EL-18-286 I
Inspection Worksheet
+ Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL d
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-296712 Permit Number: EL-2-18-286
Scheduled Inspection Date: February 21, 2018 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: SAUNDERS, MARCIA Work Class ification:Repair
Job Address:520 NE 93 Street
Miami Shores, FL Phone Number
Parcel Number 1132060141080
Project: <NONE>
Contractor: LANGER ELECTRIC COMPANY Phone: (786)251-8585
Building Department Comments
REPAIR PANEL Infractio Passed Comments
INSPECTOR COMMENTS False
TO REPLACE EL14-1651
Inspector Comments
Passed
Failed
f7 /B
Correction ❑
Needed d
d
Re-Inspection ❑
Fee
r
No Additional Inspections can be scheduled until
re-inspection fee is paid.
r
February 20,2018 For Inspections please call: (305)762-4949 Page a 21 of 44
Pe mit No. EL-2-18-286
�sH°mss L,� Miami Shores Village Et PermitIType.-Electrical-Residential
10050 N.E.2nd Avenue NE ��
� WarkClassticatian:Repair
Miami Shores,FL 33138-0000 Pennit Stat&ls:APPROVED
p—mss Phone: (305)795-2204
FLORIDA
issue Date:2/8/2018 FTp7ation: 08/07/2018
Project Address Parcel Number Applicant
520 NE 93 Street 1132060141080
Miami Shores, FL Block: Lot: MARCIA SAUNDERS
f
Owner Information Address Phone 1 Cell
MARCIA SAUNDERS 520 NE 93 ST
MIAMI SHORES FL 33138-2844
Contractor(s) Phone Cell Phone Valuation: $ 1,045.00
LANGER ELECTRIC COMPANY (786)251-8585 (305)759-5777
�_ �..._e _.�. m...... Total Scl Feet: 01
Type of Work:REPAIR PANEL Available Inspections:
Additional Info: Inspection'Type:
Classification:Residential Final
Scanning:3 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# EL-2-18-66343
DBPR Fee $3.38
DCA Fee $2.00 02/05/2018 Check#:8079 $50.00 $117.58
Education Surcharge $0.40 02/08/2018 Check#:8081 $ 117.58 $0.00
Permit Feb Additions/Alterations $150.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $167.58
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 t II t f6regoing information is accurate and that all work will be done in compliance with all'applicable laws regulating
construction and zoning. au ize a above-named contractor to do the work stated.
February 08, 2018
Authorized Signatu .Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 08,2018 1
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SCSI—Z3�1 — SSS �o
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RECEIVED
LJD- FEB 0 5 2018
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 200.1
BUILDING Master Permit No. C-- L _-7— 'Ll - I(vS
PERMIT APPLICATION Sub Permit No. 11A - 29(p
BUILDING FE�ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ;RENEWAL
PLUMBING E] MECHANICAL MPUBLICWORKS M CHANGE OF CANCELLATION M SHOP
CONTRACTOR DRAWINGS
P
JOB ADDRESS: 520 NE 93RD STREET j
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#:1132060141080 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE
OWNER:Name(Fee Simple Titleholder):MARCIA SAUNDERS Phone#:305-495-19091
Address:520 NE 93RS STREET
City: MIAMI SHORES State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email: MARICATLC@BELLSOUTH.NET
Y
CONTRACTOR:Company Name: LANGER ELECTRIC Phone#: 954-984-8489
Address: 6500 NW 21ST AVENUE SUITE 1
City: FORT LAUDERDALE State: FL Zip: 33309
Qualifier Name: Phone#:
ROGER LANGER 954-984-8489
State Certification or Registration#: EC#0000099 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$1'69@'99 Square/Linear Footage of Work:
Type of Work: LJ Addition ❑ Alteration EI.New 0 Repair/Replace ❑ Demolition
Description of Work: PANEL CHANGE f` l 10� 2 6A A
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$ i
Scanning Fee$ Radon Fee$ 7 DBPR$_3, 39 -Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
t -
Bonding Company's Name(if applicable)'.
Boriding Company s Address'
city .. State Zip
Mortgage Lender's Narrie;(if applicable)
j 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 installationhas
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 rriust be secured,for ELECTRIC,'PLUMBING, SIGNS, POOLS,
FURNACES'BOILERS;HEATERS,TANKS,AIR CONDITIONERS,ETC.....
.-
# OWNER'S A&IDAgVIT Igcertify that all the foregoing information is accurate and that'all work will be done in compliance with all
- applicable,iaws`re ulatin construction and zanin'.
R:, YOUk"F v .r 4
I `WARNING TO OWNER:, ALLURE fTO_=RECORD A,NOTICEOF -COMMENCEMENT MAY
,-
RESULT IN'YOUR PAYING TWICE FOR fIVIPROVEMENTS TO:YOUR PROPER INTEND
TO.OBTAIN FINANCING,CONSULT WITH YOUR LENDER:OR,AN ATTORNEY B 4ORE RECORDING"
Y' O(i NO'TICE OF COMMENCEMENT:"
Notice to Applicont:`As a condition to the issuance of a building permit with on estimotedv$lue exceeding$2S00_the applicant must '
promise in good faith chat o copy of the.notice of commencement and construction Gen low broch-ure will be delivered to the person_:
whose property is subject to attachment's Also a'certified'topy of the recorded notice of commencement must be posted at the fob site,'
for thefirst inspection;which_occurs'seven (7).days"offer the building.permit is:issued,^the btisence of such posted`notice, the
inspection will'not be approved dntl;o reinspecfi'on fee will be.chorged
'Sigriatur Signature
OWNER or AGENT CON CTOR
.. The foregoing instrument was°acknbwledged before me this The foregoing instrument was acknowledged before'mexhis
311 . day of JANUARY'. _... 201$ , by 31. day of JANUARY, .2018", by
MARCIA SAUNDERS`-< . who is personally known to ROGER LANGER who i` ersona ly kno to
me$r who h' ' du 1. r -as me or who has p r as,.
MpgLWO
t
identification an idU aq1"` ems, idio
entification a
NOTARY PLIBLi QifCS Iv13ipll 1,, NOTARY PUBLI W*res:AWO �, f
- . rv;i�OntNAI� �I�ilpcllllr
Sign:. . Sign:
Print: - 4 A 4
'Seal: Seat
APPROVED BY",-]���7� Plans Examiner w_ Zoning.
Structural Review Clerk
(.+ {Revised02/24/2014)
• �"'1 LANCE-2 OP ID:NR
CERTIFICATE OF LIABILITY INSURANCE
DATE 0712912014 712 912 0 1 4 )
07/29120'[4
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 terina and conditions of the policy,certain policies may require an endorsomant. A statement on this certificate does not confor rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER CONTACT
NAME; _
Brown&Brown of Florida,Ina rHaut
1209 WCyp cess Creek Rd#130 (A o Ext); (Arc,No)__„_
P.O.Box$727 �•�i,,�
FL Lauderdale,FL 33310.5727
Andrew Noye,CIC,CRIS INSURERS)AFFORDING COVERAGE NAIC a
__..,.,•_,______� _..__.._•••INsuRER A:FCCI Commercial Ins Co+ 33472
INSURED Langer Electric Company INSURER e:RFFVA Mutual Insurance Co.+ 10366
Langer Electric Service Co INSURER C:
_6600 NW 21st Ave,Suite#1 -
Fort Lauderdale,FL 33309 INSURER b: M_
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, 'NOTNIVITHSTANDING 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 13 SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSLTR ADUL WON TYPE OF INSURANCE POLICY NUMBER M1DODF—ffal LIMITS
GENERAL UABIL17Y r
EACH OCCURRENCE S 1,000,00
A X COMMERCIAL GENL•RAL LIABILITY GL0016519 0311012014 03/10/2016 L'REINLQES LFa ocnxmrtcol € 100,000
-- CLAIMS-MADE �OCCUR MtDSXPS 5,000
PERSONAL&ADV INJURY I $ 1,000,000
V
' ORNHRALAGGREGATE S- 2,000,00
OEN'L AGOREGATE UMIT APPLIES PER: PRODUCTS-COMP/CP AGO 8 2,000,00
POLICY .X P Loc Emp Ben. s 1,000,000
AUTOMOBILE LIABILITY ONIEWNEED SINGL6 LIMIT
_A accldeht) 1,D00,00
A X ANY AUTO CA0028498 03/10/2014 03/10/2015 BODILY INJURY(Por Fnrnon) a_
ALL OAUTOS
AUTOSS AUTOS 'n BODILY INJURY(Per.aodagnt)
X HIRED AUTOS X` pip QED DAMAGE S
ER ACGDENT)_�
X UM6RELLA LIAOX OCCUR EACH OCCURRENCE__ S 5,000,00
A EXCER€UAB CLAIMS-MADE UM130018524 03/10/2014 03/10/2015 AGGREGATE, € 5,000,0
OED X T RF:TFN'nnm€ 0 Is �.�..
WORKERS COMPENSATION X WCSTATU. OTH-
AND EMPLOYERS'LIABILITY ARYJ iMIISrp
B ANY PROPRIETOR/PARTNER/EXECUTNE Y/N WC8400030013 01/01!2014 01/01/2015 ICL EACH ACCIDENT s 800,00
OFFICERIMEMSER EKCLUMt)? N/A
(Mandatory ab r In Under
E.L.DISEASE-EA EMPLOYEE $ 500,1)0(
Ityyea,tleerrlbe under �
E8 IPTION OF OPERATIONS bo ow L•.L DISEASE-POLICY LIMITV.$
-, 500,00
A Equipment Floater CM0008069 03/10/2014 03/10/2015 Leased&
Rented 100,00
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Adtlltienal Remarka Schedule,Ir mom PIP,ce la required)
Li,censo # EC0000099
CERTIFICATE HOLDER CANCELLATION
MIAMIA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miami Shores Building&Zoning THE EXPIRATION bATE THEREOF, NOTICE WILL BE DELIVERED IN
10060 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores,FL 33128 AUT11ORIZED REPRFSENTATIvr;
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