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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)