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EL-16-2502 (4)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 OP-n 1C Im Inspection Number: INSP-267017 Permit Number: EL-9-16-2502 Scheduled Inspection Date: November 29, 2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: Work Classification: Temp for Construction Job Address: 1201 NE 96 Street Miami Shores, FL 33138-2553 Project: <NONE> Contractor: FOSTER & SON ELECTRICAL CONTRACTORS, INC. building uepartment Comments TEMP FOR CONSTRUCTION Passed Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Phone Number Parcel Number 1132060143830 Phone: (305)644-5869 inrractio Passed Comments INSPECTOR COMMENTS False Inspector Comments l rG A0 November 28, 2016 For Inspections please call: (305)762-4949 Page 16 of 54 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 BUILDING PERMIT APPLIC TION ❑BUILDING LECTRIC ❑ ROOFING Jm� s w o� ta9� BY: _.. FBC 20 (14 L:;, Master Permit No.�--'b 1UU"1 Sub Permit NoIG_ 2 ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF [—]CANCELLATION ❑ SHOP p ` CONTRACTOR DRAWINGS i JOB ADDRESS: _- 120) N' �' 16 �4�/1�' City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: /�+C,,onstru1ction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): A�yAhc�t;n, 611f �C�,Ar Phone#: Address: City: State: `1017-jc' " Zip: Tenant/Lessee Name: Phone#: �- c�,O 16611 Email: CONTRACTOR: Company Name: Vory2 q"j Scan OMI)r,y� l0141`0ri jt,( Phone#: 3gb•4t3 �90c r Address: Z4� � W. Ij f �,� City: IV 1� At/I: _� �` State: 1'rr�U ij& Zip: 39)zT Qualifier Name: W16C L, T�W +*N Phone#: 209'. -1113' SPI t State Certification or Registration #: DESIGNER: Architect/Engineer: Add CACI P1000Z Certificate of Competency #: one#: City: State: Zip: 00 Value of Work for this Permit: $ .1614 are/linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace Description of Work: )Q r ❑ Demolition Specify color of colo"r thru tile.:._ Submittal Fee $ Permit Fee $ l CCF $ btu �..� :. CO/CC $ 0 Scanning Fee $ Radon Fee $ (9. DBPR $ Notary $ Technology Fee $ Training/Education Fee $ _h 2� Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) a,, 11 s'; 3 Bonding Company's Address City State 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 reinspectiomfee will be charged. Signature r NER or AGENT The foregoing instrument wasacknowledged before me this n� day of 5*,Q1fVY1 61f /' , 20 1 CO by 0'ay( ley &(i4(6,v- if , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:'✓`'wu LLi Print: /Pl SC!//A �?rl'hv— Seal: ""' - PRtSCILLA BRITO-CUMf ,�Y P`A Notary Public - State el Flodit • Commission # FF 91/209 My Comm. Expires Nov 30, 2019 *********�t9.9faias�k**BAnlledthr+eAgh#Iati611af1�A�11. APPROVED BY as 1i, �(t rSignature 01vL T, CONTR CTOR The foregoing instrument was acknowledged before me this day of 20 J L , by CifL - -Po,-who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Si Print: t Seal: NOTARY PUBLIC STATE OF FLORIDA • Comm# FF241965 • Expires 6/18/2019 ****************************************************************** Plans.Examiner Zoning (Revised02/24/2014) Structural Review Clerk' 20160831_204039.jpg 9/1/16, 7:17 PM tea. CT�QConstructi 3USlNESS COMPETENCY 99EO00259 FOSTER & SON ELECTRICAL CONTRACTORS INC C.B.A.. L« FOTER JORGE L I- -e►tified under the provisions of Chapter 10 of Mia, IFICATE OF COMPETENCY JORGE FOSTER Mir Eiactrician FOSTER Al!,D ELECTRICAL CONTRACTIOR INC amww"CItU't-CME-1979-R EXPIRES 08/31/2018 about blank Page 1 of 1 20160831_204134.jpg 9/l/16, 7:16 PM STATE OF FLt7RIVA ' DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Y, ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 0781 FOSTER, JORGE L FOSTER 8 SON ELECTRICAL CONTRACTORS INC '498 NW 3RD STREET MIAMI FL 33125 ^fth this license you become one of the nearly licensed by the Department of Business and Our professionals and businesses range brokers from boxers to barbeque ,,s an_ _ :ey . aep Florida s economy strong i6. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ry day we work to improve the way we do business in order ER0015146 ISSUED: 08/11/2016 erve you better For information about our services please ,into www-myfioridalicense.com. There you can find more REG ELECTRICAL CONTRACTOR ,oration about our divisions and the regulations that impact FOSTER, JORGE L subscribe to department newsletters and learn more about FOSTER & SON ELECTRICAL CONTRACTOR department's initiatives (INDIVIDUAL MUST MEET ALL LOCAL ^,,ssion at the Department is License Efficiently, Regulate LICENSING REQUIREMENTS PRIOR �',(e r,onstantiy strive to serve you better so that you can TO CONTRACTING IN ANY AREA) ,. Ou s[omers yThank you for doing business in Florida, HAS REGISTEREC under the prov,rcns of Cn 489 FS i+_ 2� \t608t90C727a cnQrgratulabons on your new license! E.oaazun �auG DETACH HERE RICK SCOTT GOVERNOR KEN LAWSON. SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD x �_ ER�55?45 t he ELECTRICAL CONTRACTOR Named below HAS REGISTERED.~ Under the provisions of Chapter 489 FS • �� Expiration date AUG 31 2018 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REOUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) r0$TER JORGE L �0 FOSTER 8 SON ELEC IRICAL CON TRACTORS INC 2498 NW 3RD STREET MIAMI FL 33125 ' 0 about:blank Page 1 of 1 20160831_203830.jpg 9/1/16, 7:15 PM 2496 1~3 Sr Punwent to County Cafe MAW FL 33125 Sec 10-24 11!1 — PA Y4f EMT REGEIVED O VVNlH ii11.INr:1N /;1 MItlW.il lit RY IA% COLI.FCTOR p0MR!t,X)N141l (1MV112:MR 2WOq) 0811112016 (YO.lriia t ►11:111Z f�*!i1HN1 0213-19-Qp1422 IM• rwvll� r^ !�� vend In RI" I!+1!!wlnp M."!/r�ll!�Ileee A.yr"!hlw, Wr, tideef�, Ka FT+erwl.+w. MrwmS (i"•M!!* M/wll'f 1/1!e", 1'Nne!IM flnY 111y,pteet. !L.nN INM rf..l:ft, Townd r]Me. tiey. . M� rtn nitre 1111/M"Im", NNI WW W ITf RIttAOde.l te:'itC[ ID L-pcai Busi Tax Fbcei pt Miami_Dade u y, State of Florida THIS IS T A L - DO NOT PAY 4149977 B USiNESS NAM E/LOCATION RECEIPT NO. FOSTER & SON ELECTRICAL RENEWAL CONTRACTORS INC 4333787 2498 NW 3 ST MIAMI, FL 33125 BT i EXPIRES SEPTEMBER 30, 2017 Must be displayed at puce of business Pursuant to County Code Chapter 8A - Art. 9 & 10 A N'ER SEC. TYPE OF BUSINESS PAYM ENT RECEIVED FOSTER &SON ELEC CONTRS INC 196 ELECTRICAL BY TAX COLLECTOR C/O JORGE L FOSTER, PRESIDENT CONTRACTOR 45.00 08/11/2016 Worker(s) 1 99EO00259 0233-16-001422 This Local Business Tax Pempt only con"rms payment of the Local B siness Tax The %ceipt is not a iic ease, permit, or a certi"cation of the holder's quali "cations, to do txsiness. m der must cort>pty w ith any gwernmental ornoromermentai regulatory laws and reglirenlentswhich apply tothe business, The FEMP rW above n st be displayed on all convnerdal vehides - Miami -Dade Qade Sec 8a-2T6. 0MIANFbrmoreinformation, visit wwWIldarrlidade itrxlllecflor about:blank Page 1 of 1 20160831_203942.jpg 9/1/16, 7:17 PM ;lam M uni ci p, 31 C mtractor's Tax FLacei pt ► Miami - Dace County, State of Florida -THIS S NOT A BILL - DC NOT PAY CC NO: 99e:)002bw Q S` BUSINESS NAM E/LOCATION RECEIPT NO EXPI S FOM & 9CN H.E('TRICAL SEPTEMBER 017 CONTP CTORS INC 7488577 2498 NW 3 ST Pursuant to County Code MIAMI. FL 33125 Sec 10-24 OWNER TYPE OF BUSINESS PAYMENT RECEIVED FC61ER&9DN ELF:r,CONTRSINC flBaTRIC&ODNTRPCTOR BY TAX COLLECTOR C/ 0.1oRGE L FOSTER PFESIDENT 200.00 08/11/2016 0233-16-001422 This receipt is not Valid in the following Muricipdities:Aventura, �h� own of �� Miarti owdens. Miami Lakes. Pwr tto Bay. Rnecrest. Sunny isles nu►nt� For n ore irforrrobon, "t Www rnanidade. ascdled LocalBus s Tax %ceipt Miami -Dade u y, State of Florida THIS IS N TA L - DO NOT PAY 1149977 LISINESS NAM E/LOCA TION 'OSTER & SON ELECTRICAL :ONTRACTORSINC RECEIPT NO RENEWAL 4333787 EXPIRES SEPTEMBER 30, 2017 about:blank Page 1 of 1 ACORbr CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/08/2016 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(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 confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTNAME: Ana Camafreita Jenca Insurance Consulting Corp. PHONE (786) 227-6935 ac No): (786) 250 5465 E-M12150 ADDRIESS: info@jencainsurance.com SW 128 Court Ste. 132 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Colony Insurance Company Miami FL 33186 INSURED INSURER B: Associated Industries Insurance Company INSURER C : Progressive Express Ins Company Foster & Son Electrical Contractor, Inc. INSURER D : I INSURER E: 2498 NW 3rd Street _ 1 INSURERF: Miami FL 33125 COVERAGES CERTIFICATE NUMBER: RFVISION Nt1MRFR- 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM DD POLICY EXP MM DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F;;-v;l OCCUR Y CPS2548121 8-25-2016 8-25-2017 EACH OCCURRENCE $ 1,000,000 DAMAGE T RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER- POLICY ECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS HIRED AUTOS X NON -OWNED AUTOS 03785578-0 05/29/2016 05/29/2017 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A AWC1046487 5/1/2016 5/1/2017 X STATUTE X EORH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Electrical Contractors CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores Village FL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 33138 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD