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EL-16-2465 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-267195 Permit Number: EL-9-16-2465 Scheduled Inspection Date: September 14,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: , Work Classification: Alteration Job Address:10417 NE 2 Avenue Miami Shores, FL 33138-2058 Phone Number (305)219-8267 Parcel Number 1121360130530 Project: <NONE> Contractor: APC ENGINEERING ENTERPRISES INC Phone: (305)219-8267 Building Department Comments SIDE LIGHT SWITCH Infractio 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 September 13,2016 For Inspections please call: (305)762-4949 Page 36 of 44 f E 3 l :"'l A *' T Eitl Miami Shores Village y M 10050 N.E.2nd Avenue NE �t?tkcW ter'1''o" Miami Shores,FL 33138-0000 M F - Phone: (305)795-2204 , IN E 'ii �t Expiration: 0612017 Project Address Parcel Number Applicant 10417 NE 2 Avenue 1121360130530 Miami Shores, FL 33138-2058 Block: Lot: LUCKY 13 HOME INVESTMENTS Owner Information Address Phone Cell LUCKY 13 HOME INVESTMENTS 8004 NW 154 Street (305)219-8267 MIAMI LAKES FL 33016- 8004 NW 154 Street MIAMI LAKES FL 33016- Contractor(s) Phone Cell Phone Valuation: $ 200.00 APC ENGINEERING ENTERPRISES IN (305)219-8267 ._.. .._. __ . . ....._.:. .__, Total Sci Feet: 0 Type of Work:SIDE LIGHT SWITCH Available Inspections: Additional Info:SIDE LIGHT SWITCH Inspection Type: Classification:Residential Review Electrical Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.80 Invoice# EL-9-16-61237 DBPR Fee $2.00 09/06/2016 Credit Card $50.00 $58.60 DCA Fee $2.00 Education Surcharge $0.20 09/07/2016 Credit Card $58.60 $0.00 Permit Fee-Additions/Alterations $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 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 AFF IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction nd zo ing Futhe e,I authorize the above-named contractor to do the work stated. September 07,2016 Autiz d Signatu a Owner / Applicant / Contractor / Agent Date Building Department Copy September 07,2016 1 Miami Shores Village SEP 0 0 2816 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 fi~ INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 BUILDING Master Permit NO.NIVS 1(D` - PERMIT APPLICATION Sub Permit No. CHU- zq (D5 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:/db/7 N6 c2"0/,fflv4_ 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): L.r4 mfG y 13 Phone#:.S-Z/f- Fr_6 .7 Address: /Dy/7 /V•B '2 w6*'aC-4- City: M c a w,o• $h o¢?S State: Zip: 33 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: A-f G *'_!211ne+en e!24 F-,7 Phone#:20 C-2/Q-JZ 6 7 Address: WS-0 k, ItJ+h ave- City: fie#.4% State: L Zip: 33,0!0 Qualifier Name: Ta rn C s e-e c 6i Rad°f Phone#: State Certification or Registration#: 9-:6 L100A 75-3 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value .9510.1s Permit:$ A 04 d° Square/Linear Footage of Work: TypeolN°�k '�g ❑..,Alteration New ❑ Repair/Replace El Demolition Description of Worr GSI .s1 9g%"+S%P�fo2 -pi;6teo! 06 r ¢u /Ak�/�� ar Ota on Specify Colo a of color thru tile:w °° Submittal Fee$ '�` °'` Perm9t' ee$ `"��e� CCF$ '� CO/CC$ . 05 Scannings ° " 0( - Q3 DBPR$ °Q3 Notary$ 0 Technology $ "' Fee TratO'ih Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 8 . 6o (Revised02/24/2014) 4 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 jK,L�iyLO"`y� s �'�')�''!� Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this ----�� 1 day of ,20 /6 , by �p day of -196-A/ ,20/4 by /6fL 44n a/ � /L�,who i so rnally know o -! .�. �/Gti0'-�C/2 ,wh s personally kno to me or who has produced as me or who has pr ncodL s "iQ identification and who did take an oath. identification and apatF. b 7 c-' State of FIN NOTARY PUBLIC: NOTARY PUBLIC: • • Commisaiotl!�l16 ' Thr Coaae. so T,201t �� 6an010 NMIo�IlfadryAssn. ,, Sign: Sign: t1 Print: r-0 Print: ` SANDY ROMERO Seal: Seal: +°` �o Notary publk.State of Florida M iR . •g Commhision I FF 915708p1lr a woo My Comm.ExpirPs Sep 7,2019 Bond Bonded through N�°icna!P; _ I Plans Examiner � �%& SANDY ROMERO APPROVED BY '�` c. e oFlorida Zoning • COmatbalon IFF 915708 a ��°`�; ' My Comm.Expires Sep 7,2019 Structural Review Bonded National Clerk (RevisedO2/24/2014) e,rs;� nve w r le_e�r RICK SCOTT,GOVERNOR KEN L.AWSON,SECRETARY S' A'C OF FLORIDA DEPARTMENT AF BUSINESS AND PRA�ESSiQi�Al.Rh l�LATION ELECTRICAL CONTRACTORS L ICISMI IC SOARD W �r 'EC13008753 AWITIONAL. BUSIl tSS QUALffT F7N' The ELECTRICAL CONTRACTOR Ian below IS CERT( #ED H Uttet M6�risl0 i Cfitper489 FS, E art date, AUG 1� 1 ,1pj , RI ARDS;JAMES ?„ 'APC ENGINEI RIN 16M INCORPORATED IMMI"al HIALEAH • WoM \ ISSUED: 07119/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1607190001507 AFFIDAVIT 1,lames P Richards,will be the only person working on the project at 10417 NE 2nd Ave Miami Shores, FL 3315382058. James P. Richards (305)885-5371 daviddapc@gmail.com Signature: " The foregoin nstrument was acknowledged before me this I day of 20 ByftS who is personally known to me or who has produced � Y As identification and who did take an oath. NOTARY PUBLIC: Signatur Print: =ROMEAOOg �q®1 Fip{i�1570�8gqp 7,2019 APC EnginwAng Enterprises,Inc. 2150 west 1 Avenue a Hialeah,Ft.33010•Phone:(305)885-5371a PAX:(3115)885-5073 a spcongineering@gmaii.ccm Page 1 of 1 .. Miamishores Village Building Department 0060 N.i .2nd avenue Miami Shares, Florfda 33136 Tel: (306)795.2204 Fax:(305)756.6972 F Notice r— Workers' Compensationur 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 pan-time or full-tirm enVloyw.%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 l.. The officer awns at least to percent of the stack of the corporation,or in the case of an LLC,a statement attesting to the minimum IO 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 listed as active with the Florida Department of State;Division of Corporations. No more than three corporate officers per corporation or luinted 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 contrac4or is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-tine employees or subcontractors for your project.The contractor has provided aro affidavit stating that he or she will be the only person allowed to work on your prdxject In these circum es,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor, -rime employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEI)GE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: -M-76 owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day ofsw ,20 . By who is pinsonally known to nae or has produced as identification. `rotary: t SANDY ROMWER0 ftwy pw tc«State a8 FWW Commiss to#FF MISS MY Coarm.Expires Sap 7.2089 P,pL Evnsintert,*"&- eK�. �2 a�e� fY Zl S0 w ►°�� - 9000 t+ I q 33n�Q h � o � •.• •... 9999.. ELECTRIC Sa..n.a.S �%c-ha2S ,JIEC R �F-w � , , • .•,. 999••9 SOS- - 2 4 s'Z 6 -7 APPR VEDA • 9999 3 9999.. ATL • ., .. .. 9999.. qS � � :999:9 9••999 . . 9999•. �enel' slde aS�D 00 d J� aN�aw `� s C-- ANa ow C6 foo