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EL-11-418Inspection Number: INSP - 158114 Scheduled Inspection Date: April 11, 2011 Inspector: Bruhn, Norman Owner: HEFFERNAN, COURTNEY Job Address: 9120 NE 10 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: NOVOA ELECTRICAL CONTRACTOR Building Department Comments April 08, 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 Number: EL- 3- 11-418 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060030010 Phone: (305)665 -9247 REPAIR WEATHER HEAD SERVICE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 18 of 20 BUILDING PERMIT APPLICATION FBC 20 Tenant/Lessee Name kJ/ Email & €Z7 CO &LLSo .ri* Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contra o 's A City Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: DAddition Describe Work: 17a eta - F - - t {�qc., g Miami Shores Vila e Building Depar ent 10050 N.E.2nd Avenue, Miami Shores, Flo 'da 33138 Tel: (305) 795.2204 Fax: (305) 756. INSPECTION'S PHONE NUMBER: (305 . 762.4949 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) ( v r - r'-an Owner's Address 9/20 n--Pr /f51.1` .e City /..fic a ryes State 7L State Qualifier Name f% ) 7o /1/16e P State Certificate or Registration No. & 130 /309/2 Certificate of Co Contact Phone W 92 ' '2 E -mail ® 0 DAlteratioii County Miami -Dade ******* * * ** **** * *** * *** * * * * * *** ** * * * ** *F * * * * * * **** ** * ** Submittal Fee $50 Notary $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: Mas Zip Phone # Nf hone # ip One # hone # Square / Linear Footage Of Work: ❑New BMIDTVW1 At MAR 0 8 2011 Permit No. E L__ (H 91B 1B er Permit No. Q 3o-R-7 o.SS Zip Flood Zone chi petency No. ®q a® ® Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * ** 1 Permit Fee $ ��r° e? CC? $ CO /CC $ Training/Education Fee $ Structural Review. $ Total Fee Technology Fee $ Bond $ Now Due$ 10 See Reverse side -+ Bonding Company's Name (if applicable) A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) / f Mortgage Lender's Address l 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 Al+ii'IDAVIT: 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 no be approved and a re- inspection fee will be charged. Signature Owner o _ The foregoing instrument was acknowledged before me this 3 day o f ltsi 20` O , by c Ptu l (L1.Ci lL who is personally known to me o who ha pro ,S wh 4'..e."S e As identification and who did take an oath. NOTARY PUBLIC: P My Commission Expir APPROVED BY 1 (Revised 07/ I 0 /07)(Revised 06/10/2(109) � JAMIE M. MANGER Commission xpi� December8 2120 2 Bolded TAN TrayFe'I 80041354019 ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer The foregoing ins day of 1 s personally kn Signature NOTARY PUBLIC: Sign: Print: Contractor went was acknowl - . ged before me s 20 //, by � L�,l 11 , ,c. 11 o me or who has produced as identification and who did take an oath. * * * * * * * * ** My Commission Expires: 411 EXPIRES: NOV t > 4 landed tin 1st scale 014 Zoning Clerk checked ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DDNYYY) 9/28/2010 PRODUCER ' POWER INSURANCE AGENCY 7221 Coral Way #204 Miami, FL 33155 (305)261 -2559 INSURED NOVOA ELECTRICAL CONTRACTORS, INC 1580 WEST 38TH PLACE HIALEAH, FL 33012 COVERAGES 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 QF ; 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 j POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 'p.DDOO''LL LTR SNSRD YP • IN GENERAL LIABILITY X I COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE I X I OCCUR • GEN•L AGGREGATE LIMIT APPLIES PER X I POLICY j JECT f ` I LOC AUTOMOBILE LIABILITY - IANYAUTO I ALL OWNED AUTOS I SCHEDULED AUTOS • I HIRED AUTOS • NON-OWNED AUTOS �._I. GARAGE LIABILITY I ANYAUIO EXCESS/UMBRELLA LIABILITY OCCUR ( i CLAIMSMADE r I DEDUCTIBLE RETENTION 5 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/WADER EXCLUDED 11 yes, descnbeunder SPECIAL PROVISIONS below OTHER ELECTRICAL WORK CERTIFICATE HOLDER ACORD 25(2001/08) GL -32721 NOT COVERED NOT COVERED NOT COVERED WCP760428500 DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES / EXCLUSIONS ADDEO BY ENDORSEMENT /SPECIAL PROVISIONS MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 N.E.2nd Avenue Miami Shores, FL 33138 T ? POLICY EFFECTIVE 7 P000Y EXPIRATION,` POLICY NUMBER ' DATE MMFDD/YY DATE MMIDDNY • 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 NAIC# i INSURER A ASCENDANT INSURANCE CO . INSURER 8 CASTLEPOINT FL. INS COMPANY INSURER C I INSURER D INSURER E. LIMITS EACH OCCURRENCE 151,000,000.00 1- DA.M5GE it) HINTED 5100,000.00 PREMISES (Ea accurenca) MEDEXP (Arty One parson/ $ 5_,000.00 I 09/23/10 i 09/23/11 _ PERSONAL BADVINJURY $ 1,OQQ QQQ GENERAL AGGREGATE 32,000,000.00 1 ' PRODUCTS - COMPJOPAGG 51,000,000.00 '08/21/10 08/21/11 COMBINED SINGLE LIMI1 (Ea acadenq J I BODILY INJURY (Per Person, BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) • OTHER THAN AUTO ONLY ;EACH OCCURRENCE AGGREGATE AUTO ONLY• EA ACCIDENT $ EA ACC 5 AGG 5 $ EXCLUDED EXCLUDED' EXCLUDED EXCLUDED EXCLUDED EXCLUDED EXCLUDED EXCLUDED EXCLUDED EXCLUDED EXCLUDED EXCLUDED W A U- • H. TORY LIMITS . ER E L EACH ACCIDENT $ 1 0 0 _ , 0 0 0 00 , E L DISEASE • EA EMPLOYEE 3 100,000.00 E L DISEASE • POLICY LIMIT $ 500 000.00 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL Sly NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR RE TAT ACORD CORPORATION 1988