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EL-11-217Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 155849 Permit Number: EL -2 -11 -217 Scheduled Inspection Date: September 26, 2011 Inspector: Devaney, Michael Owner: HUTCHINSON, MARK Job Address: 1041 NE 96 Street Miami Shores, FL Project: <NONE> Contractor: HI -TECH ELECTRIC & FIRE CORP Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060143720 Phone: 3051225 -1447 Building Department Comments ADD, REMOVE AND REPLACE LIGHT FISTURES AND KITCHEN APPLIANCES /A-' I-f'' /j Passed - `/4-L,}/2-k Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments September 23, 2011 For Inspections please call: (305)762 -4949 Page 3 of 41 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: Electrical AEvfS /04/ OWNER: N. 'e (Fee Simple Titleholder): Address: /� ` /V Permit No. f--1—'1 -2 Master Permit No. /C'// _ 9' i /N4 #1, r( /f JNso V Phone #: 951- ¥ 7 s Y7© 5 City: 1 //q Tenant/Lessee Name: 4/4 State: PL Phone #: Zip: 3 3/3e‘ Email: JOB ADDRESS: City: Ai I Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: iliC Vecirl G �° �/j� CAolr Phone #: .3ra5" - 7 3 /7 Address: City: /li' / /kg*/ Qualifier Name: �i State Certification or Registration #:c.:6-13 DO 24 /� d / 4/dtie4' State: ,74t Contact Phone #: 7,/,‘ ?2t 9..3 DESIGNER: Architect/Engineer: Phone #: Zip: 3'3 / Certificate of Competency #: Email Address: Phone #: Value of Work for this Permit: $ /442-4141.011/1/ ,..e-Square/Linear Footage of Work: /�A Type of Work: °Address ❑Alteration -Clew °Repair/Re la e °Demolition Description of Work: * * *** * * * *** * *** ** rev ** ** * ** **F ees * * ** * ** rya * * * ***** r*** ***** Submittal Fee $ Permit Fee $ aoi m I Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ UV 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 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 The foregoing instrument was acknowledged before me this 1 The day of , 20 J j, by 4 ! -)- 1-0)11 OS 6/V, day o who is personally known to me or who has produced li (Sc)flGtlkc j who is v41rvs -u)n As identification and who did take an oath. Art ontractor trument we ac ,2011 ,by own to me or who has produc as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: al ADO Ati to ary Public - State of Florida defnmissko Expires Feb 4, 2012 Commission # DD 754950 •' Sanded Through National Notary Assn. * * * ** * * * *** * * * * * * * * * * *;;*7r * iUti* 4U4 ems* '**M* **** * *x My Commission Expires: ©4. PUBLIC: APPROVED BY Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009XRevised 3/15/09) Sign: Print: 01 My Commission Expires: 11pY•lr - v-, .**************-.*****004. ************.** Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. SG /G/ Job Name / ETC / /eit/Sey CRITIQUE SHEET d'/= J2'6' , l 4''V // Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 09/25/2011 Applicant 1041 NE 96 Street Miami Shores, FL 1132060143720 Block: Lot: MARK HUTCHINSON 1 Owner Information Address Phone CeII MARK HUTCHINSON 1041 NE 96 ST MIAMI SHORES FL 33138 -2551 Contractor(s) Phone Cell Phone HI -TECH ELECTRIC & FIRE CORP 305/225 -1447 Valuation: Total Sq Feet: $ 5,000.00 0 Type of Work: ELECTRICAL Additional Info: INT REMODEL Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $3.00 $3.37 $3.37 $1.00 $5.00 $225.00 $3.00 $4.00 $247.74 Pay Date Pay Type Invoice # EL -2 -11 -40039 03/30/2011 Credit Card Amt Paid Amt Due $ 247.74 $ 0.00 Available Inspections: 1 Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground 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 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. March 30, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 30, 2011 1 Mar 30 11 12:05p HI TECH ELECTRIC & FIRE 3052251447 p.1 LACORDT CERTIFICATE OF LIABILITY INSURANCE 1 CATE 03/zsi2o 1Y' PRODUCER Serial # 81158 MUTUAL INTERESTASSURANCE,INC. ELIZABETH VERDURA 2272 CORAL WAY MIAMI FL 33145 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Nd RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER 711E COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFOltD1NG COVERAGE NALCO INURED 111 TECH ELECTRIC AND FIRE CORP 9500 SW 101 AVE MIAMI FLORIDA 33174 I INSURER A: ASCENDANT UNDERWRITERS, `LC INSURf3R e: ASCENDANT UNOERWRITEERS, LLC INSURER C: INSURER D: INSURER E: COVERAGES _ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING MY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIP CATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE L11NTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Iw' NSW' TYPE OF INSURANCE POLICY NUMBER WIR FBCTIVB DATFf ,IDD,YY, 923/2010 P L Y p�pl TION 8g [I4'FM�n°ITIO 9123)2011 LOUTS EACH OCCURRENCE S 1 000,000 A GENERAL X LIABILITY COMLMENCIAL GENERAL LIABILITY GL -29985 BG W IT° a Pitt*t 100,000 I CLAIMS MADE X OCCUR MW EXP (Any ono is* sai S 5,000 PERSONAL& ADV INJURY 1i 1.000,000 GENERAL AGGREGATE t 1.000,000 GEMI. AGGREGATE Limn' APPLIES PER: X POLICY . PRC - LOC PRODUCTS - COMP,'OPAGG 1 1,000.000 AUTOMOBILE .....—, ..� --� F—^ LIABILITY ANY AUTO ALL OWNED AUTOS SCMEDULED AUTOS •RED AUTOS NON •OWNED AUTO& COMBINED SINGLE LIMIT (Ea nQ de,ni) . BODILY INJURY (Por DORSOn/ BODILY INJURY (Pm ACCIdenO OP GE �orArc m GAARAGE LIABILTTY R ANY ALtrO AI.TOONLY • SA ACCIDENT S OTHER THAN EA ACC $ AUTCONLY: ADD 1 ` EXCESSIBMBRELLALIABIUTY DOCCUR a CLAIMS MADE KeTeNTtDN b EACH OCCURRENCE $ AGGREGATE NT 1 $ 4 WORKER'S COMPENSATION AND AMPLOYERIETO aq.lYY ANY PROPRIETOR/PAApp77NEFIEX'cCLIT1YE OFFn,EPoMEJHE3L7 EXCLUDED? e ALPR In��Ior SPECIAL AkOYly70!IB dolow 800223 9/23/201u 8)23/2011 X I TfIRY LlN A I 19W EL EACH ACCIDENT 1 100,000 EL DISEASE -EA EMPLOYEE 1 100,000 ELOISCASE- POLICY LIMIT 1 500,000 OTHER DESCRIPTION OF DPI" RATIONSN ,DCATION$IVEHICLESTEXCLUIIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ee•nnn 441 /neer.wm SHOULD ANY OF THE ABOVE DESCRIBED POUGE$ BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WIL. - AVOR TO MAIL 30 DAYS WRITEN NOTICE TO THE CERTIFICATE HO • -L" ' ME • 0 THE LEFT. SLIT FAILURE TO 00 SO SHALL IMPOSE NO OSUOATION OR Lr OF - KIND UPON THE INSURER. h's AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESFII I' n ;.' &NDENY INSURANCE AGENCY C:IFMPROU ERTPROS.FP5 I0 /1B 39 d 1S32131N I itfr1-Lr1W (6i ACORD CORPORATION 1951I L06009850£ SE :69 IIBZ /0£/£0 Mar 30 11 12:08p HI -TECH ELECTRIC & FIRE 3052251447 p.1 115.S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301 -1895 — 954-831 -4000 VALID OCTOBER 1, 2010 THROUGH SEPTEMBER 30, 2011 DBA: Receipt #: 181 -2913 Business Name: HI TECH ELECTRIC & F/RE CORP Business Type: EI,EcTRICAL /ALARMs /CONTF (ELECTRICAL CONTRACTOR) Business Opened:12 /20/2004 State /County /Cert/Reg:EC13 002 608 Exemption Code:NONEXEMPT Owner Name: IEDMI7NDO I JARQUIN Business Location: 1500 SW 101 AVE MIAMI DADE COUNTY Business Phone: 786- 543 -5216 Rooms Seats Employees 3 Machines Professionals ForVending Business Only • Vending Tvpe: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: EDMUND() I JARQUIN 1500 SW 101 AVE iw1IAMI, FL 33174 This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold. business name has changed or you have moved the business location. This receipt does not Indicate that the business is legal or that it is in compliance with State or local laws and regulations. Receipt #04A -09- 00017669 Paid 09/22/2010 27.00 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 FBC20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): '< Address: 104/ 'V. City: /.11-04 /r .P c& es Tenant/Lessee Name:—"1/4 Email: /� 5"S, Pd.' 9s¢ 9f5.99'o5 s za -v3, 7 Et fEBZ52011 Permit No. BY@.- Master Permit No. urckni State: ,F/olt hone#: ?. - Zip: ye. Phone#: JOB ADDRESS: /0) / ,YE ?a " City: Miami Shores County: Miami Dade Folio/Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: /270 5 w /®/cc-- City: • State: ilk Qualifier Name: = v4" NO Flood Zone: /ec4 /A Phone#: 7 4 - 324 ®9 3' 43,/- 2-9 -737'7 Phone Pe 324 -05•3 Zip: ��Od State Certification or Registration #: 22 0 P. Certificate of Competency #: /3e3C) Oa OS Contact Phone#: Orv� &29°' 3 Email Address: DESIGNER: Architect/Engineer.. Phone#: Value of Work for this Permit: $ i5"; Square/Linear Footage of Work: Type of Work: OAddress teration ONew ❑Repair/Replace Description of Work: A b - EteCrgir 1r411Wf'' rO 0-- A/E4A ktrewip,,ti 41 DDemolition N * * * **** * * * *** * * * * * * * * *** **** *a ** Fees******* * * * * * * * * *** *** ****** *** * * *** * * ** * *** Submittal Fee $ Permit Fee $ x,41 --CCCF $ ✓ - °-' CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ it . 03 Technology Fee $ LA - 00 Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 2' ,1 LA • Bon ag Company's Name (if applicable) Bonding Company's Address Al A City State `� Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Nl� 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 co i _of the recorded notice of commencement must be posted at the job site for the first inspection which o a urs seven (7 , ,. ' er the building permit is issued. In the absence of such posted notice, the inspection will not be app o 'd a f / a r ection fee will be charged. Signature IOA Agent er . ■ The foregoing instrument acknowledged before me this day of �— , 20 // L. by od4 k ildTel,/<'s,.0 who is personally known to me or who has produced 47 As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Nit tort,i4 My Commission Expires: NOTARY PUi L1C -SIATE OF FLORIDA 2�.k ✓ t,, ° '.,, Natalia Jarquin Commission # UD973815 `•....•,� Expires: MAR. 23, 2014 BONDED Tan ATLANTIC BONDING CO., INC. gaga************** APPROVED BY aakgaa:a.,• Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 I l , by C7rn S- `N who is personally known to me or who has produced RA, as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: IIIIIII III I / //,1/4 •\` ens Silk Aires /2012 NOTARY PUBLIC . Cumission # . DD165901. �' yea***************k******** **********as ** ** ********da***** ******* ***********d ****** Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk r c r N R n p JOB A:`' ?r?E Ess: City:. a4, Ale . rt Fei'mit ?; EBO916i1, ML-. V A 4/C411 Ar i Phone #: 9 b 't - 4'45 _L A NO CONTI. : SouthelspR .F1gr -c.da ec , difrrc�: 7880 Wes 2,5,. h Ater, ue �' Q _Hialeah t ; �� F1�da u ��! � e.. � card G. Hornsby :.. EC13002253 305-822-550(f: ii.YSllrto Archik.1.1.Err in .4r.__ 44f4 Inc. Zip. FLAK; hi�itc 305- 822 -5500 COrgaL WM; . %::crr fort Type, : • 4 ,.. southeas chorcin ?E 2: Stpr.:,i 33016 :: , orre‘it. 3052822-5500 16138 t:;..ele @bellsouth.net \ StAli, a&: _q54 C 20 3? . =lrk: 4,00 ce �t E 1— rtt�;zti;:r,-r leemS SUhfl rt,. PI • -1Fec C .IOTA FEE • tif.applit:itfih:, • • • ••••-•''''' .• ••, ;:::Lite • • .79ortgage Le • •tvlorkt_:.tag,,e Let tder- Ad,tt , St, pit:twit • • -dr.;•-.. .arid :IISIAia'.. 7 - ' I. f cerl.l.f..i.,: tlla; ni....) . i..irl.r.::=?.. of .i.1 itii,:rnt ,11 ,t'tirk its.-ii; i-s: • itrii:itl. iliti sztr.rif.h.tr,cis i. • is;f.,ttrlIcti,l in this jut, fi.. I utt.itiorsLind wht..,Ls,.P0.01,S. iht,3; ,,,.t"iT..St fif..311..,iiRS. HitATElfs2t sisAKS itrid AtfiLt C.'fiffIrfiflONS-;. ETc.,..... • OWNER'S At, ',S• 3 P. I certify that imi is ci at all work will be:dt-tne applictOle laws ref.; corstrtictign and ,iorihit„ 'WARM-NC OWNER: R •FAITAIRE COMMIE *:",NT TkIAI r ViA EECC IPERTY‘ 'TO :RECORD A PAYING OU INTEND OR ATTOR ofk iniaii3!:Itiori has in iance with•aAl NOTICE OF ICE FOR ) 0.7T,A7N BEEORE, AI01440 ArY'SicaM: As Ondition pennitwith 1.1 xklied.valO.cceding rite•Applicant.Mas.t • .Pronii•ce 11 ly 1,,,,,hrochure br 1 u IN:person. Prolicrifl: • — 1•0 Ja. . COO' Of the tVt.'t.tid d ;i COMM enetIni." 1::f F1 .1•W 1 (11 . t •• . cte • Aft'on .7) datc.s qfte:- the building p( ran: In the 1 nc gir such •pt.kged notice. the • frOpectior ill It& W';.' • ", C-•d• d a rein he charged. • Signzoiti iA.,.111111W . • a-. ,,..,.: .12:01t . The foregoing in,..4ri.i:,-,i,•il'i <i.va..F, .tii.il.iticm&ch,,,,2d fefoftf ff: this 1 . .The lootti.Yi irmrtinleirtvit fore me this 28th .. day of ;,.e.i.2'..1 2i,j It bi4Ckik:.:..i, -01....HUL.i ASO el , „ • • • i ..ilay of Ja,r1...2pui, ,....,,,ificka..crcilA,,.A1=0).y .. : • whi:Os personal 1', Ll..',:':: 1.: zo ni.e. oh,..iht) ha., prodi .::,::::f 1 ----Itt1714(.4-1 .,,,.1,40.k 1.-,:7,0nally kno*.tito inc or ,c4it.:7:, li.. fY:', '‘It'ae`..d•PPrgOttA.11Y!:.!: ': • .• • : ...:.. .•:....i. .., .., .!. ... ............... ....... KrAinAAPV::::', .1i -J',43RE1Ctlit tACAMIFFAI. . 'known: -:':::•as identifick‘ ,,, l• in otIth.:•••• • . • . :•.:.. Notary Public - State of Florida .NOT.,.,.. RY • PI:- it IL , I (::. .14Cominisslon Expires Feb 4, 2012 . N Cl: r A in: PliBL1C: ' ".:::: Commission #.0).754.9.50. . ThfoughNationat•NataryAs0. ..Sigm • . .• • My Catriinis.sion Lspires:: 2. Z.C3 APPROVEI)TIY:. aMst:d tr.7110/07V,R:1.1..tvtlatvio,'2009i1130:.* 3/ .06°Y40111 111„1, Barbara G.. Gribi.ns M ComrnissiQq Expires: 11/19/2013 • • • *********.ti,:*.************.•••.. V/g 7*°/7 • • Zoning Plans Examiner Stna.lnral Review Clerk