EL-11-320Inspection Number: INSP - 157291 Permit Number: EL -2 -11 -320
Scheduled Inspection Date: May 04, 2011
Inspector: Devaney, Michael
Owner: NEDVED, RONALD
Job Address: 9530 NW 1 Avenue
Project: <NONE>
Miami Shores, FL
Contractor: SKY ELECTRIC, INC.
Building Department Comments
May 03, 2011
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1131010240250
Phone: 305 - 542 -0060
CHANGE PANEL 150 AMP INTERIOR PANEL, CHANGE
SUB -FEED WIRE TO EXISITNG METER CAN.
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 157134. Service need's to be 10'
above finished grade.Add smoke /carbon monoxide detectors. Up date
grounding electrode system.
Page 5 of 21
M ' - 3/9/11 Miami Shores Village
6P ui • -33 r paRFV311
Building Department i FEB 2 5 20
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 BY. ••• ••, •
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) a 4 A L,) t Aft 411 V4) Phone #
‘3 ,J LJ IS
Owner's Address
City r114 n1 f J,Fo IC 60 State
Tenant/Lessee Name 5°A 'Jo tf
Email K-od 4 *4 /41 elAreP
Job Address (where the work is being done)
City Miami Shores Villa le County Miami -Dade
FOLIO / PARCEL #
Is Building Historically Designated YES NO
-rim=
Contractor's Company Name Sik y
l
Contractors Address
Ciry(
Qualifier Name / p Gv
State Certificate or Registration No.
Contact Phone JO j - .Pa - ea G O
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $
Type of Work: ❑Addition ❑Alteration
Describe Work: 44.o, ?AAA/ /,Z ate,,
� j / Glzt hti .t>e A,' At (.7,1 n c-44
e
/1-"ste -1 W (7�,— .14u4r� "s –
Submittal Fee $
// -.3>61 - 0 24 0I
4,0 S-e f
State /(
rx
/7J .c)
9 0 4Jti /s-r k if
Permit Fee $ /e
Zip 0v
Phone #
Permit No.
Master Permit No.
3 0 S -- � - Yt9
Zip 9j /S
Flood Zone
Phone #
Zip 33( y
Phone # .S S'yz -O O' 66
Certificate of Competency No. �C /.So z 7 b .
E -mail / fc .0 _ Z r t.. a c� ,v , co„,,,
Phone #
-a1.-2
Square / Linear Footage Of Work:
❑New ( Repair/Replace ❑ Demolition
lot `€4 "'t . //201 / C,�a -6, Sv 6 - .4-ec,,/
f . i clL--
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* , * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Notary $ Training /Education Fee $
Scanning $ Radon $ DPBR $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $
CCF $ CO /CC $
Technology Fee $
Bond $
//O f°
See Reverse side -4
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 ELECTRICAL 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 inspection which occurs seven (7) days afier the building permit is issued.- In the absence -of such posted notice, the
inspection will not be approved and a re- inspection fee will be charged.
Signature
The foregoing instrument was acknowledged before me this
day of /�_ r <20 , by i // 4EPVV
who is personally own to me or who has produced 42. r c i24w
i r As identification and who did take an oath.
Sign:
Print:
NOTARY PUBLIC:
APPROVED BY
(04)13- £ vadt )
My Commission Expires:
(Revised 07 /10, /07)(Revised 06/10/2009)
,214f /9'
z'S 8Ce
0NA E. ATEN
* MY COMMISSION # DD 716397
EXPIRES: January 19, 2012
Bono IDm Budget Notary Services
e> Plans Examiner
Engineer
Cont
The foregoing instrument was ackn
i . ersonally known t
, day of
•
OT
lilif
1 /,b
as identification and who did take an oath.
LIC:
ARY PUBLIC - STATE OF FLORIDA
=Comtnissioa #DD830223
Expues: OCT 12, 2012
My CKAVAINVIATTIORMASPING co., INC.
eddged
/d2
e or who has produced
Zoning
Clerk checked
me this
ALEX SINK
CHIEF FINANCIAL OFFICER
EFFECTIVE DATE:
PERSON:
FEIN:
BUSINESS NAME AND ADDRESS:
SKY ELECTRIC INC
90 NW 156 ST.
MIAMI FL 33189
SCOPES OF BUSINESS OR TRADE:
1- CERTIFIED ELECTRICAL CONTRACTO
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
PLEASE CUT OUT THE CARD BELOW
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
SOD KR �'
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
06/24/2010 EXPIRATION DATE: 06/23/2012
WAY RICHARD JR
650759183
06- 242010
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
*
IMPORTANT: Pursuant to Chapter 440. 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this
section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the
scope 01 the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of
election to be exempt shall be subject to revocation If, at any time after the filing of the notice or the Issuance of the certificate, the person named on the notice or
certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure al the person
named on the certificate to meet the requirements of this section.
AND RETAIN FOR FUTURE REFERENCE
CUT HERE
* Carry bottom portion on the job, keep upper portion for your records.
QUESTIONS? (850) 413 -1609
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
CONSTRUCTION INDUSTRY
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS' COMPENSATION LAW
EFFECTIVE: 06/24/2010 EXPIRATION DATE: 08/23/2012
PERSON: RICHARD WAY JR
FEIN: 850759183
BUSINESS NAME AND ADDRESS:
SKY ELECTRIC INC
90 NW 156 ST.
MIAMI, FL 33169
SCOPE OF BUSINESS OR TRADE:
1- CERTIFIED ELECTRICAL CONTRACTO
IMPORTANT
Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who
elects exemption from this chapter by filing a certificate of election
L under this section may not recover benefits or compensation under this
D chapter.
Pursuant to Chapter 440.05(12), F.S., Certificates of election to be
H
exempt.. apply only within the scope of the business or trade listed
E the notice of election to be exempt.
R
E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt
and certificates of election to be exempt shall be subject to revocation
if, at any time after the filing of the notice or the issuance of the
certificate, the person named on the notice or certificate no longer meets
the requirements of this section for issuance of a certificate. The
department shall revoke a certificate at any time for faiiure of the
person named on the certificate to meet the requirements of this
section.
on
QUESTIONS? (850) 413-1609
THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR TFIE 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 OP SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1517
TR
ADD'L
A1spn
TYA1e of MISII eM AF_ _
P OLICY NUMBER
ph9T
0712612010
( M I
071°1612011
LIMITS
GENERAL
LIABILITY
COMMERCIAL GENERAL IIAelLI iY
GL- 050400553500
EACH OCCURRENCE
8 300,000
X
GE TO RENTED
D AMA LMpFa7
MED EX (Am+ one Deraon�
PERSONAL BADV INJURY
8100
0Q,0
1 CLAIMS MADE X OCCUR
$ 5,000
$ 500,000
GENERAL AGGREGATE
91,00000
GEr. L AOOR GATE LIMIT AP S PER
PRODUCTS • COMP /OP AGG
9 1,000)00
$
7 PouCY j tRi I I LOC
COMBINED SINGLE LIMIT
(Es seekIent)
AUTOMDBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUT08
NON -OWNED AUTOS
_
BODILY INJURY
(Per wee)
$
—
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY • EA ACCIDENT
$
R
EA ACC
8
OTHER THAN
AUTO ONLY: AGO
9
EXOSSSIUMBRELLA
LIABILITY
OCCUR ❑ CLAIMS MADE
DEDUCTIBLE
RETENTION _ $
EACH OCCURRENCE
8
AGGREGATE
8
5
1
5
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIEETTOR(PARTNER/EXECUTIUE
OFFICER/mEMBER EXCLUDED?
IT = s. describe under
- - c ~ .. N be • .
I mRV 1 iTR Mt
CL. EACH ACCIDENT
$
5J.. DISEASE - EA EMPLOYEE
$
E.L DISEASE - POLICY UMIr
9
OTHER
DESCRIPTION OP OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ELECTRICAL WORK
:OVERAGES
03/02/2011 14:35 9549560555
RODUCER
OVER ALL INSURANCE
800 W. ATLANTIC BLVD.
IARGATE, FL 33063
HONE # (954) 956 -0006 FAX # (954) 9504)555
13URED SKY ELECTRIC, INC.
90 NW 156TH STREET
MIAMI, FL., 33169
FAX# 305. 9494838
CERTIFICATE HOLDER
MIAMI SNORES VILLAGE
10050 NE 2ND AVENUE
MIAMI FL 33130
FAX: 305 - 756.8972
ACORD 25 (2001/08)
ACORD CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_
INSURERS AFFORDING COVERAGE
INSURER A: AMERICAN VEHICLE INSURANCE COMPANY
INSURER B:
INSURER C:
INSURER b:
INSURER E
altiN
DATE (MM/DDIYYYY)
0310212011
NAIC 5
CANCELLATION
SHOULD ANY OP THE ABOVE DESCRIBED FCUCIES BE CANCELLED BEFORE THE EXPIRATION
BATE THEREOF, Tfl - UING INSURER WILL ENDEAVOR TO MAIL 1� DAYS WRITTEN
NOTICE TO THE CA TE HOLDER NAMED •'`f/IE LEFT. BUT FAILURE TO DO SO SHALT.
IMPOSE NO OBbGA OR LIABILITY OF ANY sl LI THE INSURER.173 AGENTS OR
REPREBENTA
AUTHORIZED PRESS
CORD CORPORATION 1988