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EL-16-3169 (2),q3iob "T-0 014.4se. $ 1."-&4- -434 h4.4 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 c 681 - Inspection Number: INSP-273122 Permit Number: EL -11-16-3169 Scheduled Inspection Date: December 15, 2016 Inspector: Devaney, Michael Owner: SHOAF, DAVID Job Address: 1516 NE 104 Street Miami Shores, FL Project <NONE> Contractor: ELECTRIC SUNSHINE INC Permit Type: Electrical - Residential Inspection Type: R ugh Work Classification: Alteration Phone Number Parcel Number 1122320320360 Phone: (305)974-4339 Building Department Comments REPLACE RECEPTACLES TO ISLAND 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 December 14, 2016 For Inspections please call: (305)762-4949 Page 31 of 33 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Expiration: 06/11/2017 Applicant 1516 NE 104 Street Miami Shores, FL 1122320320360 Block: Lot: DAVID SHOAF Owner Information Address Phone CeII DAVID SHOAF 1516NE104ST MIAMI SHORES FL 33138-2666 Contractor(s) ELECTRIC SUNSHINE INC Phone (305)974-4339 CeII Phone Valuation: Total Sq Feet: $ 2,500.00 0 Type of Work: REPLACE RECEPTACLES TO ISLAND Additional Info: Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.80 $2.25 $2.25 $0.60 $5.00 $150.00 $9.00 $2.40 $173.30 Pay Date Pay Type Invoice # EL -11-16-62122 12/13/2016 Credit Card Amt Paid Amt Due $ 173.30 $ 0.00 Available Inspections: Inspection Type: Review Electrical Review Electrical 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 A constructio at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating re, I authorize the above-named contractor to do the work stated. ut orized S tM° nature: •? ner / Applicant / Contractor / Agent Building Department Copy a - !December 13, 2016 Date December 13, 2016 1 BUILDING PERMIT APPLICATION ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305} 795-2204 Fax: (305) 756-8972 INSPECTION UNE PHONE NUMBER: (305) 7624949 BY: FBC 2014 Master Permit No. kC _ 1 _I3t11 Sub Permit No. € U kb -� 169 0 RENEWAL NOV 18?416 ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [] CHANGE OF ❑ CANCELLATION 0 SHOP CONTRACTOR JOB ADDRESS: /67e-12 Ai /04-,z sr - City: Miami Shores County: Miami Dade Follo/Parcel#: /1 2 Z3z 0 3'163 &&-• Is the Building Historically Designated: Yes NO DRAWINGS Zip: 33(� Occupancy Type: 'e s. Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): /) 11:21) is. u 6 LooLre Phone#: Address: /576' , / 0 y S City: nAy State: Zip: 53/ Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: £ d`'� s tic' ('1- Address: L./ (1 Jb E ( 5 Z City: OA L State: L— Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: \C -e G / -sa 0-y4 ( Certificate of Competency #: Phone#: Phone#: 3d.5c-17`/4.537 Zip: ?7l Z Phone#: Z 7tic-1 Address: City: Value of Work for this Permit: $ Type of Work: 0 Addition 7-t 00 0 Alteration ❑N State: ______ Zip: Square/Linear Footage of Work: New ,Repair/Replace 0 Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ ls"a,/ e ' CCF $ -.. - CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ 5 Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE$_ 19- (RevisedO2/24/2014) SO. 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature (-6-1 Q/1/2Q, OWNER or AGENT Theforegoing instrument was acknowledged before me this 1 '4. day of AA , 20 1 ' , by / d-gG riv 0 41 , who i personally know) me or who has produced as identification and who did take an oath. NOTARY PUBO • Sign: Print: Seal: Jesse Walters Notary Public- Stateof Florida Commission #GG 32294 Expires 9/21/2020 **************** APPROVED BY (Revised02/24/2014) CONTRACTOR The foregoing instrument was acknowledged before me this tb day of , 20 _-L , by who is personally known to me or who has produced [e1Vi:I( as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: oi1101N11111lAA/A/ Adv N�o�$ e� tea• d o•• n= �9 •°° S' OiAZ �c ° Z�e . bl, N ° g . w •*******************+ter*******************4jr s # °°0'0#**** A9AAlAIO f 1111111110��`e Plans Examiner Zoning Structural Review Clerk A l.. /1Q /'f A I'iL/L.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 1 11/1R/2016 TYPF(1F INRI IRANGF PRODUCER SOUTH FLORIDA CASUALTY 415 North 4th Street Lantana, FL 33462 (5611533-6144 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND ALTER THE COVERAGE AFFORDED BY THE POLICIES OR BELOW. INSURERSAFFORDING COVERAGE NAIC # INSURED Electric Sunshine, Inc. 411 NE 152nd Street Miami, FL 33162 786-512-1519 Cell 1 INSURERA Scottsdale Insurance Company 41297 INSURER B FCB & 1 Fund INSURER C: EACH OCCURRENCE INSURER D: X INSURER E $ 100.000 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSN LTR AWl. NSRD TYPF(1F INRI IRANGF POUCY NUMBER POUCY EFFECTIVE DATE(MM/DDNVf POLICY EXPIRATION DATE(MM/DD/VVf LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000.000 X DAMAGE IU RtN FEU PREMISES (Ea ocourencel $ 100.000 ICLAIMS MADE In OCCUR MED EXP(Anyoneperson) $ 5,000 A CPS2532457 09/20/16 09/20/17 PERSONAL&ADV INJURY $ 1.000.000 GENERAL AGGREGATE $ 2.000.000 GEM_ AGGREGATE LIMIT APPLIES PER: POLICY ® PRO - !FM D LOC PRODUCTS - COMP/OPAGG $ 2.000.000 AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) _ __� $ BODILY INJURY (Per person) $ _ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANYAUTO AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA UABIUTY EACH OCCURRENCE $ DOCCUR CLAIMS MADE AGGREGATE $ RDEDUCTIBLE RETENTION $ _ $ B WORKERS COMPENSATION AND EMPLOYERILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 1 sCdAesLcOVONSbeIOW 10656173 2/11/16 2/11/17 I TORN i IAMITR I X IQFR E.L EACH ACCIDENT $ 500.000 E.L DISEASE - EA EMPLOYEE $ 500.000 E.LDISEASE-POUCYLIMIT $ 900.000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Electrical Contractor City of Miami Shores 10050 NE 2nd Ave Miami Shores, FL 33138 FAX 305-756-8972 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANCELLED BEFORETHEEXPIRATION D DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR III�� REPRESENTATIVES. J 1 AUTHORIZED REPRESENTATIVE �+ ACORD25 (2001/08) ©ACORD CORPORATION 1988 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 SENATORE, ALEX G ELECTRIC SUNSHINE INC PO BOX 661004 MIAMI SPRINGS FL 33266 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 inirrove the way we do business In order to serve you better Forinformation about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the Departments 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! RICK SCOTT, PROFESSIO 0EBUSINESSAND STATE OF FLORIDA DEPARTMENT .,. t. REGULATION EC130040 : 08/28/2016 MI L CONTRACTOR CERTIFIED E4 SENATORE ELECTRIC SU IS CERTIFIED under the provisions of CIL489 FS Expliattri date AUG 31 2018 1160821100454 DETACH HERE KEN-LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL. REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC130041016 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 SENATORE, ALEX G ELECTRICMI SPRINGINC PO BOX 601004 MIAMI SPRINGS ISSUED 08/2e/201 SEC L.166886064,664 004326 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6347892 BUSINESS NAME/LOCA ELECTRIC SUNSHINE INC 411 NE152ST MIAMI IL 33162 RECEIPT NO. RENEWAL 6618232 OWNER ELECTRIC SUNSHINE INC Worker(s) EXPIRES SEPTEMBER 30, 2017 Must be displayed at piece of business Pursuant to County Code Chapter 8A — Art 9 & 10 SEC. vtert BUSINESS 196 ELE .1 CONTRACTOR EC13004610 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 09/12/2016 ECHECK-16-176476 This Local Business Tax Receipt only confirms pilyment oldie Local B noes Tex. T e Receipt is not a license, penult, or a certification of the holder's goalifcadona to do business. Holder most canpIy with any governmental or nongovernmental regulatory laws and requirements which apply to that business. The RECEIPT NO. above musi be displayed on all commercial vehicles - Mianrl-Dade Code Sec 8a-876. For more information, visit www miamidade.Eovitaxcofloctet