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EL-08-1526Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -92825 Permit Number: EL -8 -08 -1526 Scheduled Inspection Date: June 09, 2010 Inspector: Devaney, Michael Owner: ALLEGRA, FRAN Job Address: 1160 NE 98 Street Project: Miami Shores, FL 33138- <NONE> Contractor: LONGMAN ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050180390 Phone: (305)758 -1211 Building Department Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments INSPECTION ALREADY DONE AND APPROVED PLEASE SIGN. ;72- June 08, 2010 For Inspections please call: (305)762 -4949 Page 25 of 26 SHORT FORM AGREEMENT Project Name: Allegra . • d Rajo Residence Village of Miami Shores 1. Parties: OWNER: Fran Allegra and Marybell 1160 NE 98th Street Miami Shores, FL General Contractor: Gulf Building Corp. 633 South Federal Highway, 5th Floor Ft. Lauderdale, FL 33301 (954) 492 -9191 FAX (954) 492 -9192 Contractor's Representative: Chip Derrer/ John Scherer 2. Effective this 16th D : y of September, 2009. 3. Scope of Work: Contractor will provide Construction Renovation Services for the Allegra and Rajo Residence as outlined in Exhibit " If 4. Schedule: The Work schedule between Co manner, sequence an covered under this Agreement shall be completed in accordance with the agreed upon tractor and Owner as outlined in Exhibit `B ". Contractor agrees to perform the Work in such timing to fully comply with Owner's schedule. 5. Compensation: The ompensation for this Scope of work shall not exceed $155,000.00 . This estimate will not be exceeded without c ient approval in writing. 6. Payment Terms or chedule: 10% Deposit Required upon Contract Execution, Then monthly draws will be submitted 25th of each mo th for work completed, payment is due on the 30th of each month. 7. Taxes: Included 8. Terms and Conditio s: The terms and conditions shown pages 2 through 4 apply to this Agreement and are incorporated by this eference. OWNER: Francis By: Rajo Date: Page 1 of 4 General Contractor: Gulf Building Corp. By: John Scherer Title: Preside Date: giz210-1. 000° 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 Permit Not--\ G6i S'=0 Master Permit No. BUILDING PERMIT APPLICATION FBC 20(f) Permit Type: ELECTRICAL VMEEVI II: Ig OCT 1 4 2009 Owner's Name (Fee Simple Titleholder) rTC i� P PG GAR- Phone # Owner's Address 116 0 j.6 '9 " S City itidiVAA.1 S 1kQ,6 State Ft Zip 73/3g 3g 1( Tenant/Lessee a Email Job Address (where the work City Miami Shores FOLIO / PARCEL # -C@ div( -tds Phone # is being done) 11 (ob .CAE 1 8 k Si Village County Miami -Dade Zip 3135 Is Building Historically Desi Contractor's Company Nam Contractor Address City It Qualifier Name State Certificate or Registratio nated YES NO 9C Flood Zone 1.64-160-AA U612 t C Phone # 3C6 :1X1911 RE 1 L.4 State LEMILtA=Tf cis Contact Phone No. Zip Phone# ��= , -�� Architect/Engineer's Name (i E -mail applicable) kke_p_7---- Value of Work For this Per 't $ 46 0O. Type of Work: ❑Additio *Alteration Describe Work: Certificate of Competency No. ZARA Phone # Square / Linear Footage Of Work: 099? • ['New ❑ Repair/Replace ['Demolition (te&-- Vie( Am) acitt},gn Submittal Fee $ * x****** ,r * * * *:�,x * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * **r * * * * * * * ** ** *x* *x ** * ** * * Permit Fee $ 7.5-70'e CCF $ 1.24 CO /CC $ Notary $ Scanning $ 3 Double Fee $ Structural Review. $ Training/Education Fee $ Q AO Radon $ g •13 DPBR $ 62 `13 Violation date: Technology Fee $ 1.(60 Bond $ Total Fee Now Due $ VOI. • 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 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 inspectis which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not I= approved and a re- inspection fee will be charged. 41116W Signature Signature Owner or Agent Contractor The fore oing instrument was acknowledged be411 e this The foregoing instrument was acknowledged before me this Yol day of i 'l�Vd�� 20 b�J , by 1 ) C day of ('J , 20 , by � l r' i E' 1 1.�r'1 h who is personally known to me r who has produced who is personally known to me or who has produced �/ �� tion and y�ho did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC• Sign: � 'i.'► 1`'i /' Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY UBLIC -STATE OF FLORID/ F. Gonza ez 175E Expires: JAN. 02, 201( Bonded Thru Atlantic Bonding Co., Inc 8171 in 1 ii;! Sign: Print: A 41` My Commission Ems' ' ,o le 1 O10 �G9 **************************************************** ft tr+1 ** ** * * * * * ** **** 2 /' Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009)