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DEMO-14-108Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-205972 Permit Number: DEMO -1-14-108 Scheduled Inspection Date: July 09, 2014 Permit Type: Demolition Inspector: Devaney, Michael InspectionType: Final Owner: PALMISANO, INGRID & ERIC Work Classification: Electric Job Address: 1035 NE 96 Street Miami Shores, FL Project: <NONE> Contractor: KILBY ELECTRIC CO Builcling Department comments DEMOLITION ELECTRIC Phone Number Parcel Number 1132060143730 INSPECTOR COMMENTS False Phone: (305)233-2965 Inspector Comments Passed12f Awl Failed el A �a 14,1 Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fed is paid. July os, 2014 For Inspections please call: (305)762-4949 Page 6 of 34 ' 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 Permit Type: Electrical FBC 20 JAN 22 2014 Permit NoDe/Yf6 — /O � Master Permit No. iP �7 - l o�— JOB ADDRESS: IDS tyle R(D City: Miami Shores County: Miami Dade Zip: .3 315 5 Folio/Parcel#: 014-3-130 Is the Building Historically Designated.: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder):;;9W0 Y 6& B/11.Ad I,SA40 Phone#: 30. '--Igg".•q F3 Address: 10-96- uEQ& 51&�q city: _HiAxi �SlagjFS State: FL Zip: 3-4136 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company ,Nam: KI Address: Ad IM �7N _ 16 7 city: Qualifier Name: _ W 1 State Certification or Registration #: r� C 1-5 C B 2 9 5(o Certificate of Competency #: .3 Z.93 -2<76S Contact Phone#: JOS- :)33 -2 --vas- Email Address: 0 1 �bq ans- LQ be IIsaJAA, A (lc --4 . DESIGNER: ArchitectlEngineer. Phone#: Value of Work for this Permit: $ 2)O®• ®CD Square/Linear Footage of Work: Type of Work: ❑Address LIAlteration ONew ORepair/Replace olition Description of Work: Submittal Fee $_50 -0--'' Com--'' Permit Fee $ 10-011A' CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Doable Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 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 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 I/ 9 Signature Signature Owner or Agent The fomgoing instrument was acknowledged before me�dus �y day of Ad , 201" by j;� i4D ?A Ll't kI—ewl , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: S M Commission Expires:'- my comm. twes r.eo za, zui i YCommission #► EE 849356 Bonded Through National Notary -Assn. Contractor The foregoing instrument was, acknowledged before me this Vim. day of r , ?A %'l by L(?A)1 t /Gf f who is personally known to me or who has produced >e,/e-1 APPROVED BY Plans Examiner Structural Review (Revised 3/1212012)(Revised 07/10/07)(Revised 06/10f2009)(Revised 3/15/09) identification and who did take an oath. My-Ccunrai ELIZABETH HERNANDEZ Notary Public - State of Florida Commission # EE 842729 zoning Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET WE• TALLAHASSEE FL 32399-0783 MILLS, VELORIUS E III KILBY ELECTRIC CO 18720 SW 107 AVE MIAMI FL 33157 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better For information about our services, please log onto www.myfloridalicanse.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new Iicensel RECEIVED AU6 0 0 2012 DETACH HERE ACt&243. STATS OF I DHPiRTil2ENT 4F ST7SINESS AN E�EC'I"�.IC,AL CQ�T'I'RACT The ELECTRICAL+ r ai(�I£d .belova I8 CERTIFIED: � ��'h ��m.; 4 Under the provisions of Chaptqq Expiration date: AUG 31, 2014 z� �dw za, -.x-ry MILLS., V;EL'0R2US E III A KILBY ELECTRICCO. 18720 SW 107 AVE MIAMI FL 33157' "e RZOK SCOTT; GOir rRNOR DISPLAY AS REC UIRED'BY LAW SEW L12072701277 KEN LAWSON SECRETARY i SEC. TYPE OF 196 SO#C ELE0 all �kIXH51Y063$13 z Tax. The pt is notsiconaea must com_ any g�iemme�rtal or � MR, h �I9iamt—de Sec 8 k • 01/22/2014 13:40 3052325362 KILBY ELECTRIC PAGE 01/01 AC !G•3m K14BY-1 OP ID: I �- CERTIFICATE OF LIABILITY. DATE (M 12!16/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND. CONFERS NO WtiHTS UPON THE CERInFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRa1ATp&L4f Orli NEGATIVELY AMLND, :E)TEND OR A•LTER•THE'COVERAGE AFFORDEb BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE iSSUWG INSURER(4 AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IN F5RTANT: If the certificate holder is ari• ADE*TIONAL INSURED, the policy(las) must be andarood. If SUBROGATION IS WAIVED, auf4ect to the terms and conditions of tie po(cy, cggain pollClas �Y require an endorsement A•statBrrrerrt on this e/1rt�iCate doafa not oonfar rights Cartiticate holder in I of sudh riwn r to the PRODUCER hCehn_Ca305305-446-2271ASl inompanY.1110 NAME ._ MISURW 18720 SW 107 Avenue Miami, FL 33157 TNS NIIMRF32- THIS IS TO CERTIFY THAT THE POLiciES OF INSUi INDICATED. NOTWITHSTANOiNG ANY REQUIkEME CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. hence Co. Ins Co C uo i MU oeLVVV HAVE SEEN ISSUED TO THE INSURED NAL'ED ABOVE FOR THE POLICY PERIOD 'ERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INSURANCE. AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, S SHOWN MAY HAVE BEEN REDUCED BY PAID'CUUMS. L•R TYPE OP O:SURANC? POLICY NUMBER C�IItFAL LIA ZMNF X CMdERIL)CDE ' 7008LAIP�A OCCUR X PER AGGRE OEN'LAQGREOATR WAT APPLIES PER: D LOO P� It,TF7 AUTOMOME LKmLITY A X ANYAUTo a3NE AUTOS ACMNED UTO$ D HIRM AUTOSE0 X UMBRELLA LL40 IX OCCUR L'. EXCESSLFAB CWM041ADE UH4s3s315708 DED X TENTION 0 WUMW-SRE COUMBA170H B AND EMPLOYEW LIABILITYANY N Y! �10ERN M RR E7CCLUppD y NIA SS0308EE Mye- o8,de under DESCRIPTfOh10FOP'BRAT Ply 67JOIJ13 { .07101/14 071'41113 1 07/01/14 07/01/13 1 07101/14 01/01/14 1 0110111S. _-._-•_•-��••••..wr rvw�.rees (nIWPf1AWR0101, AAGiN8ria1 - _ Iicm+IIrlW BChedulq P 1D0116 speve - ) Miami Shores vi fte 10060 N.S. 2nd Avenue Miami Sharps, FL 33138 ACORD 25 (2010105) NUM -04 PRODUCTS • COMPIOP ACs, 10 Ben, S 1NE0 S UM 6dDILYTN,IURY(P&pgwM S 800lLY 9UURy (Per opNgN) i axMc� $ a EACH occugpa= a 1 1 SHOULD ANY OF THE ABOVE DESCRWD POLICIES BE CANC�! men g� THE EXPI[RAT(ON DATE THEREOF, NOTi+ E • WILL BE ' ORn ACCORDANCE WITH THE POLICY PROVISIONS. OOLNERfM IN AUTHOPj=1Sp#tE'SENTAr4E Thg ACORD name and Iogo are reglstered marltS Of ACORD rights reserved.