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EL-13-2528Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 inspection Number: INSP- 209841 Scheduled Inspection Date: April 01, 2014 Inspector: Devaney, Michael Owner: GORDON, REED Job Address: 1271 NE 97 Street Miami Shores, FL 33138 -2559 Project: <NONE> Contractor: STEVENSON'S ELECTRIC SERVICE COMPANY Building Department Comments PHOTOVOLTIC Permit Number: EL -11 -13 -2528 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number INSPECTOR COMMENTS False 1132050090430 Phone: (305)253 -1500 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 209763. No rough inspection. Panel installed over sink. Not as per plan Failed Correction Needed ❑ �% Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 31, 2014 For Inspections please call: (305)762 -4949 Page 32 of 50 X N Miami Shores Village" Building Department Nov o 2013 90050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY.- Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 SuhS4C -OAS a_l BUILDING PERMIT APPLICATION Permit Type: Electrical FBC 20 Permit No. --�� Master Permit No. JOB ADDRESS: 12 111 &1C- 9 "1 S�- City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: `,S,4 p, Do - t — ®y SO Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): �°1'e `31b�/' Phone#: Address: 1 Z 1 f (v � ct ' 1 S e Zi 3 O city: �A cGY`n % state: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: dye ie mzn e i e_L-�"r , C— Phone#: 64 '732 4/VF. Address: YG `7 10 S LV vl A C S city: \YN `e CAYYN , ' State: zip: Qualifier Name: Gn Ir',ew) S �—W e mr oy') Phone#• _ State Certification or Registration #: t -C, D 0C) Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone #: 3�1 Value of Work for this Permit: �O 0 0 Square]Linear Footage of Work: - Type of Work: DAddress OAlteration ONew ORepair/Replace ODemolition Description of Work: Oxu �b Un 1 'VS C' Submittal Fee $ t/ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ • C Bgndi Company's Name (if applicable) hondin ompany's Address City State 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 appr and a reinspection fee will be charged. Signature Signature tient ] Owner or Agent- " " Contractor The foregoing instrument was acknowledged before me this The foregoing inwas acknowledged before me this day of , 20 /A, by / QD G-0 day of AV6 1 , 20 J, by G .ZWOWWA who is personally known to me or who has produced who is EEEZ own to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: ilv� Print: My Commission Expire APPROVED BY JOSEPH PAVLINEK MY COMMISSION P EE859471 EXPIRES Deoemb@r 19 2016 (e y> aev /7 17- Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06110 /2009)(Revised 3/15/09) NOTARY PUBLIC: Sign: Print:�'�� My Commission Expires: / ALEXANDER JOS M PAKINEK MY COMMISSION E EE859471 ,9Z -PJ1ff 19 2016 Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. - IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 BUSINESS NAME: `: , UO hf:)Io n BUSINESS ADDRESS: '1 10 c--;W 9k C CITY \ Cky"� 1 STATE fL ZIP CODE �S9 - BUSINESS PHONE: 7( �� 1 17 S Z ` (L/9 Z FAX NUMBER CELL PHONE ( QUALIFIER'S NAME: �� n�,o n QUALIFIER'S LIC NUMBER: CC CAD O 1�$ S E -MAIL ADDRESS (IF APPLICABLE): 6en 1Se-(�O SDU `�6' tpyj c1c- -e1'1�1�01y �IUPI'S rCD� Created on 3119109 BY MLDV 1 RV 3126109 MLDV Rug 30 12 12r36p 6- ISESCI / RREI 8502488008 p.1 STATE OF FLORIDA DEPARTI�NT OF 3II8IV288 AM PROFESSIONAL r:>arar LATION C&NONROZ CONTRACTORS LICENSING BOARD (850) 48�' -1395 TALLAFNIAi STRE�32399 -0 ?83 8TEV=90N, ORWORY PAUL 8T 8V 0 Sl ?62WACTRIC SERVICE COMPANY IN PANAMA CITY BEACH FL 33417 Cor wratulationsl With lift license you become one of the nearly one million Flor1dlans licensed by the M of Business and Profesaional Regulation. Our professions and Businesses range from architects to yacht brckora, from bazars to barbecue restaurants. and they keep Florida's economy strong. Every day we work to improve the way we do business in order to survo you bob For Information about our services, please log am ww%v rnAorhWIasrnse com. There you can find more infomlation about our divisio ns and ttw reguiadono that Impact you. a dwicribe to department nsweloiters and learn more about the Department's innMoSves. Our mission at the Department Is: License Etiiclently, Regulate Fairly. We constantly strive to Serve you better^ so that you can serve your custOmvrs. Thank you for doing business In Florida, and congratuienona an your new Womf t DETACH HERE Allik STATE OF rM, WA AC# 6 2 5 6© 3 DEPARTWEIT OF BUSINE88 Aim P8OF898YGI�1r : REf#TlLATIbN E00001685._ "09/0#112 128033568 CEMzI -- 2ZXC1 =CA& CONTPAMP. STEV301803yi t, SPRY PA,WO STtifvSrTSOWSf• 81='1'RtC•.SElM0Z COX S8 CBRTZV= linear the pMWL WW 02 Ch.$89 PO animueo "to, AUG 31, 2014 02090002036 AC# 6256011 ��gg_��STATE OF FLORIDA - - DEPAR�TRICALSLO RPL;FCZCM303NGrL80 R TIO3T SEQ #L1208080203e L Man NSR 0-8/08/2012 11280 3568 JEC0002.68l `-: A"W BuYi�aGiSilr.... irNiYdiifllrJ:�7dG Named below IS CERTIriam Under the proviaio= of Chapter '- 489 -'1~ 9 , Fmpkratioa date: AUG 31, 2014**.,.'*,.:. STEVENSON, GREGORY PAUL 9TEVLNSON19 ELECTRIC'SERVICE.COMANY IN 19710 SW 99 CT CUTLER SAY FL 33157 ' RICK SCOTT ;��WAR N 601MMOli DISPLAY AS REQUIRED BY LAW oviro ; sea S ?NS ELECTRIC 4V INC '• 198 E `S) 2 ECG Mae CRA(FO'f gas*"TML Us &A ar�aw.aaove a an clorliffiffifid r Ll Miami -Dade My Home My Home Show Me: Property Information u Search By: Select Item v M Text only Report Homestead Fraud IJ Property Appraiser Tax Estimator IJ Property Appraiser Tax Comparison M Portability S.O.H. Calculator Summary rlptailc: olio No.: 11- 3205 - 009 -0430 Property: 1271 NE 97 ST Mailing REED D GORDON Address: CARMEN ACEVES GORDON eds /Baths: 1271 NE 97 ST MIAMI loors: SHORES FL _iving Units: 3138- Property Information: rimary Zone: 1400 SGL FAMILY - 2012 3001 -3250 SO LUC: 001 RESIDENTIAL - uildin Value: INGLE FAMILY eds /Baths: /4 loors: 1 _iving Units: 1 d' Sq Footage: P,093 of Size: 8, 175 SO FT ear Built: 1952 $243,557 53 42 EARLETON $50,000/ SHORES PB 43 -80 LOT egal 18 BLK 3 LOT SIZE Description: 75.000 X 109 OR 17546- $50,000/ 222 0297 1 OR 12352 0312 30 AARP-CCmpnt Infnrmatinn- ear: 2013 2012 and Value: $148,975 142,03 uildin Value: $267,106 303,35 arket Value: $416,081 445,391 ssessed Value: $298,547 293,55 Exemotion Information: ear: 1 2013 1 2012 omestead: 1 $25,000 11 $25,000 nd Homestead: I YES I YES Taxahlp Valup Infnrmatinn- ear: 2013 2012 Applied Applied Taxing Authority: Exemption/ Exemption/ Taxable Taxable Value: Value: Regional: $50,000/ $50,000/ $248,547 $243,557 ounty: $50,000/ $50,000/ $248,547 $243,557 ity: $50,000/ $50,000/ $248,547 $243,557 choolBoard: $25,000/ $25,000/ $273,547 $268,557 Sale Information: ale Date: /2012 ale Amount: P275,000 Page 1 of 1 Aerial Photography - 2012 0 14 ft My Home I Property Information I Property Taxes I My Neighborhood I Property Appraiser Home I Using Our Site I Phone Directory I Privacy I Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site 02002 Miami -Dade County. All rights reserved. http://gisims2.miamidade.gov/myhome/propmap.asp Legend Property Boundary Selected Property -A Street #*4/ Highway Miami -Dade County . Water N W+I S 9/18/2013 STEVE03 OP ID: CP `;` °R °® CERTIFICATE OF LIABILITY INSURANCE °A�'107113'"' 11/07/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endoreemen s . PRODUCER Phone: 305-270-2100 FILER INSURANCE, INC. Fax: 305 - 270 -2195 9440 S.W. 77 Avenue Miami„ FL 33156 Keith R. Miller WONEACT PHONE FAX c No Ext : a N,): E4Y1AIESS: INSURER(S) AFFORDING COVERAGE NAIC # 06/12114 INSURER A: Natlonwide Insurance Group $ 1,000,00 pREMISES Ea oowrrence INKED Stevenson's Electric Service INSURER 3: Business First Insurance Co. $ 5,00 Co Inc S A Able Electric Inc 19710 S.W. 99 Court INSURER c: Allied PSC Insurance Co 42579 GENERAL AGGREGATE Miami, FL 33157 INSURER D PRODUCTS - COMP /OP AGG INSURER E $ WSURERF: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTO AUTOS H REDSAUTOS X NON-OWNED AUTOS COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL POLICY NUMBER POLICY EFF MM/DD POLICY EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ACPS934021661 06/12/13 06/12114 EACH OCCURRENCE $ 1,000,00 pREMISES Ea oowrrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- LOC PRODUCTS - COMP /OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTO AUTOS H REDSAUTOS X NON-OWNED AUTOS ACPS934021661 06112113 06112114 COMB— INdEDISINGLE LIMIT 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ C X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE ACPS934021661 06112113 06112114 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS• LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 052107189 07113/13 07/13/14 X WCSTATU X OTH- TO R f L M TS E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 EL DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 111, Additional Remarks Schedule, if more space Is required) MIAM109 Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U.7-- — (YA ` � CHRISTINE PIERS0L -A20M1 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD FEB 142014 SALES/PURCHASE ORDER 1BY: *0-/;, r-tolww 511)41rw SELLER: G� el 12 5 Z �C�064�-) Specia l Buyer's Nam '" Instructlons: Address �%/ State _'L _ 7jP GOODS OR SERVICES The undersigned agrees to purchase and Seller agrees to sell the listed items, provided the Sales/Purchase Order is accepted under the Revolving Credit Application/Agreement (the °Credit Plan'. The undersigned jointly request that this Sales/Purchase Order be accepted under the Credit Plan, and agree to pay the Unpaid Balance in accordance with the terms of the Credit Plan. The Minimum Payment under the Credit Plan to be paid each month by me, will be (circle one) 2% 2.5% 3.5% 4% 5% 7% 10% of the sum of the Unpaid Balance on this order and any other amounts currently owed for prior purchases (but not less than $15.00), plus previous unpaid Minimum Payments I acknowledge receipt of a complete copy of this Sales/Purchase Order and two copies of the Notices of Cancellation form. I have also received oral advice from you of my right to cancel. TERMS OF SALE A Sales Price SK 0-<: 0 C.) P.P.S.I Tax —�- New Order ❑ Add Og Order ❑ Balance Down Payment: ❑ Cash ...=- ❑ Check C.O.D. Total Down payment Unpaid Balance Monthly Minimum Payment First Payment Due Monthly Due Date 1, 5, 10, 15 (circle one) NOTICE TO BUYER ❑ Automatic Payment Withdrawal YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM INSERT THE 3rd BUSINESS DAY FOLLOWING THE DATE OF THIS ORDER. Buyer's Signature Date of co-Buyers SI Date of Orddr./ // / 7 "i re AUTHORIZATION AGREEMENT FOR PREAUMORIZED CUSTOMER NAME SOCIAL SECURITY# I hereby authorize the above referenced seller and seller's successors and assignees, hereinafter called COMPANY, to initiate debit entries to my checking or savings account indicated by the attached VOIDED CHECK or SAVINGS ticket with T/R#'s, at the following financial institution, and to apply this payment to the Credit Plan represented above. FINANCIAL INSTITUTION CITY STATE ZIP CODE Financial Institution telephone number ( ) Acct.# T/R FIRST PAYMENT TO BE DRAWN ON (date) This authority is to remain in full force and effect until COMPANY and FINANCIAL INSTITUTION have received written notification from me of its termination in such time and in such manner as to afford COMPANY and FINANCIAL INSTITUTION a reasonable opportunity to act on it Any changes in Financial Institution account information must be received in writing no less than 25 days before the automatic payment is scheduled to occur'.: NOTICE OF COMMENCEMENT CFN 2013ROB97764 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTIOW ek 2S908 Ps 31371 (I P s ) RECORDED 11/13/2013 09957:14 11 ARVEY RUVINv CLERK OF COURT PERMIT NO. TAX FOLIO N0.11 �Z®`5 �-Ua "1 � � IANI -DAOE COUNTYr FLORIDA AST PAGE STATE OF FLORIDA COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements 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. Legal 2. 3. 4. 1 . Description of improvement: Owner(q) name and address: W -0-P,A rte.-, An V-1 f) E C1 -1 <, 4- interest in property: vtx3 -b EL >- Name and address of fee simple titleholder. and B �t 5. Surety: (Payment bond require by owner from contractor, if any) Name and Address: Amount of bond $ 6. Lender's name and address: 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. Name and Address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and Address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a Print Owner's Name Prepared by Sworn to and subscribed before me this , day of I4.0 L0 20 I. Notary Public: Print Notary's Name: j My commission expires: Address: =J01qgpN VL"VeK 1HERR8YCCRTIFYth8t(ft1S4 @aue� WM9 6894 -ri tiM$ ��.r ►�9 2016 env = A.O.20..,_,.,,,,.. WITNESS mybsnd arts► WW SW