EL-11-1873Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 165414 Permit Number: EL -10 -11 -1873
Scheduled Inspection Date: May 10, 2012
Inspector: Devaney, Michael
Owner: KOTALIK, KENNY
Job Address: 950 NE 100 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: JACQUES ELECTRIC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Pool - Private
Phone Number
Parcel Number 1132060340200
Phone: (954)214 -8711
Building Department Comments
POOL MAIN DRAINS, SKIMMER, POOL PIPING
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
f-KcP)--v /2_
May 09, 2012
For Inspections please call: (305)762 -4949
Page 2 of 25
Vami 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
RECEIVED
OCT 19 2011
BY-
Permit No. � (S13
Master Permit No.
Permit Type: Electrical
OWNER: Name (F Sim 1e_ Titleholder : Ker7IL/1h' -q l i
Address• t lJ ) Alp a 571 FC,
City: J I ` 114 i
Bonding Company's Name (if applicaTle)
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
Owner or Agent 2
The foregoing instrument was acknowledged before me this J3�4
day of , 20 by Kle.Av,Et -i
iJA'p .r
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Ex s GWENDOLyy B. STEWART
PAY COMMI °SIGN # DD961586 6,
K �oaF � EXPIRES. April 19, 2013 ee�
1- - P'0.3- N1ARY Fl. No*uy Dlseouet.4,:,¢e. C9. CJ
APPROVED BY
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of 5
who is
ersonally kno
,20 LL, by Jvkm /A.. La.-ANA,1
to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
ter_ -
My Commission E's
OVENDOLYN B. STEWART
Ml CUP: MISSION # DD96I586
`c,:, EXPIRES: April 19, 2014
'+ „no.3,14,,TARY Fl. Notary D+s C�
ml t2: ;
� �n nv-ir1
:* ** >ti>F** ** * * ** ** ** * *** *:s *** *** * * ** ,4 *(rte tt 9 : * ***
(Revised 07 /10 /07XRevised 06 /10/2009)(Revised 3/15/09)
Plans Examiner
Structural Review
Zoning
Clerk
MIAMI -DADE COUNTY
TAX COLLECTOR
140 W. FLAGLER ST.
let FLOOR
MIAMI, FL 33130
2011 MUNICIPAL CONTRACTOR'S 2012
TAX RECEIPT
MIAMI -DADE COUNTY - STATE OF FLORIDA
PURSUANT TO COUNTY CODE SEC. 10-24
EXPIRES SEPT. 30, 2012
THIS IS NOT A BILL — DO NOT PAY
RECEIPT NO. 30- 1728972 CC NO: 000017232
BUSINESS NAME / LOCATION
JACQUES ELECTRIC
DOING BUS IN DADE CO
OWNER :JOHN 14 LADOW
SEE BACK OF RECEIPT FOR
A LIST OF NON- PARTICIPATING
MUNICIPALITIES
Receipt holder must
register in the city
where work Is to be
done.
PAYMENTR cE1VED
MIAMI -DADS COUNTY TAX
m9,4028/2011
02260033002
000200.00
FIRST-CLASS
U.S. POSTAGE
PAID
MIAMI, FL
PERMIT NO. 231
RECEIPT HOLDER MAY DO
BUSINESS AS A CONTRACTOR
AS SPECIFIED HEREON.
ELECTRICAL CONTRACTOR
DO NOT FORWARD
JACQUES ELECTRIC
7450 FARRAGUT ST
HOLLYWOOD FL 33024
1: :111::11111:I::: III: l:: 1:: lint ::l::,ll,ll::,l:l:llI::e!ll
172897 -2
BUSINESS NAME / LOCATION
JACQUES ELECTRIC
DOING BUS IN DADE CO
FIRST -CLASS
U.S. POSTAGE
PAID
MIAMI, FL
PERMIT NO. 231
THIS IS NOT A BILL — DO NOT PAY
RENEWAL.
RECEIPT NO. 172897-2
CC 41 000017232
OWNER
JOHN M LADOW
Sec. Type of Business WORKER /S
This pa (116A F ECTRICAL CONTRACTOR 1
BUSINESS TAX RECEIPT. rr
HOLDER ' O VIOOLLATE �
EXMTING REGULATORY OR
ZONING LAWS OF THE
COUNTY OR CITIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERMIT OR LICENSE
REOTRREO BY LAW. THIS IS
NOT HOLDER'S GUALIFICA-A-
TIONS.
PAYMENT RECEIVED
MLAMMOADE COUNTY TAX
COIAECTOFR
09/28/2011
02260033001
000075.00
DO NOT FORWARD
JACQUES ELECTRIC
7450 FARRAGUT ST
HOLLYWOOD FL 33024
1.. 11... i1. 11 ..... 1. 1. 1.. 1.. i.11...1...I1.il...IJ.Il.148.11