EL-14-571Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-222285
Scheduled Inspection Date: November 18, 2014
Inspector: Devaney, Michael
Owner: TORO JTRS, LUIS
Job Address: 1270 NE 98 Street
Project:
Contractor:
Miami Shores, FL 33138 -
<NONE>
R.Q ELECTRICAL INC
Building Department comments
FLOOR LIGHTS ON DECK BACK AND FRONT LOW
VOLTAGE
Permit Number: EL -3-14-571
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)733-3821
Parcel Number 1132050090310
INSPECTOR COMMENTS False
Phone: (305)790-9169
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-222187. Electrical nonmetallic
tubing not permitted in direct earth burial, N. E. C. 362.12(5).
All existing need to be removed.
Failed
Correction
Needed
Zee -
Re -inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
November 17, 2014 For Inspections please call: (305)762-4949 Page 15 of 45
Miami Shores Village
Building Department MAR -21 2014
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 BY:
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20
BUILDING Permit No. E
PERMIT APPLICATION Master Permit NoQ.,S 1�A —T(-)
Permit Type: Electrical
JOB ADDRESS: 1 L--�-® '%'1z q9 S f
City: Miami Shores County: Miami Dade Zip: S3 13 -9
Folio/Parcel#: h ^ a.JZOS 0001 —0--5(0
Is the Building Historically Designated: Yes
Zone:
OWNER: Name (Fee Simple Titleholder): Phone#:
City: "-h(o I, 1 R-0 Z- Q State: b— Zip: -6--5 1
Tenant
Email:
CONTRACTOR: Company Name_ -� ' �� nil �e- Phone#: 3-05—
Address:
-05—
Address:
City:
Qualifier Name: \tC> ��otQy 0 \ TNr4 Ps-
State
S
State Certification or Registration #: Cc,
Contact Phoneb Q�D )'D 01 (Co�) Email Address:
DESIGNER: Architect/Engineer:
of Comnetenev #:
Value of Work for this Permit: $2pSquare/Linear Footage of.Work: CJI
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Dem lition
Description of Work:
Submittal Fee $_3 i 0 ` CD 6 , 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 $_ 1� -
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
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.
Si ture Signature 3-4. e
Owner or Agent °y r Contractor
The foregoing instrument was acknowledged before me this The foregoing i trument was acknowled ed before a thi
day of (��� �, 2 bypoL� `r fes® day of 20 i by f
who is personally nown me or who has produced #I, who is personally known to me or who has p duced d7w%yrs
As iden ' who did take an oath. L 14,1%E as identification and who did take an oath.
AMBAR ABEIJON TARYPL'E. C� : TE OF FLORIDA
NOTARY PUBL "' ° NOT P BLIP ` °�15
Commission # DD 969514 '•;:1 '. Reiser
�e a8 My Commission Expires -C ..LSS, a #DD995616
' „;�• March 09, 2014 i } E 05, 2014
Sign: ' '
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Print: Print: �R.v I t= �-e, �
My Commission Expires: 'i10 A wg ,og 2oltt My Commission Expires: Tu,,, e 4'� 2oty
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APPROVED BY 2 9 J41G kPlans Examiner _ Zoning
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised3/15/09)
Clerk
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DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
n " GIRTIFICATE OF ELECTION TO RE EXEMPT FROM FLORIDA WORKERS! COMPNHSATION LAW « +�
CONSTRUCT" INDUSTRY EXEMPTION
Thou cartifiet that the individual listed below hats elected t4 Do exa mpli front f'lorida Worttorg' Componmatton I4W.
DATE: 12/02/2011
PERSON: QUINTANA
FEIN: 453137487
BUSINESS NAME AND ADDRESS:
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OWC•252 CERTIFIC.4ff OF FFEerioN to SF Extmoor REVI;ED 01 11
Lwa}i Business Tax Receipt
Miami -Dade County, State of Florida
6904735 LBTJ
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QUINTANA RODOLFO
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eFFECUM ELATE: 17i1M3 EXPMATION DATE 12Jlm5
PERSON: 13UINTANA ROQOLF0
FEIN: 45313M7
VSsNAME AND A
R Q ELECTRICAL INC
9901 NIN 123 TERWE
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UCENSEO ELECTRICAL
CONTRACTOR
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project
prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner, must obtain workers' compensation coverage. Corporate
officers or members of a limited liability company (LLC) in the construction industry may
elect to be exempt if.
1. The officer owns at least 10 percent of the stock of the corporation, or in the case
of an LLC, a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
3. The corporation is registered and listed as active with the Florida Department of
State, Division of Corporations.
No more than three corporate officers per corporation or limited liability company members
are allowed to be exempt. Construction exemptions are valid for a period of two years or until
a voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village
does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be
personally liable for the worker compensation injuries of any person allowed to work under this permit Please check with your
insurance carrier since most property insurance policies DO NOT cover this type of liability.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Ower
Print Name: S7—w1a_ Ako ( A
Signature:
State of Florida)
County of Miami -Dade )
Sworn to and su
day of Vb
CI
(SEAL)
Tvpe of Identification
20 i '� ANUON
NMI PeOik - 81111e o1 Florida
ConnnlNM I FF 105077
Contractor
Print Name:
Signature:
State of Florida )
County of Miami -Dade )
Sworn to and subscribed before me this G
day of
0
ANW AKWN
IV Com. 10M Yu 23,
FL®RIE)A INTERNATIC)N`'iL
_ ENGINEERING & TESTING LAB
9:�,>L.-. �'B � � I',': "�.I a. S`. , e_7 f� row.;♦ 8:`-;l-ff. r_�[= �..I t�_1'�
""AS BUILT CERTIFICATE"
7500 NW 25th Street, Suite 241, Miami, FL 33122 Ph: 305-378-1991 Fax: 305-378-1997
MARCH 14, 2014
City of Miami Shores Village
BUILDING DEPARTMENT
10050 Northeast 2nd Avenue
Miami Shores, Florida 33138
Address:
Owner:
Re:
1270 NE 98 St
MIAMI SHORES, FI.
Luis Toro
c, 1"A--
1 Vr-
MAR 2.1 2014
$Y:
PARCEL#1132050090310
New concrete pool deck and concrete slab at rear yard and front patio
Dear Building Official:
This letter is issued to inform you that Florida International Engineering & Testing
Laboratory has been retained by the owner, to perform a pachometer visual inspection
of the concrete slab and their reinforcements and installed file . On March 11, 2014
representatives of Florida International Engineering & Testing Laboratory performed an
inspection at the referenced site
BACKGROUND INFORMATION
During our site visit, the following item was covered in the meeting:
. Surveyed a detailed visual inspection for the reinforcements.
Photographs were taken.
• Reviewed the provided plans and photographs.
Based on our methodology of inspection and testing:
NEW CONCRETE SLAB
• The reinforcements and size of the concrete slab was installed as following:
New 4" conc. slab non-structural w/ 6" x 6"-1.4 x 1.4 w.w.m. over well compacted fill:
Finish floor at pool deck and concrete slab with tile.
Note:
The structure is structurally sound and the concrete slab and tile installation satisfy the
requirements of the Florida Building Code in effect on this date.
See copy of pictures in the time of construction for further references.
To the best of my knowledge and ability, this report represents an accurate
appraisal of the present condition of the structure based upon careful evaluation of
observed conditions to the extent reasonably possible and based on the plans
submitted to us.
Florida International Engineering & Testing Laboratory appreciates the opportunity to
have been of service and look forward to assisting you in any way possible. If you have
any questions or comments concerning the report, or if we may be of further assistance,
please contact us at your earliest convenience @ (305) 378-1991.
Respectfully submitted,
Florida International Engineering and Testing Lab.
W
Vinayagar M. Balakrishnan V., P. E.
State of Florida License # 63107