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EL-14-2538 Inspection Worksheet Miami Shores Village L d 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-223548 Permit Number: EL-11-14-2538 Scheduled Inspection Date: November 12, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: RICE, CORRIE Work Classification: Pool - Private Job Address:41 NW 105 Street Miami Shores, FL 33150- Phone Number Parcel Number 1121360050290 Project: <NONE> Contractor: ON CALL ELECTRICAL CONTRACTORS INC Phone: (786)388-5880 Building Department Comments NEW ELECTRIC FOR POOL Infractio Passed Comments INSPECTOR COMMENTS False Inspector CommqAts PassedE�r Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 10,2015 For Inspections please call: (305)762-4949 Page 2 of 34 Miami Shores Village Building Department Nov 1 s 204 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305)795-2204 Fax:(305)756-8972 T INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 I BUILDING Master Permit No. f:)1P'p ID 1-4 Z�lt�l PERMIT APPLICATION Sub Permit No. �'�`�- 3 ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF F-1 CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 41 MW. 10'5 St- City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): co 1t' e 12 is Phone#: Address: 4-1 NQ- los; nft. City: M%GQY % ny)L_Vr9_% State: —41• Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: O(yz&.\ A_A�0__j Phone#: 1-2.t •594.1 Address: --14400 )6aZ. qZFT• City: W%G-VVN.1 State: 41. Zip: 3312.00 Qualifier Name: 1Lcji,nit i's Phone#: �+61LQ.•Sq96- � IS7+4 State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ -100- yC) Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration K New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: G�f Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ O)e 60 (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." 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. Signature ++-"f- ' ' . 4' ., Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of c� IJI�) 20 14 by VK day of NO" 20 14 by K-1�C1.. who is personally known to V.W4^ Q44 WN who is personally known to me or who has produced 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: Print: Seal: JACMEUNECOBA Seal: CQUJA EUNECOBA MY COMMISSION#FF 099383 =* + MY COMMISSION#FF 099383 : a EXPIRES:March 22,2018x` EXPIRES,March 22,2018 Bonded Thru Notary Public Underwriteers !f,tk•" Bonded Th-Notary Public Undenvriters APPROVED BY ( /'e Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ♦S�0% D logo ,,,,,l" Miami shores. Village Building Department rag �0 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 i£ 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 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: C 0 R,R ��F_ R t cl( Print Name: X-4-y l l-, 8 �.� Signature: `' Signature: State of Florida) mState of Florida) County of Miami-Dade) c n County of Miami-Dade .. Sworn to and subscribed before me this lq m Sworn to and subscribed before me this 4� m day of NOJ ,20 14 w day of 1J OJ 20in rk s rn By Q. K..,Cl�.. �� By �lC W VS, owA (SEAL) m � (SEAL) � l Type of Identification produced �; Type of Identification produced LOCATION SKETCH SCALENTS TS tE OZ c©�y 122.67' ' r^.Vii .S - � C"' t" �.•s 37.50' e •' •'"-Sl ,p z it—....�s...�t.�...tt_..-.�tr�z�.i .t..:..v�.�.� ..s z..— 6' N _ +"� S® ,`�r y r o-o"'✓y r• o�� • ,v �;. � n' •++.�.r�: �`i Y r.:,t i.. d�i.+"tw1� 26. •`P^ Cc.�. mCII Gt7ri .t0oib _NXr p•y r'r"`--''" 4' 6.40`E 40 :i iEa.' CR 31.16'30' 3100 3.00' 4,00' 12,00' 9 C): L N h C , o '"WI 9.01 t 9.01 41 0 OZ WNy p � '4 \ u 0.30' C 3c en 4.00' N rno 0 3 NORTH MIAMI AVENUE 4,00' p O c o t M f,,. , • • • •• • Mf'`± ons w ; •••• i •••• • !�' 28.83' • • W9 : s••••• ••c• •••• l t" •�•••• . • � A/C13' r� " :.tri • + . • 00*0 14 CL. 37.30' �,r C 61VVIF C •••••• • >� �:`' o b 122.71' ( R ,& M ) �' � q fob �A ® � t PROPERTY ADDRESS: 41 N.W. 105TH ST. , MIAMI SHORES, FL. 33150. _ LEGAL DESCRIPTION: LOT 13 BLOCK 203 ABBREVIATIONS: - OF DUNNING'S MIAMI SHORES EXTENSION NO. l SUBDIVISION SVN(=SIDEVALK,CBS=CONCRETE BLOCK STRUCTURE,CLF=CHAIN LINK FENCE,PL=PROPERTY LINE,DUE=DRAINAGE UTILITY EASEMENT,IP=IRONPI?E,' F=FOUND,A/C=AIR CONDITIONER PAD,P/C=PROPERTY CORNER,DM=DRILLED HOLE,VWF=WOODEN FENCE,RES=RESIDENCE,CL-CLEAR,RB=REB,:R, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 41 AT PAGE 51 UE=UTILITY EASEMENT, CONC=CONCRETE SLAB, R/W=RIGHT OF WAY, DE=DRAINAGE EASEMENT, C/L=CENTER LINE, O=DIAMTER. TYP=TYPICAL, M=MEASURED.R=RECORDED,ENCR=ENCROACHMENT,COMP=COMPUTER,ASH=ASPHALT,N/D=NAIL&DISC,S=SET,FEE=FINISH FLOOR ELEVATION, - OF THE PUBLIC RECORDS MIAMI—DADS COUNTY FLORIDA O/S=OFFSET.P/P=POVYER POLE.OHP=OVERHEAD PO WERLINE,VW=VW TER METER .. -VYOODFENCE= I — ' I .•.. yMASONM'VALL= ELEVATION BASED ON LOC.# 3100 -. CONCRETE -.:•.s..s.:•:s:. •s:. •s .: .: :..s.:. NOT VALID UNLESS EMBOSSED WITH MAINTENANCE&DRAINAGE EASEMENT=M&D.E. CBM# N-567 ELV. 10.54�YPE OF SURVEY:BOUNDARY SURVEY SINCE 1987 SURVEYOR'S SEALI HEREBY CERTIFY That the survey represented SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2)NOT VALID WITHOUT THE SIGNATURE thereon meets the minimum technical requirements BLANGO SURVEYORS ING. A AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NoT adopted by the STATE OF FLORIDA Board of Land W-�— = COVERED BY PROFESSIONAL LIABILITY INSURANCE- 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) Surveyors pursuant to Section 472.027 Florida Engineers•Land Surveyors•Planners•LB#0007059 UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODET;CStatutes. 555 NORTH SHORE DRIVE VERTICAL DATUM OF 1929-__7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL There are no encroachments, overlaps, easements RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9). appearing on the plat or visible easements other than MIAMI BEACH,FL 33141 CONTACT. THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING as shown hereon- (305)865-1200 Email:bioncosurveyorsinc@yahoo.com Fax: (305) 865-7810 INFORMATION. 10)EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED REVISED: INSTRUMENTS,IF ANY,AFFECTING THIS PROPERTY. n 4 `� Additions or deletions to survey maps or reports by other than the signing party or parties is prohibited FLOOD ZONE: g SUFFIX: j, DATE:9/11/09 BASE:N/A G1> }C�(lr�� without written consent of the signing party or parties. ADIS N.NUNEZ PANEL: 0302 COMMUNITY# 120652 _ REGISTERED LAND SURVEYOR DATE: - SCALE: DWN.BY: JOB No BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE-OF SAib f 41 PAGE 51 STATE OF FLORIDA#5924 7/24 14 1"=20' F.Blanco 14-6.26