The URL can be used to link to this page

EL-16-2514 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL P L Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-267198 Permit Number: EL-9-16-2514 Scheduled Inspection Date: September 14,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: NEWBAUER,JEFFREY ADAM & Work Classification: Alteration MAI C11A QnTTA Job Address:70 NE 92 Street Miami Shores, FL Phone Number (305)799-0885 Parcel Number 1132060130020 Project: <NONE> Contractor: AUSTIN BRITE ELECTRICAL SERIVCE LLC Phone: (954)931-4641 Building Department Comments INSTALLING NEW OUTLET FOR WATER HEATER Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments PassedD5 �1 Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid September 13,2016 For Inspections please call: (305)762-4949 Page 38 of 44 Is �,� Miami Shores Village 10050 N.E.2nd Avenue NE UYr#C CJaS Miami Shores,FL 33138-0000 hA Phone: (305)795-2204 Expiration: 03/12/2017 Project Address Parcel Number Applicant 70 NE 92 Street 1132060130020 Miami Shores, FL Block: Lot: JEFFREY ADAM&MALENA BO- Owner Information Address Phone Cell JEFFREY ADAM&MALENA BOTTA 70 NE 92 Street (305)799-0885 - - -- MIAMI SHORES FL 33138- 70 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: �300.00 AUSTIN BRITE ELECTRICAL SERIVCE (954)931-4641 Total Sq Feet: Type of Work:INSTALLING NEW OUTLET FOR WATER HEA Available Inspections: Additional Info:INSTALLING NEW OUTLET FOR WATER HEA Inspection Type: Classification:Residential Review Electrical Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-9-16-61298 DBPR Fee $2'25 09/13/2016 Credit Card $ 109.10 $50.00 DCA Fee $2.25 Education Surcharge $0.20 09/12/2016 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $159.10 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 AFFID ' certif a oregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructio zonia re,I authorize the above-named contractor to do the work stated. September 13, 2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy September 13,2016 1 Miami Shores Village �T , �- g ((�� P Building Department SEP 12 20�� `-9 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 ;1FBC 20I�I BUILDING Master Permit No. PL--�-IG `2.°'B PERMIT APPL CATION Sub Permit No. ELI -ids I� BUILDING ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �30 �)f _I Z Sit cC�t City: Miami Shores County: Miami Dade Zio: 77'L�Xz Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): �V-Ery Awn Be Phone#: Oa Address: In Ne, n Z S)cee V City: M%CkgiQl' `n� State: Zip: 1Y1 Tenant/Lessee Name: Phone#: Email: a 1 � u�G�t^C CONTRACTOR:Company Name: `Js 4� -1Een„ 'Phone#:� L-16 Address: GL101 Cck�at'cl% cue- City: 7Gc C?'G State: P_ Zip: 3 3 az 1 Qualifier Name: C%Nre +e-. A -i n Phone#: State Certification or Registration#: not 4tyliT Certificate of Competency#: DESIGNER:Architect/Engineer: 1�J0\�� Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work:7iL 1;1--4 4 L 1/4- N !�✓ ®Gt T z5 Specify color of color thru tile: Submittal Fee$ ✓�' Q Permit Fee$ /f27 1,0709 CCF$ ® CO/CC$_ Scanning Fee$ Radon Fee$ DBPR$ ° �� Notary$� Technology Fee$ b Training/Education Fee$ 0° 2-0 Double Fee$ Structural Reviews$ Bond$ 0 TOTAL FEE NOW DUE$ 109. V (Revised02/24/2014) r s 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 Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before/m'a this The foregoing instrumentwasacknowledged bef re me this �\ day of ,20 IG ,by a day of o .20 � 0 'by Cntk Q0,, OR��LQ( ,who is personally known to ��'/� �9�/I// U��/N ,who isPersonally known to me or who has produced T-L as me or who has produced �L ` as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: AQtj ;�'�G�• .!!Irk% ;��Q`;•• N►issr0,�4 Sign: = Sign: Z MUD— �L Print: = FF206 S •:* Print �4 (� - - * Mac•4, r°= c•Y9 Seal: •9y •�'` Seal: =2°fa'RAN Aly:�� NNotP-'o��C�.; Nol p �blic,Stage°�.� '�. rublic�skok •�. 1110, wwwwwwwwwwwwwwwwwwwwwwwwwwwww��wlwwggwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww APPROVED BY 0"0"Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) r , Invoice ALL 4 ONE PLUMBING INC Toll Free: 1-888-943-1453 10795 NW 53RD STREET#201 Local:954-990-7666 SUNRISE,FL 33351 E-mail:service@a4ls.com 9/8/2016 A2767 Licensed&Insured:CFC 1427942 Jeff Newbauer Jeff Newbauer 70 NE 92nd Street 70 NE 92nd Street Miami Shore,Florida 33138 Miami Shore,Florida 33138 USA USA iR _- - '�,I( :'iY= Installing new outlet for water heater None Signature for acceptance of work to be performed X Total $300.00 Payments/Credits $0.00 Balance Due $300.00 CTQB Construction Trades Qualifying Board e BUSINESS CERTIFICATE OF COMPETENCY *'' 15E000274 AUSTIN BRITE ELECTRICAL SERVICE LLC D.B.A.:�::2 �STIN CHRISTOPHER Is certified under the provisions of Chapter 10 of Miami-Dade County Austin Brite Electrical Services LLC September 9, 2012 State of Florida County Broward County Before me this day personally appeared Christopher Austin who, being duly sworn, deposes and that he or she will be the only person working on the project located at 70 NE 92nd Street, Miami Shore, Florida 33138.Swom to(or affirmed)and subscribed before mel of 20t, by rv-,?hc�e� el Personally Know OR Produced identification Type of identificationProduce O:•O �' fig'' •V RE X91 ,,' fa%N N�.a°;�. Print, typ��'i�- Sme of Notary "'• ."' Miami shoresVillage 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.• allows corporate officers in the construction industry to exempt themselves from this requirement for any conStat. § 440.05 obtaining a building permit. pursuant to the Florida Division of Workers'Compensation struction project prior to Employer Facts Brochure: An employer in the construction industry who employs one or more par-time or full-time part -lame including the owner,must obtain workers'compensation coverage. Corporate officers or members of a limited liability company (LLC) exempt if in the construction industry may elect to he 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 fora 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 and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not requir e verification of workers'compensation insurance coverage from the contractor's company for day labor,Part-lime employees or subcontractors. BY SIGNING B OW YOU ACKNOWLEDGE THAT YOU HAVE READ TRIS NOTICE AND UNDERSTAND ITS CONTENTS. r Signature: Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this OT day of c ,20_�, By ` G""M JICuW who is personally known to me or has produced r i l l o f as identification. Notary: ••' Vey Oa SEAL: `�• �' �619r � �� Mv.419 :e*o