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EL-10-10231 s. Inspection Number: INSP- 145066 Permit Number: EL -6 -10 -1023 Scheduled Inspection Date: June 03, 2010 Inspector: Devaney, Michael Owner: KAHN, STEPHEN Job Address: 1470 NE 101 Street Project <NONE> Contractor: BRITE ELECTRIC Building Department Comments REPLACE BURNED UP METER CAN Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments C/e-- 3 ft ekl° June 02, 2010 Miami Shores, FL 33138- 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: Addition /Alteration Phone Number (305)758 -7912 Parcel Number 1132050240060 Phone: (954)214 -7908 Page 31 of 39 Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground W. W. , Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 1470 NE 101 Street Miami Shores, FL 33138- 1132050240060 Block: Lot: STEPHEN KAHN Address Contractor(s) BRITE ELECTRIC Phone Cell Phone (954)214 -7908 , Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $3.00 $0.80 $104.60 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy June 02, 2010 Phone STEPHEN KAHN 1470 NE 101 ST MIAMI SHORES FL 33138 -2613 (305)758 -7912 1 Type of Work: ELECTRICAL Additional Info: REPLACE METER CAN Classification: Residential Scanning: 1 Valuation: Total Sq Feet: $ 1, 0 1 , Pay Date Pay Type Amt Paid Amt Due Invoice # EL -6 -10 -38084 06/02/2010 Check #: 18270 $ 104.60 $ 0.00 Date Ceil Available Inspections: 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. June 02, 2010 1 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 tanust be secured fo r'ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TAI � h AIR CO TIONERS, ETC..... 4 � OWNER'S AFFIDAVIT: I certify tha ll the Aire oing information is accurate and thatiall work wittlerfol,ta cgrpftiklkti with all applicable laws regulating construction "artcf zo g.' ` "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTMO YOUR, PROOPEtTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEgball OR•. 4 :AN AUTO . BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT "T . r R• 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 nettce of commencement must be posted at the job site for the first f ree 4: waielt: occursicvlen (7) days after the buildin per t is issuea U "th nce of such posted notice, the inspection will not be approved and a reinspection fee will be chard ±�, ° • ; 3 Signature Signature Owner or Agent The for'egt ng instrumentw•as acknowledged before me this The f or'egoing ilistr`umeut 3 v . day of ,20 ,by , day of who is personally known to me or who has produced who • .As identification and who did take an oath. NOTARY PUBLIC: . Sign: Print: APPLICATION APPROVED B chc 05/13/03 NOTARY PUBLIC: •�� nmmission DD108114 'jms's - y :.t; t4 °4 Contractor fal‘cicnowledged before me thigh by ( me or who has produced ation and wh,, did take an oath. . r te Q .12:0 • My Commission Expires: t 4 0 . ; 6; sion) xpires: , at y *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *e • * ** ** *** * * * ** *** *dreYeYak*3ek**4reYoYeY*** ** **Ir9 ^e• * * * * * * * * ** ************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Engineer Zoning Miami Shores Village palm, rh) 0 2 2010 !Yi Building Departm.ent 1 0050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No.€1 -. 10P, Master Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: ELECTRICAL E K Am ,/ cfr olvrat4 e # 0S 9 -R3 Y9 Owner's Name (Fee Simple Titleholder) Owner's Address Al . 6. 1 (2/ City 07 i,1 (•) tiokac state Fa Zip 3313a Tenant/Lessee Name Phone # Email Job Address (where the work is being done) / 4 /7 0 A C. JO/ „Of City Miami Shores Village County Miami-Dade Zip 33 I3g FOLIO / PARCEL # ac - 002 -0060 Is Building Historically Designated YES NO 1,/ Flood Zone Contractor's Company Name Sp., Lec - re J Phone # Contractor's Address 33,23 6-21 pop/ RI, ir 7 City DJ State Zip 7Z3 v Qualifier Name -S/M/ &'1 f Sc-Aie a ),01 Phone # 95 -.21(/ -1902 State Certificate or Registration No. eG 00'00/03 Certificate of Competency No. Contact Phone 95'9 - ,21Y - 7 9 � E-mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ ..50 - 0 Square / Linear Footage Of Work: Type of Work: DAddition DAlteration :New 12Repair/Replace 0 Demolition Describe Work: GPAA /94 EL/2/1/ 6'0 a,° 2qr2 g,'tJ # 1- CiP Itki”r4 k-N.114 ** *****************F i! NOVA Permit Fee $ AePeOf e' 4iii-Astrvevcro- Notary $ Scanning $ Double Fee $ Training/Education Fee $ Radon $ DPBR $ Violation date: 0/CC $ Technology Fee $ Bond $ Structural Review. $ Total Fee Now Due $ See Reverse side 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 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 re- inspection fee will be charged. Signature 0 e or Agent The foregoing instrument was acknowledged before me this 2 E day of (n/i y ,20 by lyNi Wm who is personalty known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: A Sign: ?7 Print: t� A My Commissio APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) ,?. t' 4®Plans Examiner Engineer Signature Contractor The foregoing instrument was acknowledged before me this Z day of W41 , 20 iz2, by S, A.mrY SCNR9106V who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Zoning Clerk checked CERTIFICATE OF LIABILITY INSURANCE Date 5/28/2010 Producer: Lion Insurance Company 2739 U.S. Highway 19 N. 9 Y Holiday, FL 34691 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 polides below. Insurers Affording Coverage NAIL # Insured: South East Personnel Leasing, Inc. 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company 11075 Insurer B: Insurer C: Insurer D: Insurer E: 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 condrhon of any contractor other documentwNu 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 polcies. Aggregate limas shown may have bean reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM/DD/YY) Policy Expiration Date (MM/DD/YY) Limits GENERAL j General 3 LIABILITY Commercial General Liability Claims Made Occur 3 Each Occurrence $ Damage to rented premises (EA occurrence) Med Exp $ Personal Adv Injury $ aggregate limit applies per: — General Aggregate 3 Policy ❑ Project LOC Products - ComplOp Agg $ AUTOMOBILE ■ ■ ■ ■ ■ LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Nan -Owned Autos Combined Single Limit (EA Accident) 3 Bodily IBA (Per Person) 3 BodM Injury (Per Accident) $ Property Damage (Per Accident) EXCESS /UMBRELLA LIABILITY I Occur ❑ Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Employers' Liabllty Any proprietortpartner /executive officerlmember excluded? If Yes, describe under special provisions below. WC 71949 01/01/2010 , 01/01/2011 INC 1 I ER E.L. Each Accident $t.t . E.L. Disease Ea Employee 31,001)01)0 E.L. Disease - Policy Limits $1000,000 Otter Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /LocatlonsNehlcles/Exclusions added by Endorsement/Special Provisions: Client ID: 30-03-288 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to the following "Client Company": Brits Electric Coverage only applies to injuries incurred by South East Persomel Leasing, Inc. active employee(s) , while working in Florida. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938-5562. Project Name: FAX: 954.791 -9416 / ISSUE 05-28-10 (SD) Benin Date: 8/5/2002 CERTIFICATE HOLDER CANCELLATION CITY OF MIAMI SHORES 10050 NE 2ND AVE MIAMI SHORES, FL 33132 Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon Me insurer, its agents or representatives. ;f 5/28/2010 17:03 2010 - 05 - 28 16:04 SOUTHEAST PERSO Lion Insurance LION INSURANCE COMPANY- ►BRITS ELEC Page 1 1/1 A © r CERTIFICATE OF LIABILITY INSURANCE 1 DA o /28/10 DIVY) PRODUCER Annette Mils Insurance 18401 H.W. 27 Ave Marra, FL 33056 Phone (W5)625 -2403 Fax (305)625 -6472 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT 14MEND. EXTEND OR ALTER THE COVERAGE AFFORDED EN THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL # INSURED Ju-My-Da Corp DBA Brice Electric SIDNEY SCHREIDELL 3325 Griffin Road # 267 [Ft Lauderdale, Fl 33312 INstiRER A: ATLANTIC CASUALTY INSURER 8: US SECURITY INSURANCE INSURER C: INSURER 0: INSURER E: COVERAGES INSURER F :. THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INTED. NOTWITHSTANDING ANY REQWREtAENT, TERRA OR CONDfTION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WI -UCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCWSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE UMITS SHOWN MtA,Y HAVE BEEN REDUCED BY PAID CLAIMS. INSR i A �ADM D TYPE OF INSURANCE POLICY MJftER D ( IM DATE POUCY UMITS ❑ GENERAL LIABILITY k CCM ERaAL GENERAL LIABILITY 0❑ CLAIMS MADE ® OCCUR ❑ L0390014880 12/11/09 12/11/10 EACH OCCURRENCE 1,000,000 PREMISES (Eaaooccurence) 50,000 MED EXP (Any one person) 5,000 PERSONAL &ADVINJURY 1,000,000 GENERAL AGGREGATE 2,000,000 ❑ PRODUCTS - COMIP/OP AGO 1,000,000 GEM_ AGGREGATE LIMIT APPIJES PER: ❑ POLICY ❑ PROJECT ❑ LOC B ❑ AUTOMOBILE UABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS ® SCHEDULED AUTOS 0 HIRED AUTOS ❑ NON OWNED AUTOS • CA 94491 - 03 01/13/10 I 01/13/11 1 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) 10,000 BODILY INJURY (Per accident) 20,000 PROPERTY DAMAGE (Per accident) 10,000 ❑ 0 GARAGE LIABILITY 0 ANY AUTO ❑ ' AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGO ❑ ElICESSIUMBREI.LA LIABILITY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE 0 RETENTION $ EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? ff yes, describe tinder SPECIAL PROVISIONS below E 0 y TTIATU— © OTH ER E.L EACH ACCIDENT EL. DISEASE vS.A EMPLOYEE E.L. DISEASE . POUCY UMIT OTHER DESCRIPTION OF OPERATIONLSJ LOCATIONS ! VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS ELECTRICIAN May. 28. 2010 4:36PM CERTIFICATE HOLDER ACORD 25 (2001108) CIF CITY OF MIAMI SHORES BLDG 10500 NE 2 AVE MIAMI SHORES, FL 33138 2010 -05-28 15 :58 ANNETTE WILLIS CANCELLATION AUTHORIZED REPRESENTATIVE No. 6549 P. 1/1 SHOULD ANY OF THE ABOVE DESCRBED POUCtES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SNAIL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITSAGENTS OR REPRESENTATIVES. ACORD CORPORATION 1t Page 1 Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 CHARLIE CRIST GOVERNOR DBA: Business Name: Owner Name: Business Location: Business Phone: Rooms Number of Machines: CENSR N3R 07/31/200808600068 _EC0A00103 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter Expiration date: AUG 31, 2010.'' SCHREIDELL, SIDNEY F BRITE ELECTRIC 3325 GRIFFIN RD SUITE #267 FORT LAUDERDALE FL 33312 SIDNEY F SCHREIDELL SIDNEY F SCHREIDELL 3325 GRIFFIN RD # 267 FT LAUDERDALE 954- 214 -7908 Seats STATE OF FLORIDA AND PROFESSIONAL REGULATION C'PORS.,_ LICENSING BOARD SEQ# z,0807310142 DISPLAY AS REQUIRED BY LAW For Vending Business Only CHARLES W. DRAGO SECRETARY BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000 VALID OCTOBER 1, 2009 THROUGH SEPTEMBER 30, 2010 Receipt #: 180 - 230821 Business Type: GENERAL CONTRACTOR Business Opened: 02/02/2010 State /County /Cert/Reg: CGC 0110 8 6 Exemption Code: NONEXEMPT Employees Machines Professionals 1 Vending Type: O THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS