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EL-10-368 Af Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 140271 Permit Number: EL -3 -10 -368 Scheduled Inspection Date: May 24, 2010 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: BELTRAMINI, CIRO Work Classification: Alteration Job Address: 1170 NE 97 Street Miami Shores, FL 33138 - Phone Number Parcel Number 1132050170150 Project: <NONE> Contractor: J&E ELECTRICAL SYSTEM CORP Phone: (305)883 -5009 Building Department Comments Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 139994. Service has to be 10' to bottom of drip loop. 200 amp.sservice requires 2/0 copper conductors. panel requires T clearance. Bond water system.Repair connections to water heater & sprinkler pump. Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 21, 2010 For Inslpections please call: (305)762 -4949 Page 9 of 39 E � � l � EY � } 0 Miami Shores Village 10050 N.E. 2nd Avenue r Miami Shores, FL 33138 -0000 " Phone: (305)795 -2204 s � K Expiration: 09/11/2010 Project Address Parcel Number Applicant 1170 97 Street 1132050170150 Miami Shores, FL 33138- Block: Lot: CIRO BELTRAMINI Owner Information Address Phone Cell CIRO BELTRAMINI 1170 97 Street MIAMI SHORES FL 33138 -2558 Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 J&E ELECTRICAL SYSTEM CORP (305)883 -5009 Total Sq Feet: 0 Type of Work: ADD MAIN BREAKER Available Inspections: Additional Info: ELECTRICAL Inspection Type: Classification: Residential Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice # EL -3-10 -37235 Education Surcharge $0.40 Permit Fee - Addrdons/Alterations $225.00 03/09/2010 Credit Card $ 50.00 $ 181.20 Scanning Fee $3 04/07/2010 Check #: 1037 $ 181.20 $ 0.00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $1.60 Total: $231.20 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 that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. April 07, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy April 07, 2010 1 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIM 03/25/10 PRODUCER Prime Rate Irmaanae THIS CERTIFICATE IS ISSUED AS A MATTER OF FORMATION 13874 SW 8 St ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Miami, FL 33184 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (305)5173737 Fax (305)5173736 INSURERS AFFORDING COVERAGE NAIC # INSURED J & E Elechical System Corp. INSURER A: ascendant 18501 Pines Blvd #201 INSURER B: Pembroke Pines, FL 33029- INSURER C: 222 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS14 AWL I TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER DATE MAlUD DATE LIMITS GENERAL LIABILITY EACH OCCURRENCE ❑ C OLINERCIAL GENERAL LIABILITY DAMAGE TO RENTS PREMISES 'e occurrence A ❑ ❑ ❑ CLAIMS MADE ❑ OCCUR NED EXP (Arty one person) ❑ PERSONAL & ADV IMURY ❑ GENERAL AGGREGATE GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG ❑ POLICY ❑ PROJECT ❑ LCC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 30,000 ❑ ANY AUTO 05327841-0 03104 03/04/2011 accident ❑ ALL OWNED AUTOS SCHEDULED AUTOS BODILYINJURY 10,000 ® © ❑ HIRED AUTOS (per BODILY INJURY ❑ NCNV OWNED AUTOS (� ��) 10,000 500.00 DED COLL ❑ 500.00 DED COMP PROPERTY DAMAGE (Per accident) GARAGE L UMILITY AUTO ONLY - EA ACCIDENT ❑ ❑ ANY AUTO OTHER THAN EAACC ❑ AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EAC OCCURRE ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY VI/C- 61864 -0 03/19/2010 03119/2011 ® WRY TAT 8 [j OTH- ER A ANY PROPRIETOR / PARTNER / EXECUTIVE YM E L EACH ACCIDENT 100,000 OFFICER / R48WOM EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE 500,000 describe under under SPECIAL PROVISIONS below EL DISEASE - POWY LIMIT 100,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL CITY OF MIAMI SHORES VILLAGE DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 NORTHEAST 2 ND AVE THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY MIAMI SHORES FLORIDA 33138 OF ANY KIND UPON THE INSURER ITS AGENTS OR EINTATIVES. AUTHORIZED REPRESENTATIVE DAN" DE LA NOVAL ACORD 25 (2008101) OF ©1888 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i -44APr. 7. 2010 9 O8AM I TIFI CATi OF LIA BILIT Y I No.5093 P. 1 /1. — ... _ �u*%l n Imm/DDIYY) PRODUCER Florida Bankers IMsumce 04/0 THIS CER77FICgTE LS ISSUED AS A MATTER OF INFORMATION 7278 SW 6 Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami, FL 33144 HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Phone (306)266 — F ax (3 flN -T THE COVERA AF S Y TH P OI -CR BEL U RERS AF C INSURED J & E ELECTRICAL SYSTEM CORP. R ER A A ME RIC AN VEH IN S URA NCE CO 18501 Pines Blvd #201 M -5 RER B: PEMBROKE PINES, FL 33029 - R ER O. �OS 9a9� RER p• C OVER A GES RER F_ _ SU R ER F. - THE POLICIES OF INSURANCE USTED HAVE BEEN ISSUED TO THE INRED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT. 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 - S UBJE CT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH N POLIC A GGREGAT E LIMIT SHOW M AY HA BEEN R EDUCE D B YPAIb C LAIMS. I AWL POLIC NUM LTR INSRD TYP O INSU P*JCY EFPECUVE POLICY E7XPIRAMON GENERAL LIABILITY — Dp_� - B A� MlD _W_y LIMIT . COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 30 GL 0501003417 -00 11/11/09 11/11!10 PR ° — A r , J I---j❑ CLAMS MADE n OCCUR . 1 F MED EXP (Any one pe rgon) 5 .0 00 .00 H _ — P ERSO NA L &AD I NJURY 3 GEN'L AGGREGATE LIMIT APPLIES PER: GENE A _ 300 64 POLI 1:1 P I ] LOC P RODU CT S - CO /OP AG 30 0.DDO .O� L] AUTOMOBILE LIABILITY _ I J ANYAUTO COMBINED SINGLE LIMIT ❑ ALL OWNED AUTOS (Ea a — ❑ F] SCHEDULEDAUTOS BODILY INJURY HIRED AUTOS e p Cl NON OWNED AUTOS BODI INJURY LJ CJ _ _ (Peracuder* PROPERTY DAMAGE j GARAGE LIABILITY —. ( Per acG L 11 ANYAUTO AUTO ONLY - E ACC IDENT f ..I OTHER THAN EA AC C ExC IMBRELLALIABILr Y AUTO ONLY —_jk I rI U OCCUR U CLAIMS MADE EA O AGGRE �. I I DEDUCTIBLE ❑ RETENTION 11 WORKERS COMPENSAT O- N AND - �J El EMPLOYERS' LIABILITY ANY PROPRIETOR! PARTNER / EXECUTIVE ❑ WC STA7U F OTH. OFFI CER /MEMSER•EXCLUDED7 ~ —S TS ER If yeg describe under E EAC ACCID SPECE4L PROV belkwv E.L. D ISEASE - E A EM j OTHER — E L DIS - PO LIM — j — — DESCRIPTION OF OpERAT15N9 !LOCATIONS /VEHICLE / EX ENT ADDED BY ENDORSEN(ENT /SPECIAL PROVISIONS I — I I _ CERTIFICATE H OLDE R _ — CAN --, i SHOULD ANY OF THE ABOVE DESCRIpED POLICIES BE CANCELLED BEFORE THE _ CITY OF MIAMI SHORES EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10050 NE 2 AVE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE L EFT, BUT FAILURE TO.DO SO SHALL I NO OBLIGATION OR L1499LITY MIAMI SHORES, FL 33138 OF A NY K IND UPON TH E INS IT S AG ENTS OR REPRESENTATNES, AUTHORIZED Ri;PRESFJd VE ACORD25 (2001 108) 4F —. r MA ALOSNO (24 " `, ®ACORD CORPORATION 1988 JI Miami Shares Villa o ge � � 4 � f Bui ding Department MA ° 9 2910 10050 N. .2nd Avenue, Miami Shores, Florida 33138 ✓ Tel: (305) 795.2204 Fax: 305 756.8972` INSPECTION'S PHONE NUMBER: (305). 762.4949 BUILDING Permit No. 2_ U O " o b PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) C 112 10 A . gA Nj % Phone # _5G /L 712 01 152,7 Owner's Address 2 1 &6® rr f:tCC_°I' % Q ICJ L of City 824: (1A-r, aly State F1_ Zip Z��J2_e Tenant/Lessee Name W E LL-t Phone # _S'0 !G ff6 2 01C? qA Email Ca % o t✓ Job Address (where the work is being done) A1 77 City Miami Shores Village County Miami -Dade Zip 3 FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone T401 � Contractor's Company Name , �L S Phone # 3 ® RAZ _�� Contractor's Address 18,5 PiWg d _53 - Zol City I rower F; State FL®.T tJDA Zip XS 0,2 C Qualifier Name R 4,17VA11,0 Phone # State Certificate or Registration No. ® Certificate of Competency No. Contact Phone � - E -mail aj4 C0;e do WO' Architect/Engineer's Name (if applicable) Phone Value of Work For this Permit $ ®® ® Square / Linear Footage Of Work: Type of Work: ElAddition ❑Alterati n ONew .� Repair/Replace El Demolition Describe Work: „ E c r Fee $V Permit Fee $ XSe ®e's _T l A-'S/ CCF $ CO /CC $ Notary $ Training/Edu ation Fee $ 0 Technology Fee $ • _ Scanning $ Lap Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ mi /_ See Reverse side -a 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose'property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such osted notice, the inspection will not be approved and a re- inspection fee will be charged. Signature Signature �— Owner or Agent Contractor The foregoing instrument was acknowledged before me this � The foregoing instrument was acknowledged before me this day of Marsh , 2010 , by Ci . CS@ \ A nni YY\ t day of Yl(c�1n , 20 t u , by JPs v s Vc, 7ye >? , who i personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: i- a ,.,u Sign• Print: AM V, , Print: # A*\G t� ESQ My Commission Expires: =00y P'O Notary Public State of Florida My Commission p1W:av� Notary Public State Of Florida Ana K Casal ? Ana K Casal A My Commission DD761739 +� c p Q My Commission DD751739 OFM1OQ' Exprres 03/23/2012 �'oFfl Expires 03/23/2012 ,' t: redt4etk�te4t�k�1tilnY ,YeY4ta1taY4rt'ttYde oY 4t4e4edeot9rdr ,Y�YoYoY9i &9r9nY,�r4c4e9edt4roY APPROVED BY / lans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) i �Fx�a °� ��rrien�iieelw , 02/08/2010 14:31 9543010417 GBS GROUP PAGE 02/02 J &•L WACTRICAL'8Y$TMU CORP. ' 1$801 PING$ BLVD, V=T 201 -$. PmoROR8 Pnm FL 33029 . 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'. i1, . 1 1i :. 1,'•1 02/06/2010 14:31 9543010417 GBS GROUP PAGE 01/02 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. Ai -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000 VALID OCTOBER 1, 2009 THROUGH SEPTEMBER 30, 2010 DBA: ROCeipt #: 181-3442 Business Name J & E ELECTRICAL CONTRACTOR Business Type: ELECTRICAL /ALARMS /CO Og Owner Name: MOLERO ANTONIO ( ELECTRICAL /CONTRACTOR) _ Business Location 18501 PINES BLVD 201 Business•Opened: 10/31/2008 PEMBROKE PINES State /County /Cert/Reg EC13002792 i Business Phone 954 -659 - 8935 . Exemption Code NONEXEMPT Rooms Seats .. kil . 6y , t` :-M •a Ines i ' PI Professionals For vending Business Only . Number of Machines: • ' = Tax Amount Transfer Fee NSF. F.eG:••..;, Vending Type: 27.00 . Pry/ -Y y ' Collection Cost Total Paid 0.00 .. .. .. Vi:Y-.I .het.. .•D `.ft•.. -' ...:vK.NO. 0.00 27.00 1 ! 1 THIS RECEIPT MUST BE POSTP-D CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is WHEN VALIDATED non - regulatory in nature. You must meet all Cou and zoning requirements. This Business Tax Receipt be h the business Is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that Mailing Address: it is in Compliance with State or local laws and regulations. J & E ELECTRICAL CONTRACTOR, i 18501 PINES BLVD #201 Reasipt #013 -08- 00000331 I PEMBROKE PINES, FL 33029 paid 09/04/2009 27.00 i y.R- MR, - � w N q 9 A r f f � ,�, .�G i 'i �'� �%��get a � I 'h. r�'3�'[gSf I I I I 1R I1. �.'�{ R `•� .. 3 I ) fa}� �,r 'z� — 4... �✓ i i.... �",- 4 Ke'_ F � My � t � , � � Le=, a { k b t y _ 4 "�� n . � M1u r ' ' � M1 x. �',..c� q Fs #A � , ��il ' P ' _: �• Y .�.. > '�. }�,.?` � � lbs. - b t �3 x�� - . s �' - P. I n "�, �, s . '" Is , fit '"� ,"`' +' w d3.'w�: �'�' '� d I � )� � y,'. � + • „�'i�ilS.A�'�� - Gi �'I °I� i �IW Pr i r I r :f ���77�, rt7 + � a a,u�q �,'�,C ��. �� � v =}''; e, � :�t %�nJ �uu��,w•a.::;s �: , �, P r : a �7 '..^ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 In spect i on Number: INSP - 139994 Permit Numb EL -3 -10 -368 Scheduled Inspection Date: April 08, 2010 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: BELTRAMINI, CIRO Work Classification: Alteration Job Address: 1170 NE 97 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132050170150 Project: <NONE> Contractor: JI&E ELECTRICAL SYSTEM CORP Phone: (305)883 -5009 Building Department Comments Inspector Comments Passed 7 h- Failed Correction�� _ Needed Vale 7�c�T� S Re- Inspection lv;e � '� ° Z Low& Ap - Fee No Additional Inspections can be scheduled until re- inspection fee is paid. p April 07, 2010 For Inspections please call: (305)762 -4949 Page 20 of 26