The URL can be used to link to this page

EL-14-2426 (3) ILI _'4eu 7y Inspection Worksheet Miami Shores Village 9 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-239343 Permit Number: EL-11-14-2426 Scheduled Inspection Date: July 29,2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: BUCKLAND, CASSIDY Work Classification: Alteration Job Address:358 NE 94 Street Miami Shores, FL Phone Number (786)797-0522 Parcel Number 1132060136150 Project: <NONE> Contractor: ALLIED ELECTRICAL SERVICES INC Phone: (786)566-0863 Building Department Comments INTERIOR REMODEL,ADD NEW BATHROOM, KTICHEN Infractio Passed Comments REMODEL AND RELOCATE LAUNDRY ROOM INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-239288. Failed Correction Needed /Z 91 1, `d Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 28,2016 For Inspections please call: (305)762-4949 Page 21 of 31 Miami Shores Village mac'- "` 7I Building Department NOV 201� x,- - - 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 _ -- --- - Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC200t Y BUILDING Master Permit No. C-1 ` `�2C3 1 PERMIT APPLICATION sub Permit No. ❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISIO - EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [-]PUBLICWORKS ❑ N OF ❑CANCE ION ❑ SHOP CO OR DRAWINGS JOB ADDRESS: 358 NE 94 ST City: Miami Shores CountIVIL Miami zip: Folio/Parcel#:11 320601 361 5 the Building Hi ally Designated:Yes X;NO X Occupancy Type: SGL FML Lo Cons on Type: Flood BFE: E: OWNER:Name(Fee le Titl er):JONATHA �'','BUC D Phone#: Addrd&358 NE'94 a City: IVIWI SHORE State: FL Zip: 331 w Tenant/Less ame: Ph Email: NX l •Co Name: vV� \'-t `wC-T " Phone#: 3o � 2CONTRACTOR. mp �I 4 Address: 1 ra® City: \QV'�1 State: Zip: 33015— Qualifier Name: Phone#: V& 11L State Certification or Registration#:MjX00-55 71 Certificate of Competency#: DESIGNER:Architect/Engineer: FLO NTERNATIONAL ENGINEERING phone#: 305-378-1991 Address:7500 NW 25 ST, SUITE 24 City: MIAMI State: FL Zip: 33122 Value of Work for this Permit:$ � Square/Linear Footage of Work: Type of Work: ❑ Addition Q Alteration ❑ New ❑ Repair/Replace El Demolition Description of Work: INTERIOR REMODEL, ADD NEW BATHROOM, KITCHEN REMODEL, BATHROOM REMODEL, RELOCATE LAUNDRY ROOM Specify color of color thru tile: Pl �� `ly Submittal Fee$ 5-b03 Permit Fee$ CS$ ` CO/CC$ Scanning Fee$ t Radon Fee$ "� DBPR$ Notary$ 13 Technology Fee$ ' �� Training/Education Fee$ G , Double Fee$ r45 Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ o (Revised02/24/2014) 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." 4 Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice©f commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature10 . OWNER o AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of QC 1 ,20 1_(A .by (`"( day of ®c- t �e— ,20 V( by EJA 44,tj �JDA.L Lijt�who is personally known to V-kak S who is personally known to me or who has produced ` zp',Uu;E� as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: 40 Notary PublicState or Florida Print: +� < I a verez � • � ORLANDO LEON MEDIA Seal: My FF 168750 Seal: •� •�, �1o,pd� Expiros08/03fT018 Commission M EE 196835 My Commission Expires March 30, 201 6 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) KEW IAWSOK SECRETARY RICK SCOTT,GOVERNOR STATE OF FLORIDA DEPARTMENT OF SUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD R.--8" The ELECTRICAL CONTRACTOR Named below IS CERTIFIED p EXplydon tfaba-.er the RU G3!2818 Lf � MAT'O$,JOSE DEL CARMEN SOUTH DOM ELECTRIC;INC. 6WO NW 192ND STREET a HIALE4H FL33095 q©- tSSLIM. 07114=4 DISPLAYAS REQUIRED BY LAW SEAS L14UI40MI21 402242 Local Business Tax Receipt •Miami—Dade County, State of Florida THIS IS NOTA BILL - DO NOTPAY 5355755 BUSINESS NAMIEILOCATIOIII RECEIPT NO. EXPIRES SOUTH DOM aETRICINC FENEnAL SEPTEMBER 30, 209E 5860 NW 192 ST 4732082 Must he displayed at place of business MIAMI FL 33015 Pursuant to County code Chapter BA-Am 9&10 OWNER' SEC.TYPE OF BUSINESS PAYMENT RECEIVED SOUTH DOM ELECTRIC INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR Wcder(s) 1 04ECOO56D 875.00 08/15/2014 CHECK21-14-050654 This Local Business Tax Recelppt only 00dm7s paymnot of lha Local Business Tam.The Recelpt is not a license, Permit,er a CerARce6on Gift 6D1deI'3gaallfieatiaa%to da business.Rolderawsi comply with any gevermmamtai orcongavemmental regolmory laws matt requirements which applyta ft basinesm The RECEIPT NM above mmsthe displayed as all commercial vehicles-Miaml-Dade Code Sec aa-M Tar mom informatiomvisit wwwmiomidadegcMh &Lantos £'d 'V0699Z990C sown esof d9Z:I.0 tr I.LZ 130 I JEFF XWXrER � E CHIEF FINANCIAL OFFICER sTArEOFR.aRmA DEPARTMENT OF FINANCIAL,SERVICES DIVISION OFWCN09M•COMpENSATiON `•CIRTIFICATE OFELECTION TO BE EXEMPT FROM FLORIDA WOMOMW COMPENSATION LAW•' CONSTRUCTION INDUSTRY EXEMPTION This Carnes that the individual listed below has elected to be exempt from Florida Workers''Compensa#ion law. EFFECI7{fE DATE: 7!31!2013 EXPIRATION DATE: 7/312015 PERSON: MATOS JOSE FEK- 200699773 BUSINESS NAMEAND ADDRESS: SOUTH DOM ELECTRIC INC 5880 NW 192 ST MIM FL 33015 SCOPES OFBUSIVESS OR TRADE: ELECTRICAL.WIRING --VVFFHW-BUIL- F+asu�t6oChepoer4ga�('H7F.S„mio6lOerdamrporef7m�ahoele�e fien9dsaf�r aaa99�atedeleotlm��immay �� afelm �� •4F4.09.p.��CertlHt�es�daladiettobe ¢pply mn�o�sf�all6asu/�ecticreiot�tlatit,dgrytltd[er�eEMgIOdCE eeadie F-s..Na�oesddegfmmertp� ateytttlfr�c�se� Persmr�anptlC�n6ie �t�o ►eq�gnatsd{C� dace�cmeTfndepap��re��$ c��forfafliired�tl�a DFS-F2-DwC-262 CERTIFICATE OF ELECAON TO B E)EMPr REVISED 07-12 QUESTIONS?(8W)4M16W Rn uAF per. IN iami bhores Village Building Department R 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. £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 Corporation;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 , u_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. Owner Contractor Print Name: �r—+ Print Name: �Pl =' Signature: Signature: (si State of Florida) State of Florida) County of Miami-Dade) County of Miami-Dade} Sworn t d subscribed b e m ouOWAN Sworn to ani'subscribed before me this I day of ]'ARIf PUBLIC day of,,,0��( ,20�� STATE OF FLOR10 By�A By J%e ORLANDO LEON MEDIA es 21V26f8-- `. ommissio (SEAL) (SEAL) Y Commission Expires Type of Identification iroduced type.of Identi " i __