EL-13-2491Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 205939 Permit Number: EL -11 -13 -2491
Scheduled Inspection Date: January 24, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: TER HORST, BARBARA Work Classification: Alteration
Job Address: 1130 NE 91 Terrace
Miami Shores, FL Phone Number (305)432 -1775
Parcel Number 1132050010410
Project: <NONE>
Contractor: SOUTH DOM ELECTRIC INC Phone: (305)626 -5904
auuumg veparLment %oummenrs
ELECTRICAL SERVICE UPGRADE AND BREAKER BOX Infractio Passed Comments
REPLACEMENT I INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP- 205927. CANCELLED BY EL
CONTRACTOR JOSE MATOS 305 - 335 -9124
Failed
Correction
Needed ❑ ,�/� ® �%
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
January 23, 2014 For Inspections please call: (305)762 -4949 Page 11 of 20
Miami Shores Village
5 Building Department
10050 N.E.2nd Avenue, � enue, lVbami Shores, Florida 33138 L; Y. oo � 00000000
\� Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (3o5) 762.4949
FBC 20 ( 0
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS:
Permit No. 9—L—)'3-2,1q
Master Permit No.
City: Miami Shores County; Miami Dade Zip:
Folio/Parcel#: I t- 32.0&"- oagl _ aq�o
Is the Building Historically Designated: Yes I NO ✓ Flood Zone:
OWNER: Name (Fee Simple
CONTRAC'rOR:.,CompanyName• 56CT DQM -e16mc ' Phone#•
Address: _A�W
city. u ' I
• - ..
State Certification . 4 . .. n #:
Certificateof .
Contact Ph6": Email Address: -T'I-)P
DESIGNEL-
Value of Work for this Permi"-- TQ — Sgnare/Linear Footage of Work:
Type of Work: DAddress DAlteration UNew air/Reolace ODemolition
Submittal Fee $ �. J Permit Fee $ �° °� CCF $ CO /CC $ .
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Edacation Fee $ Technology Fee $
Doable Fee $ Structural Review $
TOTAL FEE NOW DUE $ !i(/
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
zip
r
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 can 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 coy 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..
J
Signature ! Signature . a
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 30
day of ZO I by (-e CsIL�-1 ,
who is personally known to me or who has produced IC-LA 0
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: '(2 33 .
Print: -
My Commission Expires:._
J 1W
(9 S
APPROVED BY
The foregoing instrument was acknowledged before me this
day of • bQ .:201? by ►� �+^I��,
who is personally known to me or who has produced 0
as identification and who did take an oath
Plans Examiner
Structural Review
(Revised 3 /122012)(Revised 07 /10 /07)(Revised 06110)2009XRevised 3/15/09)
NOT,t ', C:
650.£
-Signs' uo! W
print: i7and ANVIO
�� <<IIIIIIIIIII����
Zoning
Clerk
e i
THIS INSTRUMENT PREPARED BY:
HARK I BURKHALTER I YON, PL
Matthew F. Yon, Esquire
2101 N.W. Corporate Blvd., Suite 220
Boca Raton, Florida 33431
Folio No.: 11- 3205 - 001-0410
1_j ,
UR Bk 28890 Psa 4242 4245; 449s?
RECORDED 10/3+312013 14 :221:33
DEED DOC TAX 2v310.00
HARVEY RUVINY CLERK OF COURT
NIAh I-DADE COMM FLORIDA
THIS INDENTURE, Made this 18th day of October, 2013, between RAYMOND P.
GALLAT, a married man, whose address is 500 Mokena Drive, Miami Springs, Florida 33166,
and PAUL HENRI GALLAT, an unmarried man, whose address is 13512 N.E. 21s' Court,
North Miami, Florida, 33 18 1, parties of the first part, to than paid by BARBARA TER HORST,
as Trustee of the BARBARA TER HORST TRUST U /A/D 11119110, whose address is 1130
N.E. W Terrace, Miami Shores, Florida 33138, party of the second part.
WITNESSETH, That the said parties of the first part, for and in consideration of the sum of
TEN AND NO/ 100 DOLLARS -- ($10.00) to them in hand paid by the said party of the second part,
and other consideration the receipt whereof is hereby acknowledged, have granted, bargained, and
sold to the said party of the second part, her heirs and assigns forever, the following described land,
situate, and being in the County of Miami -Dade, State of Florida, to wit:
Lot 16 and W 1/2 of Lot 17, Block 2 of WATERSEDGE, according to the Plat
thereof, as recorded in Plat Book 9, at Page 141, of the Public Records of Miami -
Dade County, Florida.
Property Address: 1130 N.E. 91st Terrace, Miami Shores, Florida 33139
The subject property does not constitute the homestead of RAYMOND P. GALLAT, nor is
it adjacent to or contiguous with the homestead of RAYMOND P. GALLAT, whose
homestead address is 500 Mokena Drive, Miami Springs, Florida 33166.
SUBJECT TO: Conditions, restrictions, limitations, easements and zoning ordinances of
record, if any, and taxes for the year 2013 and subsequent years not yet due and payable.
TOGETHER with all tenements, hereditaments and appurtenances, with every privilege,
right, title, interest and estate, dower and right of dower, reversion, remainder and easement thereto
belonging or in anywise appertaining.
Book288901Page4242 CFN #20130864459
Page 1 of 4
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