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EL-13-2707Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234848 Permit Number: EL -12-13-2707 Scheduled Inspection Date: May 22, 2015 Inspector: Devaney, Michael Owner: DEL C NUNEZ, MARIA Job Address: 17 NE 107 Street Miami Shores, FL 33161-7029 Project: <NONE> Contractor: CASSIA ELECTRICAL CONTRACTORS INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1121360070340 Phone: (954)650-5840 Building Department Comments ELECTRICAL WORK AS PER PLANS 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. 2'2/cl(70/X Inspector Comments CREATED AS REINSPECTION FOR INSP-234523. CREATED AS REINSPECTION FOR INSP-233250. CREATED AS REINSPECTION FOR INSP-227987. CREATED AS REINSPECTION FOR INSP-227867. CREATED AS REINSPECTION FOR INSP-225899. CREATED AS REINSPECTION FOR INSP-225890. 14 jan. 2015 Use connectors on low voltage cables at the A. H. U.. Receptacles missing at bedrooms 1, 2 and next to the A. C. C. U.. Dead front missing on A. C. C. U. disconnect. Label panel , fix door and install arc fault breakers. Repair liquid tight Conduit. 9 feb. 2015 Repair exposed conductors in area that was in accessible . Remove all cluter to provide access to all areas. 22 apr. 2015 Receptacles hot and neutral reversed, g f i missing, not working, not tamper proof or installed. Arc fault breakers missing. Water heater disconnect missing. 12 may 2012 Clothes washer and refrig. need 20 amp rec.. 2 rec. wired hot and neutral reversed. Repair panel cover to stay open. May 21, 2015 For Inspections please call: (305)762-4949 Page 14 of 36 Arc fault breakers missing. Garage door rec. to be G. F. I. protected. Range and dryer rec. to be 4 wire. Terrace rec. missing. 15 may 2015 Repair panel cover to stay open. Arc fault breakers missing. Range and dryer receptacles to have 4 wires. May 21, 2015 For Inspections please call: (305)762-4949 Page 15 of 36 • 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 RECEIVED - DEL 0 2 2013 BY: FBC 20 BUILDING Permit No. E/ /3 PERMIT APPLICATION Master Permit No. 86 4 Permit Type: Electrical JOB ADDRESS: 0 N e (0?- S+ City: Miami Shores County: Miami Dade Zip: 3 3 1.3 8 Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Siimple Titleholder): �(t� CQ( C �uneL Phone#: flS �Q 0 t 9' 3 D Address: L �U r O ?'" W City: 1 "Q..VV\ t V.c,C'e S State: -F/ zip: 'T) 1X F Tenant/Lessee Name: Phone#: Email: �' i CONTRACTOR: Company Name: C-- 0,--S�'O (ez 1C Phone#: G - �i5'J( Se- () Addresss �'?--c5 f9 a(�c �F City: / -Gua, RleJ44,-t-1( / State: r� zip: 3 _�S .( Qualifier Name: c/)1'{7 !if /,,.a A: � Phone#: State Certification or Registration #: 6/Z/3O / 30 /3 Certificate of Competency #: 0 -C -6000 2-`i'' Contact Phone#: Email Address: f -c.. 5g.' . wci/s'Gu a+-1- DESIGNER: Architect/Engineer: / Phone#: Value of Work for this Permit: $ So '2-2- Square/Linear Footage of Work: Type of Work: ❑Address .Alteration ONew ORepair/Rep ace ODemolition Description of Work: `•� ' COY . . = A �3 situ �l t _ • t ; S **********************e****************gees************••••*•******•••*•••••••*•••••*••• Submittal Fee $ 570 •() v Permit Fee $ /'J '.' d CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Naine' (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 standardsof all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for FT.FCTRICAL 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 inspec'on which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will r be , p i roved and a reinspection fee will be charged. Signature Signature �� Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this -245 day of 60304.1 , 2013, by t--%QY t iAihnet, , day of NOV , 20 i J , by 61-EV1WCA" WO 1V -DS who is personally known to me or who has produced , f YI (l� who is - personally f�kknown to me or who hasproduced d4U 2-1 p 3- f I®U-� As ide cation ni1 whn did take an oath. 1 (CO l' () as e on pc�a�UEz •oi BARBARA Cr14. "'2!GUEZ , • `�� NOTARY PUBLIC: «, NOTARY P r="� MY COMMISSION EE053785 MY COMMISSION # ' 5 '• q �� .p�7 '3785 EyCPIRES January 09, 2015 i ';Aa,-'''''' ' EXPIRES Jant:�:r t '015 r� ("117:53) FloridallotaryService com (407) 398.0163 FbndallotarySery , • ;1 Sign: Print: erA Vl pc4- MyCommission Expires: l 1 1 Z0 \j ************* APPROVED B My Commission Expires: ray' 1 /013 **** •.********ik***+k**#******Kr*************** ►*******trY+Ir********* **** Y**rY****** /7/ Plans Examiner Zoning Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk To: Po 9e 2 of 2 2019-11-29 18:19:19 (1:3M1-) 17277911412 From: Mott LBP1,9nte Fax: (305)756-8972 ACORU® CERTIFICATE OF LIABILITY INSURANCE 4..,,,..- - DATE DDIYYYY) 1112612013 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 POUCIES 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 certlicate holder is an ADDITIONAL INSURED, the policy(ies) 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 corder rights to the certificate holder in lieu of such endorsement(s). PRODUCER LaPlante Agency 2715 State Rd 580 Clearwater, FL 33761 License # A149680 CONTTCT -. NAME: Peggy Gray PHONE FAX A1C Ne Ft,* (727)796-8566 (Arc. Not: (727)791-1412 1 DREss: Peggy@Iaplanteagency.eom INSURER(S)AFFORDING COVERAGE Nac: INSURER A: North Pointe Insurance Company L.FABILITY COMMERCIAL GENERAL LIABILITY INSURED Cassia Electrical Contractors Inc 8261 NW 48th St and Glen Walker Lauderhill, FL 33351 INSURER B: Florida Citrus, Business & Industries Fund 3094110169 INSURER C 07/29/2014 INSURER Dt $ 1,000,000 INSURER E: $ 100,000 $ 5,000 INSURER F : CLAIMS -MADE X COVERAGES CERTIFICATE NUMBER: 00000697-1341728 REVISION NUMBER: 172 THIS IS TO CERTIFY THAT THE POUCIES 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 LTR TYPE OF INSURANCE ADDLSUER INER IS/VD POLICY NUMBER POLICY EFF IMWDDIYTYY) POLICY EXP (MMrVDDIYYYY) LIMITS A GENERAL X L.FABILITY COMMERCIAL GENERAL LIABILITY 3094110169 07/29/2013 07/29/2014 EACH OCCURRENCE $ 1,000,000 AMAGE TO PREMSES (EaENTED occurrence) $ 100,000 $ 5,000 CLAIMS -MADE X OCCUR MED EXP (My one person) PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE UMITAPPUESPER: TO POLICY n JER&T n LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE — LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS ^ _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB — OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTIONS $ Ft WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEYlN OFFICERAIEMBER EXCLUDED? (Mandatory In NH) H yes, describe under DESCRIPTION OF OPERATIONS below if N 1 A 10650%9$ 10/26/2013 10/26/2014 X TORY LI LTM S ERR E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE$ 1,000,000 Et_ DISEASE- POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED B ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPRES., ATIVE / /i �7/% /%; 77,1 G) ACORD 25 (2010/05) 6) 1988-2010 ACORD CORPORATION. AO rights reserved. The ACORD name and logo are registered marks of ACORD Printed by PCG on November 26, 2013 at 01:12PM Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 05E000248 CASSIA ELECTRICAL CONTRACTORS INC D.B.A.: WALKER GLENWORTH Is certified under the ' ' ns of Chapter 10 of Mkotti-Dude Municipal Contractor's Tax Receipt Miami -Dade County, State of Florida -TtfSIS NOT A BILL -DO NOT PAY CC NO; 05E000248 BUSINESS NAM61L0CATION CASSIA ELECTRICAL CONTRACTORS INC DOING BUS IN DADE OD MIAMI, FL 33000 RECEIPT NO NEW BUSINESS 7438115 OWNER TYPE OF ROSINESS CASSIA ELKCR!CAL CON1RACTORS ELECTRICAL CONTRACTOR INC MC EXPIRES SEPTEMBER 30, 2014 Must be displayed at place of business Pursuam to County Coda Chapter SA - Art. 9 l i 10 Cyr men intotetelts. the www.miewheoto wow Local Business Tax Receipt Miami -Dade County, State of Florida -nits IS NOTA BIL, - DO NOT PAY 80930 U$IN$S$ NAME/LOCATION SIA ELECTRICAL CONTRACTORS C OING BUS IN DADE CO IAMI, FL 33000 IossNER IA ELECTRICAL CONTRACTORS INC rker(s) N.'y: RECEIPT NO. RENEWAL 5925293 P AYMENT RECEIVED EY TAX COLLECTOR 200.00 10/09/2015 0223-14-000128 est BT SE Mu SEC. TYPE OF BUSINESS 196 ELECTRICAL CONTRACT 3 05E000248 Thi: Local Business Tax Receipt only confirms payment of the Local Res permit. ore cenification of the holder's qual(Acstiaas, to do buslaasa. Haider or nongovernmental regulatory laws and requirements which apply to the b The RECEIPT NO. above must be displayed on ail common's! vehicles - For mors information, visit EXPIRES TEMBER 30, 2014 be displayed at piece of business Pursuant to County Code Chapter 8A - Art. 9 & 10 PAYMENT RECEIVED EY TAX COLLttCEOR 75.00 09/26/2013 0229-13-001455 Tax. The Receipt is not a license. ant Comply with any governmental PPM rami-Dede Coda Sac oe-rib. Home Product Control I Contractors ( Building Officials I Contact us Contractor License Information Contractor Number: 05E000248 Contractor name: CASSIA ELECTRICAL CONTRACTORS INC Address: 8261 NW 48 ST. City, St, Zip: LAUDERHILL Phone: (954) 741-1374 Other Phone: Fax: Email: D/B/A: Contractor Status: Class ELEC Category 1 ACTIVE Category Description ELECTRICAL CONTRACTOR INQUIRY COMPLETE FL 33351 Expiration Date 09/30/2015 Contractor Inquiry and Complaint Search 1 Home Page 1 State License Search Menu Home 1 Using Our Site 1 About 1 Phone Directory 1 Privacy 1 Disclaimer E-mail your comments or questions to BLDGDept©miamidade.pov © 2001 Miami -Dade County. All rights reserved.