EL-14-2416Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-223299 Permit Number: EL -11-14-2416
Scheduled Inspection Date: December 04, 2014
Inspector: Devaney, Michael
Owner: ENCARNACION, SHIRLEY
Job Address: 1125 NE 92 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: C.ALBERT ELECTRICAL CORP
Building Department Comments
Permit Type: Electrical - Residential
Inspection Type:
Work Classification: Pool - Private
Phone Number
Parcel Number 1132050270380
Phone: (786)417-4096
BOND NEW STEEL IN ENTRY STEPS AND SWIM OUT TO Infractio Passed Comments
EXISTING POOL SHELL STEEL INSPECTOR COMMENTS False
Passed/
sed
Failed
Correction
Needed
Re -Inspection
Fee
0
n
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP-222770. Check that existing
pavers over sand do not need #8 bonding conductor under them. Pool shell
is O. K.
December 03, 2014 For Inspections please call: (305)762-4949 Page 20 of 46
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING DILECTRIC ❑ ROOFING
NOV 0 3 20%
BY:
_ QO?
FBC 20 ho
Master Permit No, D N
Sub Permit No.
❑ REVISION
❑PLUMBING [:]MECHANICAL PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
❑ EXTENSION MRENEWAL
CANCELLATION ❑ SHOP
DRAWINGS
JOB ADDRESS: ZZa.� AW 9� -
City Miami Shores County Miami Dade Zip:
Folio/Parcel#: % the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: 8FE: FFE:
OWNER: Name (Fee Simple Titleholder):,Q1®4'eR% Phone#: 7��- �"-gjj t
Address: 012?4- A/d: 29 ,
City:® 'E/W/:T:;! State:.. Zip:
Tenant/Lessee Name: Phone#:
Email:.
CONTRACTOR: Company Name: . &4� ..��C6 ��L Phone#:
Address: 4693�-Y- ..trf �� .S 7 --
City:
City: )„ �� -L-. —State: lc�el 7 -Ip: °rjf/24
Qualifier Name:
State Certification or Registration #: 2�50-lar�j Certificate of Competency #:
DESIGNER: Architect/Engineer: &VA.IE J_�_ 2 Phone#:
Address:v ��c� .26-4 e-.�' City: �� State: Zip:?z
Value of Work for this Permit: $ ®®C) � Square/Unear Footage of Work: D 12�
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
j . � _ , . ,�L�►r?` lam:; ` � i<
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 4`
$ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
(Revisedo2/24/2014)
Double Fee $
Bond $
TOTAL FEE NOW DUE $
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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.
Ae Signa
OWNER or AGENT
Signature=
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of . 2014 . by ��day of _ . 20 by
Pn Q i(dwho is personally known to • wts personally kno to
me or who has produced it*- as me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC:
Sign
Seal:
TAMARA
$„ W COMMISSION II EE 84C�i9
EXPIRES: December P, 2016
a'� Bonded ThN Notmy Pifo UMWV4M
as
ssswsss*ws**s**sssssww****wswwwsw*wsww**sass*w****wws*wwss*******wswsss*sssw*sseswwwwwwswswwwss*w***s*ws*sws
APPROVED BY �%�- �•1'Plans Examiner Zoning
Structural Review
(Revised02/24/2014)
Clerk
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 m 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 mU be
personally liable for the worker compensation iniuries 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.
Print Name:
Signature:
State of Florida)
County of Miami -Dade)
Sworn to and subscribed'before me this -�Xf
day of g ® , 20
'lei
(SEAL)
TAMARA AM omm
on act r
Print Name:_
Signature: �®
1001
State of Florida )
County of Miami -Dade )
Sworn to and subscribed before me this �—
day of1..� z� t , 20 �� .
e
r �=
oos3e6
Local Business Tax He
Miami -Dade County, Steffe of FloridaLBT
-THIS IS NOTA BILL - DONOT PAY
4917663
BUSINESS NAM61LOCATION RECEIPT RIO. EXPIRES
C ALBERT ELECTRICAL CORP RENEWAL SEPTEMBER 30 2015
9445SW 110 TER 5133723 Must be displayed', at place of business
MIAMI FL 33176 Pursuant to County Code
Chapter 8A - Art 9 & 10
OWNER' SEC. TW49 OF BUSINESS PAYMENT REC6IVHD
ERT
C ALBELECTRICAL CORP 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR
EC13001341
Worker(s) 1 $75.00 07/22/2014
CHECK21-14-028724
This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license,
parnal% of a certification of the bolder s qualification, to do business. Holder meet empty with any governmental
or nongovammemal iegutalory laws and requirements which apply to the business.
The RECEIPT NO. above mast be displayed on all commercial vehicles - Miami -Bade Cade Sec ea -27&
For more Information, visit wear alamidedo.gav/texcollecter
RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING ROARO
EC13001341 ADDITIONAL BUSINESS QUALIFICATION
rhe ELECTRICAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2016
FEBLES, PEDRO L
C. ALBERT ELECTRICAL CORP
11853 SW 34TH STREET
MIAMI FL 33175
ISSUED: 08/07/2014 DISPLAY AS REQUIRED BY LAW
SEQ # L1408070002099