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EL-13-444
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 187394 Permit Number: EL- 3- 13-444 Scheduled Inspection Date: March 18, 2013 Inspector: Devaney, Michael Owner: BACH, STEVEN Job Address: 9304 NE 5 Avenue Miami Shores, FL Project: <NONE> Contractor: STREAMLINE ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number (305)754 -2705 Parcel Number 1132060140420 Phone: (954)830 -0637 Building Department Comments INSTALL 2 6' POST LIGTHS AT FRONT WALKWAY Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 15, 2013 For Inspections please call: (305)762 -4949 Page 37 of 54 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: FBC 20 Permit No. Master Permit No. Q LJ City: Miami Shores County: Miami D de FoliolParcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 0---ekesAJ o EA Op Address: 13i 3 0 Li 14� g A\ c, / ' City: ( i Or) 1 C T'`- ` ra State: F&D Tenant/Lessee Name: -1-1° 1°)'9—'° Phone #: Zip: '51 3 / Phone#: v`� ) - 1. ?" Zip: 75 Email: CONTRACTOR: Company Name: S Td `� 4•iM /14C C E //GG 'r'r C r C. Address: , 3 U 7)c r` 4( rjr- / o City: Net! G 0-c..) Jc I I State: Qualifier Nam J CJ c-Q 1 i � r zei 4 " �y State Certification or Registration #: EC- 130 0 g Contact Phone #: Ste^ Vo-O 6'3? Email Address: 34, S5-°°'`P 8e DESIGNER: Architect/Engineer:' ` °' Phone #: Vaiue of Work for this Permit: $ /000 a 00 Square/Linear Footage of Work: r Phone #: 9`,<-7 'S'd' 3-7 Zip: ,.3302_® Phone #: `z — Fgej �y -Off 1 Certificate of Competency #: Type of Work: OAddress gAlteration Description of,Work• ONew "'ORepair/Replace ODemolition ******** ** * * * * ** * *** * * * * * * * * * * * * ** * * * ** Fees************* ** * **** * * * ** * * * * ** * * ** * * * * * * * ** Submittal Fee $ Permit Fee $ dr r494' CCF $ CO /CC $ is Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 N�. 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 commenceme t must be # o ed at the job site for the first inspection which occurs seven (7) days after the building permit is issues -In th ab e g osted notice, the inspection will not be approve r - a reins ction fee will be charged. Signature Owner or Agent The forego 11 1 trument was-acknowledged before me this c day of - t- , 201 ; by 401,4 ri 61, oecolorei, k who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: ¥'����,,° [-Oka .tom i� Print:r c.(fr eS I` My Commission Expires: Contractor The foregoing instrument was acknowledged before me this day of , 20 13, by (, f thi e "' who personall 10;07) 398-0153 MARIA LOURDES COCCHIARELLA COMMISSION E EE860417 EXPIRES March lo, zu e7 F+«aaho18ryservbe.com APPROVED BY Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07XRevised 06 /10/2009)(Revised 3/15/09) to me or who has produced as identification and who did take an oath. My Commission Expires: Zoning Clerk Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCMMPTOON) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION] YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: 9fi€crV\ l l "e. & c: (NI c., LA/ C. BUSINESS ADDRESS: / 5x3 0 0/ ki Ai29TY l STATE'" ZIP CODE 3-3 a C7 BUSINESS PHONE: (q5( ) g3 ©b V 6 3 ?FAX NUMBER ( ) CELL PHONE (t..5r) gr3e2 ' ' * UALIFIER'S NAME: / C Aqtv / V 7-14A1-74 QUALIFIER'S LIC NUMBER: EC. /0193S2,71 EMAIL ADDRESS (IF APPLICABLE): Created on 3119109 BY ITV I RV 3126109 MU)V • JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION 03 -02 -2012 * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law EFFECTIVE DATE: 05/07/2012 EXPIRATION DATE 05/07/2014 PERSON: PRIZANT FEIN: 261589128 BUSINESS NAME AND ADDRESS: STREAMLINE ELECTRIC INC MICHAEL 1039 PIXIANA ST 1194 HOLLYWWMf Fl 5106 SCOPES OF BUSINESS OR TRADE: 1- ELECTRICAL WIRING WITHIN BUILD 2- ELECTRICAL WIRING (5180) * IMPORTANT: Pursuant to Chapter 440 . 051141, F.S., en officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation wader this chapter. Pusan! to Chapter 440.06112), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Perseaat to Chepter 440.061.131. F.S., notices of electies to be exengtt and certificates of election to be exempt shall be subject to revocation If, at say time *ter the filing of the notice or the issuance of the certificate, the person named on Me notice or certificate no longer meets the requirements of this section for issueuce of a certificate. The department shall revoke a certificate it say time Inc failure of the person named on the certificate to meet the requirements of this section. MC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -1.1 QUESTIONS? (850) 413 -1609 PLEASE CUT OUT. THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DMS*ON OF WORKERS' COMPENSATION cONSTKUGTION MUM' CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS` COMPENSATION LAW EFFECTIVE 05 /07 /2012 EXPIRATION DATE: 05/07/2014 PERSON MICHAEL PRIZANT PER 261588128 . BUSINESS NAME AND ADDRESS: STREAMLINE ELECTRIC INC 1830 DIXIANA ST 8104 HOLLYWOOD, FL 33020 SCOPE OF BUSINESS OR TRADE 1- ELECTRICAL WIRING WITHIN BUILD 2- ELECTRICAL WIRING (51301 F 0 L D H E R E IMPORTANT Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exertion from this tester by filing . a certificate of election under this section may not recover benefits or compensation under this Miter. Pursuant to Chapter 440.05112), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed on the notice of election to be exempt Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no lodger meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? 1550) 413 -1509 CITY OF HOLLYWOOD TREASURY SERVICES DIVISION LOCAL BUSINESS TAX RECEIPTING 2600 HOLLYWOOD BLVD, ROOM 103 HOLLYWOOD, FL 33020 STREAMLINE ELECTRIC INC. 1830 DIXIANA ST 104 HOLLYWOOD FL 33020 5269 36968 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING HOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 PRIZANT, MICHAEL J STREAMLINE ELECTRIC INC 1830 DIXIANA ST APT 104 HOLLYWOOD FL 33020 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myflorklalicanse.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! THIS DOCUMENT HAS A COLORED EIACKGROUND MICROPRINTING • LINEMARK- PATENTED PAPER 2501421' DATE 3ATCH NUMBER The ELECTRICAL CO Named below IS CERTIFI Under the provisions of Expiration date: AUG 31, ,2014 PRI STREANLINE ELECTRIC INC 1830 DIXIANA ST APT 104 HOLLYWOOD FL 33020 Gam X w A7 7 f ?a V .5 mMP ! fosf Gi9hf xa APPRO`,,IED ZONING DEP BLDG DEP l C^7 DATE SUBJECT 1.0 COMP. MNCE WI H !J_ PE' - "RA- STATE ANA f l_ LFS Ai, " - �('l1'�_ ".,SUNS (Ai ATT ,Aiecf-) .-, -r---'--, '-' 6/tovzze'Ar