EL-09-1901Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number. INSP- 171885 Permit Number: EL -11 -09 -1901
Scheduled Inspection Date: June 07, 2012
Inspector. Devaney, Michael
Owner: POLANCO, DEYSI
Job Address: 1183 NE 91 Terrace
Miami Shores, FL 33138-
Project <NONE>
Contractor: F JIMENEZ ELECTRICAL CONTRACTOR, INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1132050010200
Phone: 305/556 -5759
Building Department Comments
ELECTRIC NEW HOUSE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 129450. needs 30 day temp. for
test, and all low voltage permits finals first.
June 06, 2012
For Inspections please call: (305)762 -4949
Page 7 of 24
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 No. C -� 19 a 1
PERM ICATION Master Permit No. O °I— l S3 I
FBC 2
Permit Type: Electrical Q
OWNER: Name (Fee Simple Titleholder): D e/S 1 Po( . yV CO GO Phone #: 17g6) 37ff - $j!/
Address: *23 7 $O NS.ef .9` ri p
City: Goys rt Se. State: P1- • Zip: 333 2-2,
Tenant/Lessee Name: Phone #:
Email:
F,C ET \TED
MAR 212012
JOB ADDRESS: 11 R3 / Ji - G / `rh. R—
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: r 4 nMErJCL E(tck11 4 CO��(a C •v hone #:
Address: /L'{O( w eS T Ok Cl+O bee. g
City: [Lit tl-- Gove4ew/5) State: r L Zip: 7j 3 8/ 6 Qualifier Name: 1�raNI Ct get) JL i4 e v Phone #: C764) .Z.45%. Zt 9 b
State Certification or Registration #: E.C. (' 6/027 79 Certificate of Competency #:
Contact Phone #: (7&,) 215 J 8 0 Email Address:
DESIGNER: Architect/Engineer.. g built Q t, I-A Nt £2S Phone #: l O$) 13z3 -3958
(.30e) Ss-6 -5757
Value of Work for this Permit: $ 2.i 8)0C)
Type of Work: ❑Address ❑Alteration
Square/Linear Footage of Work:
J$New ❑Repair/Replace
Description of Work: 1;5 4ti/d {C c,14► o f 1"1.414f L' I • nn �
( ^^
Demolition
* * * * *, ** *** * * * * * * * * * * * *** * * * * * **** * * * ** Fees * ** ** * * * ** * * * * * * * * * *, *** * * * * * * * *** * ****** **
Submittal Fee Permit Fee $ L S -0 0 CCF $ CO /CC $
Scanning Fee $ 3 .0cp Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ a4 -0-)
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 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 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
Owner or Agent
The foregoing instrument was acknowledged before me this
day of nt&V`y t20 12-, by Uer Po fgt. art o
who is personywn to me or wh o has produced
As identification and who did take an oath.
NOTARY PUBLIC:
r .
Signature
Contractor
The foregoing instrum was acknowledged before me this 'f 44
day of ict,N Arw1 , 20 l 2, by 'f JC e5e-b J l rteive'L
who is personally /known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
.COMMISSION # DD854166
EXPIRES: January 23, 2013
my R. Notary Disco= Assoc. Co.
*********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Y *** **4:4estk3e**sY9e9r3e** ** Yk*9c9e4ea1 **** 3c3e&*9e**** &*3:3: *3:******
'/ & t/L Plans Examiner
APPROVED
Structural Review
(Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
•
Zoning
Clerk
Miami Shores Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR 1 ARCHITECT
Permit N.RCart - 05 •I 53(
Owner's Name (Fee Simple Title Holder):,D.+a.fS I I c.nrc o Phone #: ( ?tt) 3'7C(
Owner's Address: 2.3 7 Su vs4p.f
City: S 0 , . . , , . State : t % L - Zip Code: 3 >3 Z. 1—
Job Address (Of where work is being done):
II 83 N.e. T"ceit.
City: Miami Shores State: Florida Zip Code:
Contractor's Company Name: gJapot'tweL 6/,et.,-4r,c.,\ ,3 r.3l' ne #: 6o5) 55'4 S75-5
Address: , INVdT ("Me ko
City: < o��,r�, G m,,r tipo.. State: PI_ Zip Code: 330/ A,
Qualifier's Name : F A,NGt SG D Marie—k, Lic. Number: at;.1300 2..77 °f
Architect/ Engineer of Record Name: Ewa 26 L14N'D6 AS Phone #: (3o $.) 923-1,3g
Address: 78 5'0 & / 414 41% ...Sta. s r) Su, re .T"O
City: M A.A4 i, o tc. e S State: FL - Zip Code: '33 at b
Describe Work: �Y c�r� c �u r •94.44A) Log 1-C.
I hereby certify that the work has been abandoned andlor the contractorlarchitect is
unable or unwilling to complete the contract. I hold the Building Official and the
Miami Shores harmless for all legal involvem;' t
Signature
Signature
owCIer or Agent
The foregoing ins en was akno dged befog
thi day of 014by 1..
II is person Ily k own toe or who h ; produced
¶i 1, 462 0 q' U - 14- as indentification.
Notary
Sign:
Seal:
CLAUDIA V. CUBILLOS
"'����" Public -
tS4 nuj,:c ; Notary ices Sept Florida
23, 2015
g. ,; .'s_ My Comm. P Se 123, 2
i ac Commission Assn.
%;; •1.1 opU` . °,, Bonded Through National Notary
I F
Contractor or Arch
The foregoing instrument was y +wledged before me
this 2,0S-day of Aginelk, 20/Zy Fi limes/4z,
who is ArsonalI nnwn tg m�e or who has produced
as indentification.
Notary Pu
Sign:
Seal:
Deysi M. Polanco
1183 NE 91st Terrace
Miami Shores, FL 33138
March 12, 2012
Metro Electric Service, Inc.
Douglas Sarrow
15050 NE 20th Avenue
North Miami, FL 33181
Re: 1183 N.E. 91st Terrace, Miami Shores, FL 33138
Permit #MC09 -1902
Dear Mr. Sarrow:
1 am contacting you regarding the above reference home for which you have permit
#EL09 -1901 with the village of Miami Shores. Saad Homes the general contractor for the
project was given notice of termination on June 2, 2011 and soon thereafter terminated
from the job.
Please consider this your notice of termination from the electrical job /contract with
permit #EL09 -1901. This notice is your seven (7) day notice of termination for the
following reason:
The General Contractor with whom you had a contract, Saad Homes, Inc. of
18601 Wentworth Drive, Miami, FL 33015 is no longer the contractor for the 1183 NE
91st Terrace, Miami Shores, FL 33138.
Sincerely,
Deysi Polanco
Owner
SENDER: COMPLETE THIS SECTION
• Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
• Print your name and address on the reverse
so that we can return the card to you.
• Attach this card to the back of the maliplece,
or on the front if space permits.
1. ArNol® Addressed to
teiro Eledric
1 Co 60 IJ E as Ave
#Jorth tart
33/ g•
$.
Miele Number
ONINfar tm ser7taseIsteD
COMPLETE 77-IIS SECT CN ON DELIVERY
X
C. D
gressee
D. Is delivery
M YES, enter address below 0 No
from Item
3. Sam 'We
0 Cwt Mall 0 ergs Mail
• 0 Registered 0 Return Receipt for Merchmdse
0 Insured Mall 0 O.O.D.
4. Restricted Detivery? (Ears Fee) 0 Yes
7011 1570 0002 0352 8734
PS Form 8811, February 2004 . Domestic Return Receipt
102595-0244540
UNITED STATES POSTAL SERVICE
First-Class Mall
Postage & Fees Paid
USPS
Permit No. G -10
• Sender. Please print your name, address, and ZIP+4 In this box •
bEy�? n co
i t 9'3 E 9(Trr
'
N,arni Shores, FL 33 g
},r}} 1411} 1111}} r, 1} r} 44}1111}rJrsli},11111i111111,�l },114 } }i
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
FBC 20
Permit Type: ELJCTRICAL
Owner's Name (Fee Si
O 's Address `l
City karrt
Tenant/Lessee Name
Email
F: �1 �I Permit No. E I -
M. ster Permit No.tC a�
NSW 6 up
ple Titleholder) YlCU1p(1 .er'r2 r C
D a Ku() '1 `sT .
State :o�
`.. Phone # -aQ
Zip 33 l i (.
Phone #
Job Address (where the work is being done)
11�� rt ail c'-
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # l 1 —59-D 5 -00 - 0
Zip
X31
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address 15D5D
City N (:)11/41+1 �'1 to PVII
Qualifier Name U S I c o nz O.
State Certificate or Registration No. e� -OOC)®3 ii `5
Contact Phone
Flood Zone
E -mail
Phone # ��J - Li-q5512.,
Certificate of Competency No. t<C _Dom 5 q 6.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ ✓ 9 i6 . (2 'V Squ / Linear Footage Of Work: ��I �'j5
Type of Work: ❑Addition ❑Alteration
Describe Work:
NEW 44ou5Q
New ❑ Repair/Replace ❑ Demolition
* * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ 'Z ®P U CCF $ 4K0 CO /CC $
Notary $ Training/Education Fee $ 1. u'0 Technology Fee $ (0'40
Scanning $ ? Radon $ DPBR $ Bond $
Double Fee $ Violation date: d
Structural Review. $ Total Fee Now Due $ 45S .gj
See Reverse side '-->
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 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 • suance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the otice of commencement and construction lien law brochure will be delivered to the person
whose roperty is subject to attachme Also, a certified copy of the recorded notice of commencement must be posted at the job site
for t first i pe'tion wh'.h occu seven (7) ys after the building permit is issued. In the absence of such posted notice, the
in ection 11 no be a, . v d a re -insp ion fee will be charged.
Signatur
weer or Agent
Signature }a.
Contractor
The foregoing ins , „ ent was acknowledged before me this l 3 The fore` ioing instrument was acknowledged before me this 12-
dayofOOJ ,20 (A, by , day of N Q4,.by
o is personally known to me it who has produced who is personally known to me or who has produced
As identification and who did take an oath. StoOa/1,002qO403 as identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBL
Sign:
Print:
My Commission Expire,6:
* M1f GU14MMsSiO I # DD 1$1662
EXPIRES: Jaen 20, 2013
, 4poomeOe Bonded 'Mugu*Nay antes
* * * * * * * * * * * * * * * * * * **
APPROVED BY
Sign:
Print: ('vr -2 n -t [co
;fRY pL
My Commission Ex: 1 @s ,,,,, '
nT, EXPIRES: Jun• 20 2013
OFD. Wee%
/>if—le"fr "laps Examiner Zoning
Engineer Clerk checked
(Revised 07 /10 /07)(Revised 06/10/2009)