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EL-16-470 (2) Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972t?n I Inspection Number: INSP-261222 Permit Number: EL-2-16-470 Scheduled Inspection Date:June 20,2016 Permit Type: Electrical- Residential Inspector: Devaney,Michael Inspection Type: Final Owner: SOUZA, HENRIQUE Work Classification: Alteration 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 REMODEL 2 BATHROOMS AND KITCHEN. Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed 1E Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid June 17,2016 For Inspections please call: (305)7624949 Page 22 of 23 h Miami Shores Village 3 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 E . ` . ] r � i E , �:- Expiration:08/24/2016 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: $ 190.00 PRECISION POWER S CONTROL,COI (305)345-2161 Total Sq Feet: 0 Type of Work:REMODEL 2 BATHROOMS AND KITCHEN. Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-2-16.68757 DBPR Fee $3.38 02/26/2016 Check#:1171 $186.36 $50.00 DCA Fee $3.38 Education Surcharge $0.20 02/22@016 Check#:3024 $50.00 $0.00 Permit Fee-Additions✓Alterations $225.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $236.36 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 rate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-nam ntr to do the work stated. February 26,2016 Authorized Signature:Owner / Applicant / C ctor / Agent Date Building Department Copy February 26,2016 1 f� Miami Shores Village =BY.- Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC ZQk p BUILDING Master Permit No. , - , PERMIT APPLICATION Sub Permit No. BUILDINGELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL F-1 PLUMBING ❑ MECHANICAL []PUBLIC WORKS aCHANGE 0 ❑CANCELLATION ❑ SHOP 7 CONTRACTOR DRAWINGS JOB ADDRESS: q -79-IQ j O �ny S City: 'Miami Shores County: Miami Dade Zip: Folio/Parcel#: 6 ( "jj?=d : (684 0 Is the Building Historically Designated:Yes NO_)<, _ Occupancy Type: Load: Construction Type: Flood Zone: BFE:: / FFE: OWNER:Name(Fee Simple Titleholder): T Q, Phone#: Address: 2 City: 6 y` 3�J A Nib I JC/] State: Zip: 13 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Compan Name: J K s P c dt*% E 1ecfIC L hone#: 7 2(7_ `.3SQ Address City: HIM 1 State: Zip: -3Z7 13- Qualifier Name: O 4 Phone#:?� b 'Z"9(0 3 S� State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: �a� Zip: Value of Work for this Permit:$ /so 0 Square/Linear Footage of Work: / 1 0 Type of Work: ❑ Addition ❑ Alteration P- ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: K.diow—o .Q �. JJ `� 4�0 YI1 S k1 Specify color of color thru tile: 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$ ' (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. r _ Signature Signature OWNER or AGENT C RACTOR The foreoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20by 9-1,41 day of ,20 by 61 de— d U who is personally known to d 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 P Sign: Sign: Print: ' ' Print�qq �t � QUID OBS Seal: QUIDA JACOBS Seal: 'My COMMISSION#FF43g55 MY COMMISSION#FF43855 FIRES: gust 14,2017 EXPIRES:August 14,2017 AAAA 8ik8k*kkwffikkkkYMW&flk*k& **k8&bbi#kkkk*8+M4N*kkRs*+k*44M+kk+6+kk&**Mak**8&6*k6&dek�e*kflM4sww*Bffi.&88kk*4ssiik+k8kk+N4*k6 APPROVED BYJVCJ� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores Village Building Department R 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel:(305) 795.2204 Fax:(305) 756.8972 CHANGE OF CONTRACTOR/ARCHITECT Permit N. I OR I r—Lr -2 6_ Ob Owner's Name(Fee Simple Title Holder): a1j Owner' Address: E N D 'T City: State: Zip Code: job Address(Of where work is being done): W71 1 U0 102 h 0 City: Miami Shores State:—Florida Zip Code: Contractor's Company Name:PPL�-��I�)A] �ct/s e&hd&hone#:_ Address: 4// t<— , /0 ST City: State: —7, Zip Code:-35 Qualifier's Name: Lic. Number:_jEe/300 3q,/2 Architect/Engineer of Record Name: Phone#: Address: City: State: Zip Code: Describe Worlc (Ito Work - C Gt/K SJj 1 hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. 1 hold the Building Official and the iami Shores harmless of all legal i Ivement. SignatureAL Signature O or nt or The for Ding in was dged re me The forego! menet wwasss aknowl before me this_ ay of �- this=of T�/ k c...20/&y_fi72.41tog,�t1,60 Who is personally known to me or who has prod who is personally known to me or who has pr Aosz i ntification. Ification. Notary is Notary P '°:AMY CO MISSION#EE209595 Sign: Sign: S August 10.2010 Seal: ,� vw noa a�s3 fl �re .,�m "" Seal: My MDMISSION CO$38 5 EXPIRES:Aum# 2017 Miami-Shores VillagecE1V Building Department FE 2 2 . ois 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 FET ~ Tel:{305)795-22041 Fax:(305)756-897-2 '' BY . INSPERiON UNE PHONE;NUiVIBER {34S)T62-x4949 �T FBC-20 { BUr�D; 1G ifll�ermitcNo. PEr��ilrrT 14P� r �A'r1+oN Sub Permit NoE; (� [_]BUILDING ROOFING EjREUlSION ( ;EXFENtSiQltt: RENEWAL MPLWMBING Q MECHANICAL []PUBLIC WORKS []CHANGE OF CANCEtLAT101� [] .nSHOP CONTRACTOR DI;AWiNGS JOB ADDRESS: 4-7cl /v zdt MMiami Sh r s Mtaml fl Fouo/Parcel#: —04 — is the$uitdtng Htsstotigllylpatetl1� s Na Occupancy Type: Load..: Cons#ruction Type: '. Flood Zone: FFE: . OWNER:Name(Fee Simple Titleholder)• 1, me �¢ Fouz s Phone#: Address " (� :.State: zip:.3a/3 Tenant/Lessee IareR Phone#: {D'�6 .3 .0 . !7/ Email CONTRACT Oth Company Name: ~ 1G P.onesf Address: e tatty: ` State:ld Ztp�.. , Qualifier Name l•-� l � Phone#: State Certification or Registration • l, � #•^t ��'�'�Certificate of Competency#: . DESIGNER:Architect/Engineer: Phone#• Address: City: State Zip- Value of Word for this Permit Sl (� Square/Linear Footage pf Vllark:. -� Repai Type of Works �] Addltton C] Alteration [,]'New 0r/ftepla//c__e: D emolttion Descriptlon.of Work: !�1 f'c, ,�► Spe�1 sat©t`O;�c�t0!' tlfailE: Sut+mittralf a$c *J � ) pem*Fte � - CO/CC'S Scanning:Fee S ( Radon fee$ . `` 3 - QBPR S � NotarY S G Techrwlt'f S Trainir►gjEducation Double fee$ Structural R"Ift s$ 10 Bond S TOTAL FEE NOWOM$: (Re0%M2/24/2D14) Bonding Companys Name(if applicable) Bonding Companys Address City State Zip Mortgage lender's Name(if applicable) Mortgage lender's Address City State ZIF 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 an 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 regulatingconstruction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR:PAYING TWICE FOR IMPROVEMENTS TONYOUR PROPERTY. IF YOU ITEND TO OBTAIN FINANCING,CONSULTWITH 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$25W,the applicant must promise in good falth that a copy of the notice of commencement nt and construction lien law brochure will be delivered is the person whose property Is subject to attachment Also,a certif`ed copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (f) days after the building permit Is Issued In the absenee.of such posted notice, the Inspection will not be approved and o reinspection fee will be charged Signature C OWNER or AGENT CONTRACT The foregoing instrument was acknowledged befo►re�me this The foregoing instrument was acknowledged before 2 me thisday of ^ .20 me - ---,by I of �_ . 20 Y who is personally known to Ir-t—&-as � 41VA v e'vwho 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 P NOTARY PUBLIC: Sign: Ste; IENTO Print: IL Print:i6t (40Ti 388 p183Seal: Seal: APPROVED] Plans Examiner Zoning Structural Review aeric (Rr&ed02/24/2M4)