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EL-13-2874Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-205115 Permit Number: EL -12-13-2874 Scheduled Inspection Date: June 10, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: PATRICK DESBIOLLES & LING Work Classification: Addition/Alteration '`AOA\/A IAI OATOUIV r%CC01f%1 1 CC 4_ Job Address: 390 NE 98 Street Miami Shores, FL 33138-2410 Project: <NONE> Phone Number (305)527-4748 Parcel Number 1132060135670 Contractor: CPS ELECTRIC, INC. Phone: 305-607-8221 Building Department Comments CHANGE OF ELECTRICAL SERVICE AND PANEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. June 09, 2014 For Inspections please call: (305)762-4949 Page 4 of 46 d� � � I 'c�� _v �_!F_ ` Mi 4 t BUILDING 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 PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 390 VE / S% FBC 20 10 Permit No. :�:- L ( 3 _ co _1q. Master Permit NOK -C931 1 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple City: n(ct+ " `z) 1 �6 f Tenant/Lessee Name: Email: State: ace Zone: Zip: 33 Iq (51 CONTRACTOR: Company Name: {� n� GLS x Phone#: -3O S 6 3 y 5u'?O Address: f 6 n'o City: A 21f ly( State: L_ — Zip: Qualifier Name: State Certification or Registration #: ['') © !aj ©% Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ g LO 10, Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New �e anir/Replace ODeMplition Description of Work: p ia� Q e� ��lL PcI n -�X Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Technology Fee $ Bond $ TOTAL FEE NOW DUE $ l 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 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: 4 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 broc4urd 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 inspect*which curs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not bproved a reinspection fee will be charged. )l)l 6/ , n . Signature The foregoing instr�i ent was acknowledged before me this day of 1f `tCii •S, 20(_�_, by , who is personal! known to me or who has produced' 1 G060 As identification and who did take an oath. NOTARY PUBLIC, Sign: Print: Signature Contractor The foregoing instrument was acknowledged before me this day of'1.¢3IrC 1, S, 20 L�e, by �4.44 (—f � who is personally known to me or who has produced t(407) tvta;s►W CtUFftORA My Commission Eest MY colmmfsSK?EXPIRES September .2017 398-0153 FloridayotarySe6fae.ccrn k APPROVED BY orwflans Examiner Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) as identification and who did take an oath. NOTARY PUBLIC: Sign: \IVV%V Print: 1G,Ay-fy (o JA L N\- My Commission Exp zs ®OTIORk tsar ga�pr :: o. I, e,tc .r o�s3oi T t m.µ201 7 t►� F Zoning Clerk f ino 'S iU 'c" a 4'rS� EECTQ� 7' V 42FT6� 'Y & ORNCII;� OF 30 -11 N E Sa Ak VS S,41574 1, ,4 Aw OWOV **AS to Local Business Tax Receipt 14 - f k iw J.BT C WT, 4 m VOA L�',xC EXPIRES "NEWS SEPTEMBER 0, 2014 us "or A- �t plf TAX frM"AirfQ9 �4 -root nva, 1# 40 4", *mv c. Agma*% od 'emA42k, WtOa4mtO coat $as U4N — s. l .cVL-1 0,21A SIB VAA -)VOlUU1644 4C*EM- CERTIFICATE MZNDEZ it;supmc-r r:rxwclAL Svc 508 Z 49 ST HXALM FL 33013 LQA 7gg C. P. S. is NW 28 AVE XIAM, FZ 33125: MENDEZ INSURANCE Now 00001/0001 fii 113 A MATTER , im ) RIGHTS Itj*o E DOES UPON THE CERTIF"TE r =e%ft --- t!!�P#END, EMEND OR THE POLICIES OF I qSURANCF. LISTEOVELOW HAVE BEEN ISSUED TO THE IN ANY REQUIRgAENT, TERM OR CONDmo SUREO MAY PERTAIN, THE fNSU N OF ANY CONTRACTOR OTHER NAMED AEK)VE FOR THE POLICY PERIOD INDICATED, NOTMTHSTANDING POLICIES. AGGRtG INSURANCE AFFORDED By I -HE poLlCIES DOCUMENT MTH RESPEcr TO WHICH THIS CERTIF ATE LW DESCRIBEO HEREIN IS SUBJECT TO ALL T .............. ITS SmOWN MAY HAVE BEEN REDUCED By pAjD C~ HE TERMS, EXCLUSIONS 'CATE MAY BE ISSUEO OR mirlwovT — --- AND C0NDnVNS OF SUCH . .......... GSNERAL LIA Lffy POLICY Numack X COM"'CIAL GENERAL LlAajuTy 7 f.,&ACH DU NCE 00 oi , CLAIM r aMADIj LZ OCCUR 7" Rt!NIM 'IX -500 GL-34425-41Mw. .fttpQmm)—.0/23/13 09/23/14 PR LADV114JURY GFWL AGGRP-GATE Inv APPLIES Pr.R- so -lo -Eo 6 mucy r- P. c GRF 3 91 -Jo PA -Jo CL( AUTOMOBILEL"ILITY TS -c ANYAUTO SINGLE Ljmrr psi Lownr�DAUTVS ji SCHEDULQ0 AvTO3 H�REDAUroS —T— A GODILYINJURY parovon) s NOR-OVMF-DAVr08 09/23/12 09/23/14 1 -- nODILYINJUPY 20,000 G.AXACC UAMUTYGRI)PIER, ANYAUTO (Par".P" 10,000 MEaMMORELLA UA2ALffy -, 7 L-3 -1 OCCUR 1 CL-106MADC DEDUCY18I.G r-I`APLQyhw UABILrN MYrrsr WomakAmusam XmLL'xo? iJYEYII ELRlCTp,3:C.AL WOM I AU 11 r- LOONLY-CAM _UNT OTHCRTHAN _9AACC I AUTOONLY, ACCRI;OATr- u-d TOTR-7--� 06/02/13 05/02/14 WC -62117-2 l'liAT f-.LCACkACCMCN DIUEAS]i - VA EMPLOYE- S IA00 0 CITY or m2ou suoMS looso NE. 2nd AVE NZANI SHORES'EZ 33:L68 305-756-8972 -OP .D25(Zoef/-0S) I SHOULDANyOFTNt! +Vl; DESCRI11r,0 PoUcies ac CmeEllm 0A'rE THCREOP, ?M14F I+U#Q INSURER WILL ENDEAVOR To MAlt A�-- NOTict To THE * TIP TS ROLDER NAMED TO THE Lr4F?, SLIT F IMPOSe No 001T*OR LABILITY OF ANY IOAV UpQN THE IN +4 le CMRAPON Lys WRITTEN M SO SKALL AMNTIS OR