EL-14-2400Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-229827 Permit Number: EL -10-14-2400
Scheduled Inspection Date: March 13, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: ,
Job Address: 1090 NE 92 Street
Miami Shores, FL
Project: <NONE>
Inspection Type: Final
Work Classification: Pool - Private
Phone Number (305)987-0644
Parcel Number 1132050270410
Contractor: JLP ELECTRICAL SERVICES INC Phone: (305)725-8388
comments
GROUND FOR POOL
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-222664. Time clock is not
E�T� grounded.
Pool pumps need G. F. I. protection.
Remove all old equipment not being reused.
Failed
Correction
Needed ❑ ,�
Re -inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 12, 2015 For Inspections please call: (305)762-4949 Page 27 of 38
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
E
�I�IEI� 80 2014
FBC 20 LO
BUILDING Master Permit No.
PERMIT APPLIC TION Sub Permit No. lei -2— i
❑BUILDING LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 16 q() 0 G R1 3k
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: is the Building Historically Designated: Yes NO-
Occupancy
O-Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): JkQAL 1� �l mac. Phone#: ,�� j� L&�
Address: f 1i' S U 15-� H � Zk
City: IVkarmi State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: �z2 /7 Phone#: �4�' )`
Address:
City:
Qualifier Name:
State Certification or Registration #:f 3D/ 21 Z Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/UnearFoottage of Work:
Type of Work: F-1Addition F-1Alteration F-1NewLrF\i/epair/Replace ❑ Demolition
yl n
Description of Work: 6t 0keAUc�d1
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ �g ®° CCF $ CO/CC $
Scanning Fee $ c57 . Q Radon Fee $ DBPR $ 2- °2—a Notary $ S
Technology Fee $ C�� Training/Education Fee $ C) ' 'n
"� Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ k 10
(Revised02/24/2014)
9-1
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 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 mustpryosted at the job site
for the first inspection w ich occurs seven (7) days after the building permit is issued. In the absence f s posted notice, the
inspection will not be ap#oved aA# ayr1einspection fee will be charged.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day o"f,_,� '' 20 [Y , by
ff
�(t—.AZL1W(--- , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUB
Sign:
Print:
RX v Notary Public State o
Seal: Sindia Alvarez
My CommisFF 156750
Xa,;J Expires 0910312016
The foregoing instrument as acknowledged before me this
Z O day of C �e 20 1 �( , by
-J�OSC -T) oczo ho is personally known to
4r who has produced P as
identification and who did take an oath.
Print:
Seal:
My Comm. Expires May 30, 2015
Commission # EE 79436 Ir
Bonded Through National NotaryAssn.
APPROVED B �L Plans Examiner Zoning
Structural Review Clerk
(Rev1sed02/24/2014)
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,oy u ma robe
personally liable for the worker compensation iniuries of anyperson 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.
- Owner
Print Name: ^ �,/ r I' Print
/RO �,.
State of Florida
County of Miami -Dade) �y
Sworn to and subscribed before me this -:5
day of' � 12 , 20 .
MI-
(SEAL)
Sindle Alvaw
my COMMISAW Fft 168758
Expires O62fte
5tavv V111Vl 1u
County of '-Dade )
Sworn to d scrib
day of
By o•
(SEAL) �
Tvpe of Identification �1
Cnntrnrtnr
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My CGMMIBSIUN t Lt aaa IOU
EXPIRES: November 7, 2016