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EL-13-2184Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-227419 Permit Number: EL -9-13-2184 Scheduled Inspection Date: February 03, 2015 Permit Type: Electrical - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: KILPATRICK, JOHN Work Classification: Alteration Job Address: 621 NE 92 Street 3-A Miami Shores, FL Project: <NONE> Contractor: KELING ELECTRIC INC Building Department Comments KITCHEN AND BATH RENOVATION Phone Number (305)910-1581 Parcel Number 1132060430090 INSPECTOR COMMENTS False Inspector Com Passed s Failed �� /,� Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Phone: (954)520-0000 February 02, 2015 For Inspections please call: (305)762-4949 Page 35 of 41 10-02-'14 14:13 FROM- Southwest Ranches 9544341490 T-615 P0003/0004 F-954 0 A P 4E�9�9'b' CERTIFICATE OF LIAMUTY INSURANCE DIP60 F KGTMWWANPM ANY kEQUW-MQNT, THRIA OR CONDITION OP ANYiCONT"cr OR OMER MMMOT VAM REVIGT TO MUCH 7W THIS 6 ISSUED AS A VAMR OF BIFORMAIMN ONLY AND 60KFM NO 180M UM TH9 CENROATE iii WI% fW ATE DOES NOT AFFIMATMELY OR INWAMMY AMM, 17XTEX0 OR ALTER THE COV10RACE AMR= GY TPM POWF4 11 IM WMFWATE OF l?MKW0 0099 KOT CONSTUM A COMMar MMVMM INS WWKG INSURWqg), AWMMZFD, OR PRODUCER, AND THE CEMMATE HOLOM fmlPW,=.' If NN'RO(MOON IS WAWA subjedto6e of go Po0q, Ogden Pollan may mpilre an @zfduY$eM6�L Xot0wat on Oft ft'0046 does W *Oftf@r tWft t0,1110 ba0wiloaft Hou SOD`"m comer WEDObert Cote _ NON 9.9ik3m4m - 11784..W.Sample Rd. 0103 Coral awbgs. FL =5 T lmum__� !one 10b7 NE � 86lset CLAVASAUM ODUR FL tauderdvX-, FL Sftm - bil 7M JS TO MAFY TIAT THF ES -5 UP inromg,mv-0— MOW HAVE BWN MUW TO THe INSURED NAM ABOVE POR TW POM P9140D KGTMWWANPM ANY kEQUW-MQNT, THRIA OR CONDITION OP ANYiCONT"cr OR OMER MMMOT VAM REVIGT TO MUCH 7W MY SM 133M OR MAY MUM, THE INSUPAWN AFF03MED BY YHff POU0109 OMMSED HWEIN 18 SUBJECT TO ALL THE YEW. AND CONOMONS OF SUMO POUCM IJMW- SHO MM MAY DEW BY Huifdinq Department Wm4podANUM AU Mimi ShOrOs villaor, LFL 33130 - _­­ P-Wom pmrntlts - - .w UMW. 1Y WNWAUANUTV T lmum__� !one CLAVASAUM ODUR E*711 - A CLIUMS 03=014 M90/2015 zoomp IR AOI LOTAPPLMPM L1 f r AWAUM m&mW IMMS 12=014 FORWAUTOO qAVrOS Umma"U" 00txW 9" Ommum rx:a mimmme TNIA V*mww cow! m - WARTWNCOMMW Y" acutm 0 M 19B&MID ACORD CORPOPATIOX All fighIs MaWwd. A" 25 (20IMM The ACMD nam® and logo are mq4sted ma" of Accmo 7 SHWW ANY OF TPA ANN M=§WP0LW= Be MU46UBO Miami Shores VU.Ia" WLL 8B No Huifdinq Department 100$,1) NZ 2nd Avenue AU Mimi ShOrOs villaor, LFL 33130 M 19B&MID ACORD CORPOPATIOX All fighIs MaWwd. A" 25 (20IMM The ACMD nam® and logo are mq4sted ma" of Accmo 7 10-02-114 14:14 FROM- Southwest Ranches JI 4F 9544341490 T-615 P0004/0004 F-954 i ACbkjbP CERTIFICATE OF LIABILITY INSURANCEF041=014 THIS¢EI=flFICAT8181SSUED AS A !NATTER OF INFORMATION ONLY AND CONF>:RS NO 1d1CiHTS UPON THE CE#3 nACAATE HOLDER: THIS CERTIFtPi•A DOESNOT AFFIRMATIVELY OR NEGATIVELY AMEND EXTEND OR ALTER THE COVERAGE AFFOMED BY THE POLICIES BELOW -THIS CERTIFICATE (W INSURANCE! 11025 NOT CONSTITUTE A COIMTRACT BEM9111 THE ISSUING INSURER($$). AUTHORIZED REPRES*TATM OR PRODUCER, AND TNR CERT1EiICA`fE 14O1.DEk IMPORTANT! If tho ft"Ments Iroldor Is an A D1TI AL INSUM, the pn oy(lgs) tiRit tto SUBROGATION F9 WAIM. SUNeet to t hirtermsFand •condidens of ft-Dolicy, coon poitcles may r00Wrd an em%tsemrlt. A stgtemetrt on this ceifiTieate dew not confer rijhis,ito �® surtlticato holderin lien of suchenQolsemera<(sl. Pia Automodc Data Pnmxming Insurance Agemy. Inc. 1 ADP Boulevard _ Lam; Rosefat�d 'F -� Nd 07088 n +nt FcovsrutsE mmad uI&URERA- NorGUARDlrlsvr;wmcormmy KEUNG mmemC INC 1057 NF 43RD ST ittsiara€nc: 1' o* = 2nd Avoaua INBU ERS: *? OAKLAND PARK FL 33334 3faza Shores vil.Lag, FL $3238 t: - ..., �1C� • { VVV= /{V L=W-W16Y,I:Al}M IMIi.l•,p. J{ WA ,3FLI%S =I8"WW . THIS iS iqD CKsRTthY iKiAT THE POLICIES OF INSURANCIs tISTED BELOW HAVE BEEN ISSUED TO 7W INSUtRM NAMED ABOVE FOR T}lE IlO1.tCY• RKOQ INDICATi1;U NOTNtITHSTANDING ANY RCQUIR>rK;1ENt', TETM OR CONDI f101� OF ANY COWPACT OR OiHt_R DDMMBdT WITH MPECT TO WHO THiS CERTIFICATE MAYBE lSSK1P.D OR KAAY Pi itTAIN, THE IKdSKJRANCE AFFORDED BY TKA POUCIE.5 0E3CRM HERt;1N IS SUBJECT TO ALL THE �ERMS, r�cCLr sioNs AKaD caNDmoMN aI' svcH paucrEss raMrrs stiovJra MnY HAVE BEEN W0n1=0 SY PASO CLAIMS. si S ,' rneoFuvsul u, oo:ictrsv3rgeR' '% Lam; I> i. Shores Villag® NAeiLifY TKIK3 EXPtRATIQN DATE THEREOF!, NOTICE WILL BE OVLIV O IN BUiklding Department 1200 A11CLWRNTHEP01.10y �R011Fiftam. 1' o* = 2nd Avoaua EACHOGE S -� vi= tsps a $ 3faza Shores vil.Lag, FL $3238 t: - ..., �1C� • { ` ila�cilreunv ctmw MRm- AUrimCl3it�17 FTF4ATivE ��,`j t�• lis... L :r PSQSoaw.e.ADVBa�►Y S .`t r - cf7�►iAGt#Gq►EilwAPFUEB»R PE��GV 1.90 f : F i PlrppUCYs- tbD'+�GG S , I S • i ASiT07g�1.l;LJAB}iitY I • s A1QYAliTo XL H�DAAJiO® AUYO&lma i i. e�nvavnrlit>e<sonK j s -. itoDRYiprJiiRY(P6rayi�Cd) $ i]ICF8,41lA8 OCCUR i' EACHOCCUFM00 $ S A"RMTEim 0 RE7FhlnON $ A AAaID1=fa ,0 UARAJWY ANYffle"W'"if9mmoun* YIN OFANOLUDEbr N oivo,att,►ttet�seetgw i N1k N Ki=wCO26i7z .83120/2014 03/20/2015 XIAMOr ' E.L.EALfiACC1;1EN7 S 1+.Qt�.1 Ei o-r�.to E iootJ,oOD t;t.oi&Ea�.POLICV!lt�ft $ q N. oEsesivrr'ororFira°noRsrwcairaislvei�tca�siR+iaaaar.Misr.ae�ieb�aF�,narrrsse»avtm,,Mmo,■sra�aacmyu4eary EG'1r19t10533>I ;v CgRTIFtt:A► TE BtiIAER C'ANOEL A71ON '% SNt3ra.» TINY QF � R$t3V8 DF�,a*+l 1'OLlCnas � CANCELLI:O'i3EFQRE I> i. Shores Villag® TKIK3 EXPtRATIQN DATE THEREOF!, NOTICE WILL BE OVLIV O IN BUiklding Department 1200 A11CLWRNTHEP01.10y �R011Fiftam. 1' o* = 2nd Avoaua 3faza Shores vil.Lag, FL $3238 t: - ..., �1C� • { AUrimCl3it�17 FTF4ATivE ��,`j t�• lis... L :r Tics ACORD name and logo arc m614 n*d minks of ACOPO E Y `Siit� rc�tdlItai�if ART Stal�rtili)�;P fill A TAT TOOT., OwNs . tv�ttt I.�', . Y `Siit� rc�tdlItai�if ART Stal�rtili)�;P TAT TOOT., OwNs . tv�ttt _. lotEST„ �r�►aii � y A ONTO ba w lost Actdrss4 ; Y `Siit� rc�tdlItai�if ART Stal�rtili)�;P Y 4 '- a T Y! a- h`"fy to ;t Wfi., r F t1. T , 13o+tdin4 Cbr�r z+ti�`s f �p1�13 1 =� Piondrn Com, ,,W, aM , c.dt*is City . _,,tate Zip - —�r- z ", ROkRaio Lenda�"s'�a�i,� {�f al�a �r 11Ar�rtg Ori' 1 ''d � 1, .ty'^, 47 k` ? ! w - - C;ity z "Mate Z a- -�=-- �::.� iP ti1 I r L Applisei`spr7, rs #i y is " . tt�­11 Prtr a� c� o 0' the irk and installatipris as indicated i certify that, no worit;aor installation Kiri , f ' , _ ,"., encs i rira'r,tz hq t srt,trrr ; or p rrrlt anci That- "wr gill be; performed to,:meet tho sI of elf. lacus regulating - Y t.ork 1,tandards cortstyuctien r+Wti��tlt+n t ustertanrt that a separj pe1. must be secured;#or ELECTRIC, t'UJMBt!'dG, SIGNS, ROE?LS, ` ­1ate irmit FURNACE" y:01L�i£RS, i�A�lKfi, AlR CQiViiltONi RS; ETC .... - ' y.= 5 R - - .. 1--.,, a1 `PIE�t'S'�1Ri~lO i fi i ' e, 'l'y that ,li _ ,", foregatng lr►torrI, ation is accurate and that ali work will be done in compliance with all ` .app slirdktie'laws Oft Atln�,0 vtvi!Lxiorl aria oCt'rrt ;`a . ," Rfli��'rl BTW WNI E YAW PA1 Ll�E ' I RECQR®A lV�ii�E C®f�IiMEN Et1�E�UT Ni�4Y . `. ; , R �9tI.T :$ #F AY I . %,l , �I I . EN YtBtIR PR P�RI'Y. lF, '�19 Yi�'TE t� - - , . 1.1`� i0�`t#t�a�,1,'CI�iC�t9�`LEf®ER`CiR ��i'TT�+�IVEY �EF�IR RECC�R13diVG x 11 I x �(j . P pS a. Y��1.•1 "I �A �11.11 � �l�• a'v[P F,fi R fn Notice tax A P ed : , s o�C.or1 Tito `to the 1ss4iohce.of o �Sui4i -g pe�'rrrilt with oh estlmoted voice exceeding $200, the-oppikon -must promise ir,� 1 p -d, I titcrt o co%ay the }titnfr e of `cornmens�'ment and construction lien"!ow brochure wili,b� deiiveereo+ to the person ' , 2 whasp pro1wrt _,&;w4fect to r?sen� ACs¢, a cer. ie' to -y of the recorded notice of commencement must be posted of the Job site 1.a'" yr the, firms lnspeo - - - It occurs seticn irJ �% s oh'r the 6uiiding permit is issued. l the absence of sricti posted notice, the inspea t -O wiit i po rc ��nF or'rcf°o r� eetfon;�ee viii be charged: t '� i'tr n a s �* i s t � i r ti �,. G rx r t S+gnatur Signatu` i Uli>_ R or AGENT, • CONTRACTOR Tire fore�arni 'Ir, ant was acknowleded before me this The foregoing instrument was acknowledged before me this t * . =-� -�-� ' ,"' } i� 1"' o da of 2©t by y v, -- :� _ ,' 1 �� , ; v�,nJS pier rac'Ena11y knQ, .. to � A- ' � S� 1 ,� who is personally known to . mp o- who Eras pr_ '� ►rte, J`" as me or inrho fias produced �."v:, as ,,,,r t -� -�T ident�ficatfon "id wfac did tk­11111+� ars oath Y identification and who did taken oath. Fr. i otay P1�Ii3l.}CCz �r ` N *ARY PUBOC. 3C : h �� 1 Y - 11 y .?' T bre lkr h § `- _ , ! p.. .y- 5 f a� E _ 'J }` la Sign '�IQIi "ii" .: Rrsnt �e y 1 . .... ,, iq 10 " �'�'� ''r%ii�rinAs STEP!HEf. HAxtT Print: . 3 Seed Novatttbr Da, 2415 t ,, 18810N #E943236 ; ?(P1RE5 Sea! �'My EXPIRES Noveinper Q�, ZO i 5. I (aor`ase oas3 p �;, w a �a�+e e� �>t �s ****r# **,"* r �+a,r �F *ix, A*4&�*aA***s *+ *��ie* ;i**Ad****a**,*****+r+ ****k*******cps /6j/ A- - , r V' [i f2Y. r- - = , -, otarss Examiner g Zonin s 9 -�.� T,% ill y i 5 a 4 I1:1, 7t t t i 1b 7 4. Y4 -AW ��^ S .t I ,) , �, SErtittural Revievia: Clerk l'. ,� <: y' ` iasedtzai.odJ F, 4 f y ,., ,! J� . .. v � ��Cl{i�l v The,� v. _4��rY�RFi��n• r rf t d t on i Pp �iTATE CSF FL�3h*ibAr" u ®EFAF&i`A�E , OF B SINESS At D .. W 1 q T �R' +vt do b in prrd r ie EC 13005 38 r e r - sw 1 1qA�{�� THOMAS. - r.� f S i 1 Ply_, IS.GL�2TtFiEO ll $,i#tElei 33��d. � ��Cl{i�l v The,� v. _4��rY�RFi��n• r rf t d t on i Pp �iTATE CSF FL�3h*ibAr" y�r��j r t +ttro r ate Sd7bU �R� - ®EFAF&i`A�E , OF B SINESS At D .. W PROPE IO ALREGUV ` � T �R' +vt do b in prrd r ie EC 13005 38 +nu'. 0;la'a o AM drsfa��ree GERTIFIED EL. CTRICAL COMA{;"iC}f� brae tar's .� , d >� c��r� ��tt �bt. JiR`I'!�T{8 1qA�{�� THOMAS. - %1i��5t. �I:tNia JE1.�t:T1�RC,1�iC. " �9 ygyy y., �^ $�y�yy�� p eWAW F W.. lei, 5e G�n��lp{(Mril$twi, •p q vs ^o 9 YI.a1pQ� �' iY.nW...aY i�fNRl WIC iftfi 'lift tt�PC4�iJ. IS.GL�2TtFiEO $,i#tElei ond�r tNe provislgPiS d. DETACH HERE KC1tl CdCYYWK IVEViC 1/9R i STATE 'Fi.Ol�1�� •e- �ir°i:�i�aaS v The,� V�%I T �R' d v f T �R' 4 �+ 4 3 Miami Shores Village Building Department ,U F fr—zj 90(750 N.E.2nd Avenue, Miami Shores, Florida 33133 t� Tel: (305) 795:22(7:4 Fax: (3(6) 756.8972SE P 6 263 INSPECTION'S PHONE NUMBER: (30S) 762.4949 FBC 20 BUILDING Permit No. VU3— Q I PERMIT APPLICATION Master Permit No. 9' A 3 —9k,87-3 Permit Type: Electrical JOB ADDRESS: Gz_ 1 zfe City: Miami SI , 's Cc,unty: o,M Miant' Dade .. Zip: Folic,/Pan; c I#: Is the Buckling Historically Designated: Yes NO ae Fl(w)l Zane: OWNER. Name (.Fee Simple Titletmider): N04. k, e L 1.1nniek Address: t l �2�� 1 t.t 4 City: lv�. 6, 51.ore,r State: Tenant/Lessee Name: Phone#: Email: -Ic62 6, It .1 .eco -- CONTRACTOR: Con irony Name: K4\: "c elack—c. Ptn,ne#: Address: 1 aQ'1 ML4.7 S 4 - City: _ e qk \" tovl._ ic'1 Statc: r_l Zi p: 113 7 h Qualifier Name: II& %- a j �'t"t� a Phone#: State Certification or Registrati�)n # Certificate of Competency #: OS CM 9' — 1141 r5 - -1 Contact Phone#: Email Address: DESIGNER: Architect/Engineer: pl-wne#- ?JbAWft Value of Fork for this Permit: $ Square/L6�ear Footage of Work: 11 Type of Work: DAddre s lAlteration ZiNew -UKepair/Replace Description of Work: 00-u Is . _ L0. VA. ❑Dennilition �F=HWsHsHks4a8a+3szhsgrtCasHs::aHsHtHsHsHsaslasy:HsHsasHMsss$a�+tsRaHsH%�sy$a1"C:4'',aHsHafa$aaia3,ssx&s$ar;:sH33�adafsHsHsHshtH:H+EasisHsHrHsH;a+iaAaa�s�sHsHsH83ea�:$aE'asksHs3shsH Submittal Fee $ Permit Fee $ _ r��P ®� . _ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 1A�� TOTAL FEE NOW DUE $, Bonding Company's Nance (if applicable) Winding Company`s Address City State. Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Stag Zip Zip Application is hereby made to obtain a permit to do the work and installations acs indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be perfumed to meet the standards of all laws re:gulming construction in this jurisdiction. I understand that a sqx rate: permit must be secured lir E:LEiCIMCAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES. BOILERS. HEATERS. TANKS Mord AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: 1 certify that all the foregoing infirmattion is accurate and that all work will be clone 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 building pennit with an estintated value exceeding $2500. rltt> applicant must promise int good faith that a copy of the notice of crnninenceinent and oonstntcxion lien law brcx7hure will be deli►ered to the person whose properry is subject to attachment. Also, a cerrifred copy of the recorded nonce of cztutinenceinent must be posted at the poli site for rite first inspection which cxcuts seen (7) dais after the building pennit is issued. fit the absence of such posted notice, the inspection will notAPV�pmvrd and a reinspection fee will be charged. Signature- � e/ � C— `� Signature Ow► or Agent The: lire going ins ment as acknowledged before me this Z 3 day of ..,#L- li .by y- wlnt is personally kntow,n to me or who has prraducecl t'1— • -J— As identification and who did take an oath. NOTARY PUBLIC: Contractor The foregoing instrument was acknowle*cd More nm; this Z day of "C1 . 20 Q. by -4- A7 I/rC rJ--- who is personally known to me or who has produced t-kvt u-' as identification and who did take an oath. NOTARY PUBLIC: Sign: P 1EN HART Sign ' THOMAS Print: _ Prinv: t MY COMMISXON#F_E1439PIRES November 06, 2015 ES No2()15lacy Com i'. t it My Ccymmiss p,(407) 34Z FWridallotaryService.com f`tikit[iktki��kikiksktkikitgktsgi&ktr�ktd3>bi k tWW<iFk WAP t•V%H R�t%b'ttt. tk kid,:I�kf i�i{2kt tit k(8it$i6i ✓3i >�kititkikt C'Sijt i�t�ktkikz •tit t�is�fl�t✓.si'iC kiktk[�kidt. rE:kt k2ki •Oil t�kf %�. kkiktki 'Nf�'litfS. �,ihkikit$%�Y3$i %'�1�r,"iiitkikt�s`>xtfikikikt APPRC}VF:I) BY Plans Examiner 7Aming Structural Review Clerk (Revi%M 3112'2012)(Revi,,et n711()tn7 i(Revi,W (161111/'_'(X19)4 Revi,,xi 3/ lWt))