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EL-9-15-2304, 9999 NE 13th AveInspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246817 Permit Number: EL-9-15-2304 Scheduled Inspection Date: October 29, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: PAPPAS, MICHELLE CHERIE Work Classification: Alteration Job Address: 9999 NE 13 Avenue Miami Shores, FL 33138- Phone Number Parcel Number 1132050090460 Project: <NONE> Contractor: XTREME POWER ELECTRICAL INC Phone: (786)255-1182 Building Department Comments WIRE 2 BOAT LIFTS FROM EXISTING POWER AT Infractio Passed Comments DUCK. I INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. October 28, 2015 For Inspections please call: (305)762-4949 Page 28 of 33 `5414Rft m Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Applicant 9999 NE 13 Avenue 1132050090460 Miami Shores, FL 33138- Block: Lot: MICHELLE CHERIE PAPPAS Owner MICHELLE CHERIE PAPPAS 9999 NE 13 Avenue MIAMI SHORES FL 33138- 9999 NE 13 Avenue MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone XTREME POWER ELECTRICAL INC (786)255-1182 /pe of Work: WIRE 2 BOAT LIFTS FROM EXISTING POW dditional Info: lassification: Residential canning: 1 Fees Due Amount CCF $0.60 DBPR Fee $2.25 DCA Fee $2.25 Education Surcharge $0.20 Permit Fee - Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $159.10 Cell (305)807-2987 Valuation: $ 1,000.00 Total Sq Feet: 0 Pav Date Pav Tvoe Amt Paid Amt Due Invoice # EL-9-15-57036 09/16/2015 Credit Card 09/10/2015 Check #: 1239 $ 109.10 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Review Electrical L) 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 th II t on is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futh ore o ze the above-nam d contractor to do the work stated. September 16, 2015 Authorized Sign5tUre-t5VV—ner / v Applicant / Contractor / Agent Building Department Copy September 16, 2015 1 '6711 o0s Miami Shores Village BuildingDepartment p SEP hO 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 t INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 2010 BUILDING Master Permit No. 1 • " �Z--o PERMIT APPLI ATION Sub Permit No. � is =, 236�I ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL (PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR JOB ADDRESS: - l -1 ! i ( j •t - e - City: Miami Shores County: Miami Dade Zip: DRAWINGS Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Tenant/Lessee Name: Load Construction Type: Flood Zone: BFE: FFE: Email: CONTRACTOR: Company Name: r�� e� I'ec-�'rl CAL Pho a#: (.5 nO5-'+0110 Address: cd I N w 5q CZ City: ---`tom` Qualifier Name: r-e �L. Zip:33 (D-(a State Certification or Registration M Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ i'7 0 0 D . Square/linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: -- `A ); h2P Z ) l 14�4 5 -f t—Orr-) Specify color of color thru tile: Submittal Fee $,� �� Permit Fee $ %3�®� my CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ DBPR $ Notary $ Double Fee $ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) _ Bonding Company's Address City State Mortgage Lender's Name (if applicable), Mortgage Lender's Address City State Zip 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 on estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien low 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 per it ' issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature. OWNER or AGENT The foregoing instrument was acknowledged before me this day of me or who has produced 20 , by who is personally known to identification and who did take an oath. NOTARY PUBLIC: Sign: Print: as l'1 CONTRACTOR The foregoing ument was —acknowledged before me this ^� cielndayo'12..201-f5 by h(�aCi✓1LI? w ��+ ✓�Z , w rsona y_ keno me or who has produced as identification and who did take an oath. NO4PUSig PriG'Q. q r(�-Ict Seal: Seal: BIANCAGARCIA NOTARY PUSUC STATE OF FLORIDA Comm# FF194461 s+es*r**s**ssssssss*sss*s.r*sss*s*s*•s*s.s**.*ssssssss*�s***�e**•#s**�s� ��+��'ss*s*****ss.**� APPROVED BY �%L ��/�'� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY OE000547 XTREME POWER ELECTRICAL INC D.B.A SUA ER ZIHOSVANY Is certified under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRACTING UNTIL09/30/2015 Local Busi ness Tax. Fecei pt Miami -Dade County, State of Florida THIS IS NOT A BILL - DO NOT PAY 6721907 BUSINESS NAM E/LO.CATION RECEIPT NO. XTREME POWER ELECTRICAL RENEWAL INC 6995253 611 NW 59 CT MIAMI, FL 33126 EXPIRES SEPTEMBER 30, 2015 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE Of BUSINESS PAYMENT RECEIVED XTREME POWER ELECTRICAL INC 196 ELECTRICAL BY TAX COLLECTOR CONTRACTOR 49.50 10/07/2014 Worker(s) 1 10E000547 0225-15-000069 ThisLocal BusinessTaxRsceiptonlycon^rmspaymantdthe Local &uinessTm.The Pieceiptisnot alicense. perrrit, or a anti "cation tithe holder's quali ^cations, to do busi ness. Holder mast comply with arty gm ernmerItal or nongouerrimerdal regulatory lags and regliremertswhich apply tothe business, The FEMPrNOabovemistbedisplayedonallco nercfalvehicles-Miarri-Dade Code SecBa--27& MIAM � Wrmoreirtonrai*visitwww.rriaTidadegavUgOledor 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER 1 The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 CO Expiration date: AUG 31, 2016 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) _ ■ SUAREZ, IHOSVANY I XTREME POWER ELECTRICAL INC. 611 NW 59 CT MIAMI FL 33126 0 ISSUED: 08/28/2014 DISPLAYAS REQUIRED BY LAW SEQ# L1408280003492 1 i ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE 09 02/2015 ) 09/02/2015 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()es) 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 A&A Underwriters, Inc. CON T NAME PABLO M CONDE 305-220-7447 FAIL No: 305-220-4821 E-MAILPHONE me aaunderwriters.com ADDRESS: pmc@aaunderwriters.com ADDRESS: 8778 SW 8 St INSURE S AFFORDING COVERAGE NAIC # F133174 INSURERA: GRANADA INSURANCE COMPANY 000334 INSURED INSURERS: BUSINESSFIRST INSURANCE COMPANY 012629 Xtreme Power Electrical INSURER C : INSURER D : 611 NW 59 CT Miami Fl 33126 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 LTR TYPE OF INSURANCE A POLICY NUMBER POLICY EFF MM/DD PEXP MMIDDOLICY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A -M CLAIMSADE a OCCUR 0185FL00040143-2 10-19-14 10-19-15 DAMAGE TO RENTEU-- PREMISES Ea occurrence $ 100,000 MED EXP (Any one on) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ JECT 0LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS No"VJNEO AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN FMEMBER EXCLUDED? a (Mandatory in NH) NIA 521-10985 01-10-15 01-10-16 STR �( LITEATUE.L.EACHACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE — $ 1,000,000 E.L. DISEASE -POLICY LIMB $ 1,000,000 ff yes, describe under DESCRIPTION O OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is r"ulmd) Contractor's License Number: 10E000547 CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2nd Ave SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2013 ACORD CORPORATION. All rights reserved. ACORD 25 (2013/04) The ACORD name and logo are registered marks of ACORD