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DEMO-16-62 . U � Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-250664 Permit Number: DEMO-1-16-62 Scheduled Inspection Date: February 29,2016 Permit Type: Demolition Inspector: Devaney,Michael Inspection Type: Final Owner: SOUZA, HENRIQUE Work Classification: Electric Job Address:479 NE 102 Street Miami Shores, FL Phone Number (646)320.4171 Parcel Number 1132060170840 Project: <NONE> Contractor: B.J BURNS INCORPORATED DBA OUTLOOK INTERNATION Phone: (786)286-3584 Building Department Comments DEMO ELECTRIC OF 3 BATHROOMS AND KITCHEN Infracdo 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 February 26,2016 For Inspections please call: (305)762-4949 Page 21 of 60 irk S� w? Miami Shores Village 10050 N.E.2nd Avenue NE " Miami Shores,FL 33138-0000 ` Phone: (305)795-2204 Expiration. 07/17/2016 v' Project Address Parcel Number Applicant 479 NE 102 Street 1132060170840 HENRIQUE SOUZA Miami Shores, FL Block: Lot: Owner Information Address Phone Cell HENRIQUE SOUZA 479 NE 102 Street (646)320-4171 MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 550.00 B.J BURNS INCORPORATED DBA OU (786)286-3584 Total Sq Feet: 265 Type of Demo:Electric Available Inspections: Additional Info:DEMO ELECTRIC OF 3 BATHROOMS AND KI Inspection Type: Classification:Residential Final Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $o.60 Invoice# DEMO-1-16-68285 DBPR Fee $2.00 01/19/2016 Check#:2882 $64.60 $50.00 DCA Fee $2.00 Education Surcharge $0.20 01/11/2016 Check#:2873 $50.00 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.50 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS 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. Futherm �horlze threve-named contractor to do the work stated. January 19,2016 Authorized Signature:Owner L IAOp%cant / Cont t Date Building DepartmenPCopy January 19,2016 1 Miami Shores Village Building Department JAN Y 1.2010 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Gt.� Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20/ BUILDING Master Permit No.(J amo A6`3 -3 PERMIT APPLICATION Sub Permit NO.DeOV J6 ❑BUILDING ® ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP r ^� ( CONTRACTOR DRAWINGS 1 JOB ADDRESS: "T (9 iJ L I C)Z"'0 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 3 -72.06 0� !" d f3 4 C2 _Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): �ev��Civq �� Phone#: Address: City: State: Zip: Tenant/Lessee Name: Phone#: Email: ov ldo k _-M L CONTRACTOR:Company Name: nJ{ 3 Phone#:�� 9b _357 Address: � ( SC� / 0 58 ) 2 City: State Zip: Qualifier Name: /�l�� r Phone#: State Certification or Registration#: 6k ca f *1 / Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for thh dermit:$ r so Square/Linear Footage of Work: �o�a Type of Work ❑' Addition ❑ Alteration F-1New �(-❑ Repair/Replace 1 .,Demolition Description of Work:, GIpC4''I�iG L-�'2WWIAA Tli(RTrms 4 LLtA tw% Specify color of color thru tile: Submittal Fee$ S® •C�6 Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ //�• PP '' / TOTAL FEE NOW DUE$ iD`"1 (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 in a permit to d the work and installations as indicated. I certify that no work or installation has Application is hereby made to obtain pe o fy 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of com encement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. I the absence of such posted.notice, the inspection will not be approved and a reinspection fee will be charged. Aii—j— - — A Signature Signature- �dA I OWNER or AGENT CONTRAWR The foregoing instrument was ac;nowledged before me this The foregoing instrument was acknowledged before me this �—da f 20by day of f ,20J by %Ak who is �� l�I � ,who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and an P MANUEL REGIS NOTARY PUBLIC: NOTARY PUBLIC: Rotary Public.S•.ate of Florida My Comm.E*res Nov.30,2020 No.DD389723 led ers Sign: Sign' Print: v Print aPLU p-1 4Z C-1 Seal: MY COMMISSION#FF43855 Seal: if EXPIRES:Aught 14,2017 �s***��*�*�**��m*x*a+x*� a�**�a�*�*�$*s*w*�*s**��**��*�a*sax*��****sxmxss**��**�*�**��#<**.►u�xxx**axass APPROVED BY /a Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 1/11/2016 (4589 unread)-dj:)erry63-Yahoo Mail Back to Message Licenses(2).pdf 2 /4 �y X Local Business Tax Receipt Miami--Dade County. State of Floes -THIS 15 NOTA OCL -0O NOT PAY LB 5653713 ��/ �E WaIfO NMJSIAao^VIM OUROON�►NO. GAP�1CS 47M WS l VNE O 1O of Etc SEPTEMBER 30,2016 s7o6 alscArsff eiw SOE MVM R 33137 r a�.ree a sleoA d6wiersa Pa a caeq Cees men.x-An.s s 10 airewn aac T�fA!a Nam A 1 ON066WP66KORPOUTED 196 E-ECTRCM.COMRACiON sAravrNsraeo Ws4er{s) 1 IIETA oOUACTOM f45.O0 10/01/2015 EPPUIo-16-000077 1ria16rarRr6ee�all+r�nnr�Ir L 6rwTa iV■esia er�AraA a+N.a�rlrrr.rrrr.�rrraa.N.Isnrrery/riAaT� ea6wasrr NPrr/ra at wrrr�Yi#y r w s�y� Bi.'gt+E=S f�ttFtGi��C��1' 11E000329 8d SUNO WCORPORAM aBA:yncc,craeswaCO EuaTNc r f APtT2 YoaY.d clan 111e_pl aad C*.VW to d YaaONAsuY+t https://us-mg6.maii.yahoo.com/neoAaunch?action=showLefter&umid=2 0 0 1_13007293 AKTmjkQAAh9AVp0lxgPE2B7V90o&box=lnbox&src=hp&.rand=14... 212 1N 1P1016 (4589 cavead)-d_perry63-Yahoo Mail Back to Message Licenses(2).pdf 3 /4 X a QUAtsYlli G oom ELECTRr-N. 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THUS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUIER(SI,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. —MPMANT: It the=111111coto hoWer is an ADDITIONAL WSURED,the moat be endorsad. H SUBROCIATION M WAIVED,subject to the torm and comffilou of the policy,vermin policies may mqui a an oularsenuutt. A staSMlrent on Uds ow flodo does not cooler rights to the owNesto her In ROM of such s). 1PRODUCER WCr SUNEM HERRERA NVEINSTEIN INSURANCE SERVICESPHONE PSE DE LEON BLVD.,= � 3 3 -3236 lOORALGABLESL i COMPANY 8.33146 COM CRYSTA INSURERRAFFORDINSCOVERAGE NAICMN MEURER AMERICAN SPECIALTY 41718 INSURED OUTLOOK INTERNATIONAL ELECTRIC e:ZENRH INSURANCE COMPANY 4700 BISCAYNE BLVD AM Dounon c:SCOTTSDALE 94SURANCE CO. 41297 MIAMI,FL 33137 DSD: INSUREIRP: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBSECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPEOFINSURANCH UNITS GENEM LIA6HnY EACH OCCURRENCE $ 1, A X oommERwALeENm&uAwuTY 0001032203 0541412015 05!74/2016 pREMM Eao, $ 100 - OOCCUR MED EV(AV am pomn) $ s, X PRIMARY NON CONTR PERSONAL a ADV eIJURY $ 1,000, GAIL AGGREGATE $ 2,000. GENL A003EMTE LDDTAPPLES PER PRODUCTS-COMP0P AGG $ 2,000 POLICY rx-1 Pas' we 1 $ AUT HLIJUMBY $ ANYAUTO $ �OO BOMYUURY(Pa $AUTOS HIRED AUTO$ NON-OWNED $ $ UYBRELULIAa X I OCCUR EACHOCCURRETtCE $ SAM C X Ex< Lwe lGA3NA4AOE 804=5 05474=6 AGGREGATE $ 5, DED I IRETENTMsW $ FORM WO TNNL AND b't�fERe'LIABILITY x �ruusrs eM B IXa TN vM YO IA 1301 0801412015 05/142016 EA EACH ACCmHJT $ 1 (�WL�oo,l�M�__tr��In��NH) E.LDISEASE-EAEMPLOYEE$ 1,000, 000 under OEBCRIPrIIXOOPERATIONSbdow E.L.DMEASE-POUCYLeHT $ 11000, C 7 FLOATER 68372 02202075 022 18 PNE JOB 100,000 LOC 100,000 Dfi eE�'IpMB/tGCATtO►N/Vt08Ll'!8 W4gL ACORD 101,Ad�bmMRemaloi SdmrlWo.Nmaeapmeis, Electrical Contractors CERTIFICATE HOLDER CANCELLATION SHAD ANY OF THE ABOVE DESCROW POLICIES BE CAMMLED BEFORE Miami Shores THE MOWATTON MATE TFC, NOTICE WILL HE DEIIVNED NM Building Depatfinerd ax�A1LCE WITH THE POLICY 10050NE2Ave Miami Shores VU /rlage FL 33136 ALne�a,®r)trrATNE v e tSSO-2010 ACORD CORPORATION.AN rights reserved. ACORD 25(2010100 The ACORD Lunn and logo are registered marks of ACORD W h4sJhs-mg6.midLyahoocaNnwAamchTad on=sfoivLetter8aLmid=2 0 0 1 13007291 AKTmjkQAA119AVp01xgPE2B7V90o&box=l twAsrc=tip&.rand=14... 1/2