27
tr
AS
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP -90468 Permit Number: RC -7 -08 -1359
Scheduled Inspection Date: September 08, 2009
Inspector: Bruhn, Norman
Owner: YVEL, ARMAND
Job Address: 138 NW 106 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: JDF CONSTRUCTION AND CONSULT SVC INC
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Kitchen Cabinets
Phone Number (407)427 -1657
Parcel Number 1121360080040
Phone: (407)456 -2259
Building Department Comments
KITCHEN AND BATH RENOVATIONS /REPAIR FLOOR,
TILE REPAIR
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
c...4.-.1..... flA wino
For Inspections please call: (305)762 -4949
Donn 71 of 911.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 C
Permit No. C O U`1 S9
Master Permit No.
BUILDING
PERMIT APPLICATION
FBC 2004
t
• f ft'Yi i • '7 [ '
x,1 ,JUL 2 9 2208 1
BY:
Permit Type (circle): Roofing
_ r
Owner's Name (Fee Simple Titleholder) A t oAdNi •tiv L Phone #
Owner's Address 2-1-4— ° ,...vma° Le
City C :R m_ State °FL
Tenant/Lessee Name
Zip 'NZ-7
Phone #
Job Address (where the work is being done) 6 "s8 U) UV; t L 10---r-0--
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # n A III— 1' — a .. ®9^ V
Is Building Historically Designated YES NO V
Contractor's Company Name .J,)P C'p is I /a -!C 4
Zip
Contractor's Address ohe t .w a ii2/ XS
City OY %Cl n oh, State
Qualifier Name ° p , GK' -r
State Certificate or Registration No. CRC / Z S-741 '/S
Architect/Engineer's Name (if applicable) 414
4S-4'
Phone # 4e7- ' extol - e Z,
Value of Work For this Permit $ i 0i 75 0
Zip 3/ ?2
543
iS►.nacl .
Phone # 4/07 S` 7z Sy
Certificate of Competency No.
Phone #
Square / Linear Footage Of Work: 0 -V 4 0 130
Type of Work: ['Addition; ❑Alteration ❑New Repair/Replace ❑ Demolition
Describe Work: 'b tet, Jt,ts 3,ct,t (i tct Ali
* * * * **** * * ***, * *** *** *** *** C * * ** * * ** *** Fees************* ** *** * *** * ** * * ** * * * ** ** * *** ** **
Submittal Fee $ Permit Fee $ ZZ ° S
Notary $ S' W
Scanning $ - L'
CCF $ 62 40 CO /CC
Training/Education Fee $ Er9 40 Technology Fee $ IS_
Radon $ DPBR $ Zoning $
Bond $ ' odic E ipfo eiieiit'$ Double Fee $
Structural Review. $ Total Fee Now Due $
fcC v8
See Reverse side -+
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) Lod( s C� e
Mortgage Lender's Address P. 0, , e l 4— t A !AWN/ I
City Y;a,a9 tvarb State I
zip 5.
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 be approved and a reinspection fee will be charged.
Signature
Oz ner or Agent
Signature
Contractor
The foregoing instrument was acknowledge bef Td me is 1u The forego' s i ment was acknowledged before me this ^` �
day of 1 . i , 2001, by I }'fl y y Q � � O day of 20®0 , by 0i2-7 e er t''e-'�
who is per onally k own to me or who has produced
is person
y
known to me or who has produced
N
As identification and who did take an oath.
Y PUBLIC:
elD
ar
as identification and ' 'd take an oath.
NOTARY, LIC:
Sign: \ % l,(/ �, � �^�' Sign:
Print: S �. o� �,�' Prin
My Co
* * * * * * **** ��x�: �x�x�x�x�x •x�x�:�x�x*** * * * *:x�x�x�:** *,4* *** * *****�x** ** * *** ** * ** * *** * * * *** * * *�x�x**** **** * * **
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 07/10/07)
ZVd-f Plans Examiner
Engineer
Zoning
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YY)
02/16/11
PRODUCER Excellence Insurance Agency
3801 SW 107 Avenue
Miami, FL 33165
Phone (305)226 -3900 Fax (305)226 -3997
INSURED JDF Construction nd Roofjng, inc.
843 O'berry Hoover ate`
Orlando„ FL 32825-
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERT FICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLIC ES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
COVERAGES
INSURERA: Accident insurance Company
INSURER 9:
INSURER C:
INSURER D:
INSURER E:
THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDrnON 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MMIDDA'YYY
06/15/2010
POLICY EXPIRATION
DATEIMMIDD/YYYYI
06/15/2011
LIMITS
EACH OCCURRENCE
500,000
A
■
GENERAL LIABILITY
5 COMMERCIAL GENERAL LIABILITY
AGL83647
PREMISES (Ea occurrence)
100,000
• ❑ CLAIMS MADE 'J OCCUR
•
MED EXP (Any one person)
5,000
PERSONAL & ADV INJURY
500,000
•
GENERAL AGGREGATE
600,000
GEN'LAGGREGATE LIMIT APPLIES PER:
5 POLICY • PROJECT ❑ LOC
PRODUCTS - COMP /OP AGG
600,000
AUTOMOBILE LIABILITY
❑ ANY AUTO
• ALL OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Per person)
•
1 SCHEDULED AUTOS
❑ HIRED AUTOS
BODILY INJURY
(Per accident)
• NON OWNED AUTOS
PROPERTY DAMAGE
(Per act-Went)
❑
•
GARAGE LIABILITY
• ANY AUTO
AUTO ONLY - EA ACCIDENT
OTHER THAN EA ACC
•
AUTO ONLY AGG
•
EXCESS / UMBRELLA LIABILITY
❑ OCCUR • CLAIMS MADE
• DEDUCTIBLE
•
EACH OCCURRENCE
AGGREGATE
• RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS` LIABILITY YIN
ANY PROPRIETOR /PARTNER / EXECUTIVE
OFFICER / MEMBER EXCLUDED?
(Mandatory In NH)
If yes, deserlbe under
SPECIAL PROVISIONS below
0 WC STATU- • OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
E.L DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
OTHER
DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT!
SPECIAL PROVISIONS
_____.----2.7
CERTIFICATE HOLDER
CANCEL ION
I
Miami Shores Village
10050 NE 2 AVE
Miami Shores, Fl 33138
/lad
SHOULD A'NY OF • E A 04DESCRIB D POIJCI Erg'''. ELLED BEFORE THE
E 1 TJ.ON 0 E n E &EOF, THEJSS ING 11 UI R WILL DEAVOR TO MAIL
.. 9A ITTEN NOTJCE TO THE ERTIFIC OLDE AMED TO
H LEFXBJJT FAILUR TO"DO SO SMALL irp..9,s 0 OBLIGATI • OR LIABILITY
of A J(64D UPON THE INSURER, IT ENTS OR REPRES ATIVES.
Jp /1I�y //
RgAT
ACORD 26 (2009/01) QF
988-100 C CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
01 -13 -2011
JEFF ATWATER STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE 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:
PERSON:
FEIN:
09/20/2009 EXPIRATION DATE: 09/20/2011
FERRER JORGE D
571171728
BUSINESS NAME AND ADDRESS:
dDF CONSTRUCTION & ROOFING INC
843 MERRY HOOVER ROAD
ORLANDO FL 32825
SCOPES OF BUSINESS OR TRADE:
1- -CERTIFIED BUILDING CONTRACTOR 2- CERTIFIED ROOFING CONTRACTOR
IMPORTANT: Pursuant to Chapter 440. 054143, E.S., an officer of a corporation who elects exemption tram this chapter by filing a certificate of election under this
section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.06(12), F.S., Certificates of election to be exempt... apply only within the
scope of the business or trade listed on the notice of election to he exempt. Pursuant to Chapter 440.051131, E.S., Notices of election to be exempt and certificates of
election to be exempt shall be subject to revocation It, at any time after the filing 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 tor issuance of it certificate. The department shall revoke a certificate at any time for failure of the person
named on the certiffeats to meet the requirements of this section.
D.UESTIONS? 0150} 413 -1609
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11
L:CIII r1. VYVNLI, 1CIA %.PUIIC4.,.t4lI LAPLoCiI fc#L1°7eee7 * DCIA rtwucti.lt i,JIaI1tg.0 Luuteiy, rive II
This local business tax receipt is in addition to and not in lieu of any other tax required by law or municipal ordinance. Businesses are subject to regulation of zoning, health and o
lawful authorities. This receipt is valid from October 1 through September 30 of receipt year. Delinquent penalty is added October 1.
** *ORIGINAL*** 2010 EXPIRES 9/30/2011 1801- 0576378
1801 CERTIFIED BUILDING CONTRACT( $30.00 1 EMPLOYEE : 5000 BUSINESS OFFICE $30.00 1 EMPLOYEE t
1806 ROOFING $30.00 1 EMPLOY
TOTAL TAX $90.00
PENALTIES $12.00
PREVIOUSLY PAID $102.00
TOTAL DUE $0.00
843 OBERRY HOOVER RD (MOBILE)
U - ORLANDO, 32825
PAID: $102.00 (Multiple) 25- 024052 2/28/2011
This receipt is official when validated by the Tax Collector.
FERRER JORGE D
JDF CONSTRUCTION AND ROOFING INC
FERRER JORGE D
843 OBERRY HOOVER RD
ORLANDO FL 32825 -7008
DATE E BATCiH NUMB ET ro
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 08/25/2008
Inspector: Levrock, James
Owner: ARMAND, YVEL
Job Address: 138 106 Street NW
Miami Shores, FL 33150-
Project: <NONE>
Contractor: G&L PLUMBING SERVICE
Permit Type: Plumbing - Residential
Inspection Type: Underground Rough
Work Classification: Addition /Alteration
Block:
Phone Number (407)427 -1657
Parcel Number 1121360080040
Lot:
Phone: 305 -551 -5090
Building Department Comments
REPLACE SHOWER VALVES, RELOCATE VANITY,
REPLACXE SINK AND VALVES IN THE KITCHEN
Passed
Ins ; ct
`(
C mments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Friday, August 22, 2008
Page 2 of 2
ion:.Num
Inspection Date: 10/15/2008
Inspector: Levrock, James
Owner: ARMAND, YVEL
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972 RC)06. 3SCI
Job Address: 138 106 Street NW
Miami Shores, FL 33150-
Project: <NONE>
Contractor: G&L PLUMBING SERVICE
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (407)427 -1657
Parcel Number 1121360080040
Lot:
Phone: 305 -551 -5090
Building Department Comments
REPLACE SHOWER VALVES, RELOCATE VANITY,
REPLACXE SINK AND VALVES IN THE KITCHEN
100
Passed
In - •
Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Tuesday, October 14, 2008
Page 1 of 2
Miami Shores Village,
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Plumbing
Owner's Name (Fee Simple Titlehdlder) Ar ck„ytcQ /,, el
Owner's Address Si+ 14.1 kitoi.fje
City G z.voLuct. Stag FL
Tenant/Lessee Name
I.POidt e
JUL 2 9 2 ?08
BY: ..... ......
Permit No. Pl OK-
Master Permit No.jQn359
Phone #4O7 -614- cj5134
Zip 32
Phone # WA
E -MAIL: A r e %wx, cm Vilk
Job Address (where the work is being done) is N. tia a mat
City Miami Shores Village
County Miami -Dade
FOLIO / PARCEL # -ais 6 -008 -604 o
Zip c3'215 t2
Is Building Historically Designated YES
Contractor's Company Name G L Wu-Jo
Contractor's Address
Phone #
City ,41 4- State Zip 32./ 'L.
Qualifier Name /a„../ fkrr, ��� Phone #
State Certificate or Registration No. O® 6,`) 5..c Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable)
Phone #
Value of Work For this Permit $ 7s s! --
Type of Work:
Describe Work:
Square / Linear Footage Of Work:
['Addition ❑Alteration ['New
r� pLO c, Law eir j
Repair /Replace ❑ Demolition
re. QceL4P VOLVt. I. I
xxxxxxxx xxx xxxxxx xxxxxxxx xxxxacxxx xxxxxx Fwr* w* xxxxxx4c ***wxxxxxa'cx*xxxxxxxx* xxxx xx****
Submittal Fee $
Notary $ S•OO
Scanning $ a' Radon $
Bond $
Permit Fee $
Training /Education Fee $
6(® CC F $ a(120
CO /CC
0 '90 Technology Fee $. 4-7s
- enforcement $
Structu eview.
—S. AUG 0 7 2008
• CC,25 .z,
:',}EAMI SHORES VILLAGE
D:PBR $
Double Fee $
Zoning $
Total Fee Now Due $ 203' SS
See Reverse side —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. 1 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: [ 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
The fore of g
day oft, (�
wh is person ly known to me or who has produced
Owner or Agent
instrument was acl nowledg bef r' �mnq this 17S
,200V,by Aliti
N I TARY PUBLIC:
Sign:
Print:
My Commission Expires:
*** *********************ie****4xu *
identification and who did take an oath.
Signature
—�� Contractor
The foregoing instrument was acknowledged before me thisc
day of t u I1-2 , 20 s B'by
who is personally known to me or who has produced
as identificat'. • who did take an oath.
NOTARY PUBLI
Sign:
Prin
APPLICATION APPROVED B
(Revised 02/08/06)
*4*x *4x,4
res:
******WW xxxxxxx *xxxxx *xxxxx war*
Plans Examiner
Engineer
Zoning
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
351
Inspection Number: INSP- 159471 Permit Number: EL -7 -08 -1391
Scheduled Inspection Date: May 09, 2011
Inspector: Devaney, Michael
Owner: YVEL, ARMAND
Job Address: 138 NW 106 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: AJL ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (407)427 -1657
Parcel Number 1121360080040
Phone: 305 - 895 -4971
Building Department Comments
REPLACE KITCHEN LIGHTS AND BATHROOM LIGHTS
INSTALL GFIS IN BATH
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 06, 2011
For Inspections please call: (305)762 -4949
Page 20 of 21
-t k 4tsv eAec t oy c ItNavx.tC
Miami Shores Village
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 ':
2V73117391)
FEB 16201 NJ
BUILDING
PERMIT APPLICATION
FBC 20
•17 OOOOO 09,1,1
Permit No. EL- 7- 0 8- 131 I
Master Permit No.
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): Armand F. YveL Phone #: 407- 64 -1504
Address: 244 IJ. I,u c) it Rerl
City: Ge,„ut State: FL Zip: 3213 2
Tenant/Lessee Name: Ma.r tL h Ca .strt7 1.0 Phone #: 305 - S1 q • - 603
Email: rtMav�
JOB ADDRESS: W 13J�1 1 I(IL SEreet-
City: Miami Shores
Folio/Parcel #: 'MI A 6o 013 0 n f 0
Is the Building Historically Designated: Yes
County:
Miami Dade Zip: 3315 0
NO 1C Flood Zone: WA
CONTRACTOR: Company Name: 4a-L C-rib C rig C.. Phone #: 30S" rig-9-971
Address: I a S SS 2 (S G44/4/k• 8L-4/ 0 4? ea 0
City: /V . Aff e'T
Qualifier Name: An/7'410 Al i ■T
State: FL-
4.1.4 .0 L #-
Zip: 3 3 i g I
Phone #: 3 ®s' 85' S' c4 97/
State Certification or Registration #: EC. /3 0 o c•2 °IN Certificate of Competency #:
Contact Phone#: Email Address: RV' 4" $Z C • '(4l Mao . C6 rrt
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: Address DAlteration ONew ORepair/Replace ODemolition
Description of Work: a-KP.�4. EAge{'',cal 40 r 140. kite vt
1
Submittal Fee $ Permit Fee $ 1 ! O 1
'� CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $1451 -
pi% 1
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 Fr.FCTRICAL 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
Owner or Agent
The foregoing instrument was ackn wledged before me this
day of f , 20 /r , by / �'� eN �;r „1 cl )/v_
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commis
APPROVED BY
Notary Public State of Florida
Mary Ellen T Cechowski
My Commission DD981329
Signature
Co i ac or
The foregoing instrument was acknowledged before me this /s 4
day of F , 20 t , by R *17`4.n' 1 /C.st Po ✓�.@
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires
a e * * *e * * * ** **aa*e***e*e******** *aaaeeae * * * * * * *e * * * ********** ** *
i Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR / ARCHITECT
Permit N. t L v g- 139 I
Owner's Name (Fee Simple Title Holder): 4r m aft d `y j'e.L Phone #: .b7- Kct 4-9504-
Owner's Address: 214 M. 3 u �.cl` 11.4
City: G evteocr, State : f L Zip Code: 32732
Job Address (Of where work is being done): t 38 N Lk) t C eh 'S%ree t'
City: Miami Shores State: Florida Zip Code: 33150
Contractor's Company Name: pF 1 L. veGhri c. / IwC Phone #: 305-0i 5 -497 I
Address: '25 55 ZIA...4w a 'Mtc! ire $Z 6
City: State: FL Zip Code: 3313e
Qualifier's Name : A& oki J Lupo
Architect/ Engineer of Record Name: Phone #:
Address:
City: State: Zip Code:
Describe Work: e - etf-cwcc TaSrc.cFi Ora Al t'oeCK
I hereby certify that the work has been abandoned and/or the contractor /architect is
unable or unwilling to complete the contract. I hold the Building Official and the
Miami Shores harmless for all legal involvement.
Lic. Number: E c 130 o a.o1Q
Signature %..;:ase.
owner or !gent
The foregoing instrument w aknowledged before m
this )D elay of fe,) ,20)(,by
Con
The foregoing instrument was aknowledged before me
this /sdayof / 4 , 20i by ANretoAw.i
Who is personally known to me or who has produced who is personally known to me or who has produced
as indentification. as indentific ation.
Nota
Sign
Seal:
by ° '1c. Notary Public State of Florida
e Mary Ellen T Cechowski
My Commission DD981329
1.0,0p Expires 08/07 /2014
Notary Public:
Sign:
Seal:
Orlando, 02-10-2011
Industrial Electrical Systems Corp.
10257 NW 9th Street, Circle # 205.
Miami Florida 33172
Re: Change of Electrical Contractor notification -138 NW 106th Street Miami shores, FL 33150.
Mr. Nestor I. Corvea
We have been unable to reach you to finalize and close out electrical permit EL -08 -1391 as contracted,
for renovations performed at the property address above and hereby notify you of a pending change of
contractor on the referenced permit. The contractors information is shown below:
Anthony Lupo
AJL Electric, Inc.
12555 Biscayne BLVD. #826
Miami, FL 33138
Phone: 305-895-4971
Fax: 305- 891 -0937
Armand Yvel
407 -694 -9504
214 N. Jungle Rd
Geneva Fl 32732
Armand.Yvel @gmail.com
4 i.S. Postal Service,-
CERTIFIEDMML N ® ECEIPT
(Domestic Mail Only; No Insurance Coverage Provided
For delivery information visit our website at www:usps.coma
Postage
Certified Fee
Retum Receipt Fee
(Endorsement Required)
Restricted Delivery Fee
(Endorsement Required)
Total Postage & Fees
SeniTioi .incee 64,464c (at Street, Apt. No.; d1 f
or PO Box No. U0ZG7 ,rf _yrk.57 �
City State, ZIPM4,11. 'i�! /Di_ 33 (
?-(.
PS Form 3800, August 2006
f .
See Reverse for Instructions,
Inspection INorksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 08/25/2008
Inspector: Devaney, Michael
Owner: ARMAND, YVEL
Job Address: 138 106 Street NW
Miami Shores, FL 33150-
Project: <NONE>
Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP
ciO•- 13S1
Permit Type: Electrical - Residential
Inspection Type: Underground Rough
Work Classification: Addition /Alteration
Block:
Phone Number (407)427 -1657
Parcel Number 1121360080040
Lot:
Phone: 305/228 -1384
Building Department Comments
REPLACE KITCHEN LIGHTS AND BATHROOM LIGHTS
INSTALL GFIS IN BATH
0u G 2 6 Z ®O%
Passed
Inspector Comments
cc
e
f
7"4, 7-
, ,
�--r
pi (! Z P
, / 9 4 4 /ire
X il- i? s I) 6'''X
/2i-1e- S,/, �d �/2 `
exec -e C- 1f}12- e-, ie- ilt
4,-,
Failed
C::ion rect
ded
Re- Inspection
Fee ($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
, —�—
/V //j�'
Friday, August 22, 2008
Page 1 of 2
Inspection Date: 08/25/2008
Inspector: Devaney, Michael
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972 Jd?St:1
Owner: ARMAND, YVEL
Job Address: 138 106 Street NW
Miami Shores, FL 33150-
Project: <NONE>
Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP
Permit Type: Electrical - Residential
Inspection Type: Underground Rough
Work Classification: Addition /Alteration
Block:
Phone Number (407)427 -1657
Parcel Number 1121360080040
Lot:
Phone: 305/228 -1384
Building Department Comments
REPLACE KITCHEN LIGHTS AND BATHROOM LIGHTS
INSTALL GFIS IN BATH
Passed
Inspector Comments
CC
/
''''
/)°
.C;ze____,
/fr '''
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Friday, August 22, 2008
Page 2 of 2
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 11/13/2008
Inspector: Devaney, Michael
Owner: ARMAND, YVEL
Job Address: 138 106 Street NW
Miami Shores, FL 33150-
Project: <NONE>
Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP
r..-08--• V
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (407)427 -1657
Parcel Number 1121360080040
Lot:
Phone: 3051228 -1384
Building Department Comments
REPLACE KITCHEN LIGHTS AND BATHROOM LIGHTS
INSTALL GFIS IN BATH
NOV 17 2008
Passed
Inspector Comments
cc / X 7 ' 6' 1 1 w e d s i / " 1 n e ' ' " ° ' :
Afc Pa' sfG ig W4-1 / -'J h..., cm- `i'i
a0? J4 s'2- e41'' 2 - 0HA-GL kr, i , 60117-;
/ r
�� ®�
41/4t/, Ai toeal s i
20 etri- I-Rive &A�Ge ',
4,44 54, / 7- 1 ,0 ,4 i c��� r e'G� 2�n'�
J e Led re> 0 e i''9 /p-G6
/ � : � ��.
,
/3 4/ c'fl
Failed
Correction
Needed
/
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
e9
1
Wednesday, November 12, 2008
Page 1 of 2
Permit Number: EL -7 -08 -1391 I
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
-1375(
Inspection Number: INSP - 100099
Inspection Date: September 04, 2009
Inspector: Devaney, Michael
Owner: YVEL, ARMAND
Job Address: 138 NW 106 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (407)427 -1657
Parcel Number 1121360080040
Phone: 3051228 -1384
Building Department Comments
REPLACE KITCHEN LIGHTS AND BATHROOM LIGHTS
INSTALL GFIS IN BATH
Inspector Comments
Passed
CREATED AS REINSPECTION FOR INSP- 90829. cc
RANGE NEEDS 4 WIRE RECEPTACLE DISPOSAL REC. NOT
INSTALLED. COUNTER NEEDS 2 SMALL APPLIENCES CKTS. REPAIR
GARAGE CONDUIT AND WITH WIREING. A H.0 NEEDS A CONNECTOR
Failed
ON LOW VOLTAGE CABLES. ALL SWITCHES AND LIGHT FIXTURES
NEED TO BE INSTALLED. MD 11/13/08
Correction
Needed
/,,,, a" 9 '
Re- Inspection
Fee
5,, @,..> e;
No Additional Inspections can be scheduled until
re- inspection fee is paid.
For Inspections please cab: (305)762 -4949
September 03, 2009
Page 1 of 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
C-1- 0'6.13561
Inspection Number: INSP- 124028 Permit Number: EL -7 -08 -1391
Scheduled Inspection Date: September 09, 2009
Inspector: Devaney, Michael
Owner: YVEL, ARMAND
Job Address: 138 NW 106 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (407)427 -1657
Parcel Number 1121360080040
Phone: 305/228 -1384
Building Department Comments
REPLACE KITCHEN LIGHTS AND BATHROOM LIGHTS
INSTALL GFIS IN BATH
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 100099. CREATED AS
REINSPECTION FOR INSP- 90829. cc
RANGE NEEDS 4 WIRE RECEPTACLE DISPOSAL REC. NOT
INSTALLED. COUNTER NEEDS 2 SMALL APPLIENCES CKTS. REPAIR
GARAGE CONDUIT AND WITH WIREING. A H.0 NEEDS A CONNECTOR
ON LOW VOLTAGE CABLES. ALL SWITCHES No one home, 4 Sep. 09
430 Pm..
``s N°4I 7/ mss wit
frr /Liar
9/Z
114 'Irmo
For Inspections please call: (305)762 -4949
o ,.,e 'ICI ..s a�
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Project Address
138 NW 106 Street
Miami Shores, FL 33150-
Peen
Petrnit Type: Et
Ik #
ifteatiort Additi n/
Parcel Number
/2008
etm ## Steitlx- AFIti*ROVED
Expiration: 02/02/2009
Applicant
1121360080040
Block: Lot:
YVEL ARMAND
Owner Information
YVEL ARMAND
Address
214 N JUNGLE Road
GENEVA FL 32732
Phone
(407)427 -1657
Cell
Contractor(s) Phone
INDUSTRIAL ELECTRICAL SYSTEM C 305/228 -1384
CeII Phone
Valuation:
Total Sq Feet:
$ 1,000.00
0
Type of Work: ELECTRICAL
Additional Info: KITCHEN &BATHROOM
Classification: Residential
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$5.00
$159.99
$3.00
$4.00
$172.79
LI. VG 0 7 200 T -"
p Z�
MIAMI I SH RES /f.
Total
Amt Paid I Amt Due
$ 0.00
Payment Type:
$ 0.00 $ 0.00
Available Inspections :
Inspection Type:
Meter Box
Underground Rough
Alteration
Final
Service Change
Fire Alarm
Relocation
W. W.
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 1 assume responsibility for all work done by either myself, my agent, servants, or employes. 1 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
August 06, 2008
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
Wednesday, August 6, 2008
1
Miami Shores Village
Building Department
E;u a 9
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �� �° 9 2A8
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. In 159
PERMIT APPLICATION 0./�
Master Permit No.�0)5`, 3,s 5
FBC 2004
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder) i r , Yvei-
Owner's Address 2.I4-
City Gem State -L
Phone # 4 o7- 16q 4- / 55 4
Zip 327yZ
Tenant/Lessee Name IUoute Phone # WA
E -MAIL: A rvvici,tut e g 1w�a.t _ o t e MA
Job Address (where the work is being done) I "B N tit) t 11.
re-
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # 7156_ ,908 -r 04.0
Zip ?3t50
Is Building Historically Designated YES NO �(
Contractor's Company Name Cf j�Si 4thea, S� f
Contractor's 02.5-1 /(JCL/ °! c5/ f a;Y 5
City State /(/Y&de)-- Zip
33 "72
Qualifier Name Ate� Y L - 00 Y Yom- Phone # �O 5 22-r / Py.
Phone # 305 22 i&d
State Certificate or Repistr tion No. a 6 /3 Op 2/ c 2
E- MAIL: /CShi /a 4e74
Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 656„ .-- Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ® Repair /Replace ❑ Demolition
Describe Work: 11y2 r t0_ c e. k t % 4tetti. LtC.t 41A -5 . cLM.d . 6e2. No wit L (Gil/L{1
vu �ytfaii �= CA iat4tit..`1
** *xxxxx xxrxx *x * * * * * * *xxxx x xxrx xxxx xxx *Fees*****rrx*xrxxxxxx xx x rxx xxx xrr. xxxxrxxxxxxxxxr.
Submittal Fee $ Permit Fee $ f°,/ ®f °c��//`V �'�
Notary $ S' DO Training /Education Fee $ Q'O9
Scanning $ 3' Radon $
Bond $ �-p7? Code Enforcement $
Structural' 1 t✓iw
AUG 0 7 20
MIANIIA SHORES VILLAGE
DPBR $
CCF $ 0 {QO CO /CC
Technology Fee $ "I -00
Zoning $
Double Fee $
Total Fee Now Due $ nE. 1.
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. l 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'
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 h
Own; or Agent
The fore o'ng instrument as ac nowledged befor. me ihis Ili
day o ,2 ,byl Ile 0 1)4 _,
who is perso Ily known to me or who has produced SrN
1•I
NO AR Y PUBLIC:
identification and who did take an oath.
Sign: , ,�1\'1'
Print: t a•gy 4.
*, v .
My Commission Expires: � c �'�ti�06. ®�
ro n4
x *x,exxx xxxwxx*x**xxxxx*xx
APPLICATION APPROVED BY
(Revised 02/08/06)
Signature
/1/* z effvea,
Contractor
The fore pog�i g instrument was acknowledged before me this' t"
day of .J a //`/-' , 20 ar , by Ai 5 71t" • C
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: ,i °" Ci 51-
My Commission Expir
FRANCISCO P. MbRA1FS
* Commission # DU' 491 ,
'i
vInny Commission 11- 009
Plans Examiner
Engineer
Zoning
11/14/2008 18:58 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES
ICI 0 01
TRANSMISSION OK
TX /RX NO
RECIPIENT ADDRESS
DESTINATION ID
ST. TIME
TIME USE
PAGES SENT
RESULT
*** TX REPORT ***
a �*skxexe**xexc*xe**xcsk*xsxe ***
2822
93057707996
11/14 18:57
00'26
1
OK
2
BUILDING AND ZONING DEPARTMENT
IOG {O_ N.E. SECOND AVENUE
MIAMI SHORES. FLORIDA 33138.2322
TELEPHONE (305) 795-220.
TAX 1305) 736.8972
* * * * * * * * * * * * ** FACSIMILE TRANSMITTAL * * * * * * * * * * * * * * * **
FROM:
Michael-,A. Devaney Sr.
DATE: 14/ Aleak` g
TO:
F.P.& L. N.E. service ctr.
RE. Work with inspection O.K.
MESSAGE:
PHONE # 945 -4100
FAX # 945 -0422
FAX #
E. ` . `fir >`,L� GlE L e
NUMBER OF PAGES: (INCLUDING THIS PAGE)
ORIGINAL DOCUMENT(S) TO FOLLOW VIA:
( ) REGULAR MAIL
( ) EXPRESS MAIL
(X ) ORIGINAL DOCUMENT WILL NOT FOLLOW (ONLY IF REQUESTED)
PLEASE CONTACT OUR OFFICE IF ALL PAGES ARE NOT RECEIVED.
305 - 7707996
1