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EL-15-2565 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972Phone: (305)795-2204 Fax: (305)756-8972 I�_3� Inspection Number: INSP-245367 Permit Number: EL-10-15-2565 Scheduled Inspection Date: December 23, 2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: TCC/TCO Owner: MARIANA JULIA LIVORE, FABIANO Work Classification: Addition/Alteration cu vCIDA nr-1 m AO Job Address:9935 NE 13 Avenue Miami Shores, FL 33138-2634 Phone Number Parcel Number 1132050090470 Project: <NONE> Contractor: KINGWIRE ELECTRIC INC Phone: (954)347-0852 Building Department Comments GENERAL REMODELING AS PER PLANS ELECTRICAL Infractio Passed Comments PLANS. INSPECTOR COMMENTS False Inspector Comments Passed � }� Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 22,2016 For Inspections please call: (305)762-4949 Page 3 of 32 Permit NO. EL-10-15-2565 ,SNORES y Miami Shores Village Permit Type:Electrical -Residential 1 u.,•T 10050 N.E.2nd Avenue NE PenWork Classification:Addition/Alteration Miami Shores,FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 -�Nres me �<ORIDP Issue Date: 10/15/2015 Expiration: 04/12/2016 Project Address Parcel Number Applicant 9935 NE 13 Avenue 1132050090470 Miami Shores, FL 33138-2634 Block: Lot: FABIANO SILVEIRA AGUILAR M Owner Information Address Phone Cell FABIANO SILVEIRA AGUILAR MARIANA 9935 NE 13 Avenue --- MIAMI SHORES FL 33138-2634 9935 NE 13 Avenue MIAMI SHORES FL 33138-2634 Contractor(s) Phone Cell Phone Valuation: $ 16,800.00 KINGWIRE ELECTRIC INC (954)347-0852 Total Sq Feet: 0 Type of Work:GENERAL REMODELING AS PER PLANS ELE Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning: 1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due jAnPay Date Pay Type Amt Paid Amt Due CCF DBPR Fee Invoice# EL-10-15-57371 10/15/2015 Credit Card $585.84 $50.00 DCA Fee Education Surcharge 10/09/2015 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations Scanning Fee Technology Fee Total: 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 infor a ifc is a ur and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the abov na a t do the work stated. October 15, 2015 Authorized Signature:Owner / Applicant C nt c r / Agent Date Building Department Copy October 15,2015 1 Miami Shores Village .-- � Building Department OCT 0 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 {',vT': 3C Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 J� FBC 20 1 `� J BUILDING Master Permit No. &'­ ' PERMIT APPLICATION Sub Permit No. t-L(5 -0"-5GS ❑BUILDING F4 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-IPLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP / CONTRACTOR DRAWINGS JOB ADDRESS: 3 4�7^ ��. _/3 rQ1O I�! 9-'/ S?7-nA'f—:� J%G, 3 /-j P City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type:• I // Flood Zone: BFE: FIFE:: �1 FA ASI '31ZVI 912-4 Phone#: �.�b fly j. OWNER:Name(Fee Simple Titleholder): Address: 9p}✓� �/�, /3,04y £, k-64Ae,' g'14C::' City:Y,'t 4 P-//- S' State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: /�-l�C7G�/� �C i e /� �' Phone#: 9+I-;4-3 (0 Address: �Z� !.lw, �� l�VE• City:R 0 n D�f2-co/Gcs Plz✓ - ' State: /1 Zip: -3-3 c) 2� Qualifier Name: % �0 4 0 ��S Phone#:`%S cL7- o E3S Z State Certification or Registration#: �C �3 0-t>3�78 Certificate of Competency#: i DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 16, 8-6o Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: �iC�� ==GcScT/za c_4 L Specify color of color tthru tile: Q Submittal Fee$ eo .� Permit Fee$ �v�f3w!> 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) 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 �' Signat �re 17 ° OWNER or AGENT CONTRACTOR The foregoing instrument as 1acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 by day of ��J�(1' ,20 ,� , by � Y>70^D ► o is personally known to ho is personally known to me or who has produced as me or who has produced � le as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sig Print: V Print: ; r .P anis laciregui Seal: ;=e," .y�:_CARMEN ESTHER JUSINO SeaI 0-.O (I# • MY COMMISSION#FF046931 , * State of Florida `7 EXPIRES August 19,2017 of �a�o� My Commission Expires 93/11/2019 ********* FI a oa Service.com ,�f,�,�,� �(y� **************************.VUI171�I�1881Y11 Nd*FFTW************ APPROVED BY C elf Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ,SNORES ..•. J .....�+ Miami shores Village Lh ��d Building Department ��ORIDp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. i// COPY OF QUALIFIER'S STATE LICENCES B. ✓ COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESSNAME: 2C CL4ac.7 n/C / ,y G BUSINESS ADDRESS: A/W• 6 6 ' VE CITY / - f i�Cs STATE r4 ZIP 33 0 BUSINESS PHONE: (f%Lv ) 3 �7— v85'z FAX NUMBER Yi-&- �r-iG2— �? �2 CELL PHONE (S'qn� )-3-L7- c eC-?- QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: Lac—/-3 0c 3 Q 26? .aamIcyr r`vr%%Ljm DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850)487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 TIES,3i31_:G> KINGWIRE ELECTRIC INC 521 NW 86TH AVENUE PEMBROKE PINES FL 33024 Congratu[stions! with fiis.frcease you_beam—one_ot_fhe_warly one million Floridians licensed by the Department of Business and ----� '� Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florkws economy strong. PROFESSIONAL REGULATION Every day we work to improve the way we do business in order to EC13003678 ISSUED- 07/01/2014 serve you better For information about our services,please log onto www.reEyB ' Them You can ftnd move rnkm4tim CERTIFIED ELECTRICAL CONI TACTOR about our divisions and the regulations that impact you,subscribe TORTES,JUDO to department newstettem and lean more about the Departments initiatives. KINGWIRE ELECTRIC:INC; 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, IS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new license, EXPk1fiWdWe`AUG 31.2016 1.1407010001941 DETACH HERE RICK SCOTT GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSthIMAND PROFESSIONAL REGULATWN ELECTRICAL CONTRACTORS LICENSING BOASMM EC13003678 ADDITIONAL BUSINESS QUALIFICATION The ELECTRICAL CONTRACTOR , Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 ' TORRES, JULIO_ OR •� `KINGWIRE ELECTRIC INC-.w -T■ r 521 NW 86TH AVENUE e PEMBROKE PINES -- FL 33024 own ISSUED_ 0710112014 DISPLAY AS REQUIRED BY LAW SEQ# L140701WO1941 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S.Andrews Ave., Rm. A-100. Ft Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2015 THROUGH SEPTEMBER 30,2016 DBA: Receipt#:ELECTRICAL/ALARMS/CONTRACTOR Business Name:KINGWIRE ELECTRIC INC Business Type: CERT ELECTRICAL CONTRACTOR) Owner Name:JULIO TORRES Business Opened:10/2 5/2 0 0 7 Business Location:521 NW 86 AVE State/County/Cert/Reg:EC13003678 PEMBROKE PINES Exemption Code: Business Phone: Rooms seats Employees Machines Professionals 3 For Vending Business only Number of Machines: Vending Type: M Tax Amourd Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements.This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: JULIO TORRES Receipt #10B-14-00008814 521 NW 86 AVE Paid 07/08/2015 27.00 PEMBROKE PINES, FL 33024 2015 - 2016TLni E iBROWARD:COUNTY LOCAL BUSINESS TAX-RECEIPT KINGELE OP ID:TF ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)10/02/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Newman Insurance Agency,Inc. PHONE FAX 5700 Stirling Road A/c No Ext): A/C No): Hollywood,FL 33021- E-MAIL ss: HGF Insurance Services Inc INSURERS)AFFORDING COVERAGE NAIC k INSURER A:Florida United Business Assn. INSURED Kingwire Electric Inc INSURER B:Travelers Insurance Co 1609 Barcelona Way Weston,FL 33327 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE a OCCUR 1-660-6E761883-TCT-15 06/02/2015 06/02/2016 DAMAGE TO PREMISES RENTED occurrence $ 100,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- F7 F—]JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED ( ) AUTOS AUTOS accident Per BODILY INJURY $ NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Per accident $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONPER H- AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 10644057 04/01/2015 04/01/2016 E.L.EACH ACCIDENT $ 100,00 DED? ❑ OFFICER/MEMBER EXCLUN/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) Electrical Work within Buildings CERTIFICATE HOLDER CANCELLATION CITYMIA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building&Zoning Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E.2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD