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EL-11-1641Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 -150 Inspection Number: INSP - 164183 Permit Number: EL -9 -11 -1641 Scheduled Inspection Date: September 12, 2011 Inspector: Devaney, Michael Owner: Job Address: 1360 NE 103 Street Miami Shores, FL 33138- Project: <NONE> Contractor: SS POWER & LIGHT ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050300070 Building Department Comments ELECTRIC WORK FOR SEPTIC TANK PUMP Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Com 5)6_ iz Sr7 September 09, 2011 For Inspections please call: (305)762 -4949 Page 22 of 35 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 �EP 0 6 aott BUILDING Permit No —' R4) PERMIT APPLICATION FBC 20 Master Permit No. �L $' _11 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): Phone #: Address: City: Al. 1,7 ) SH ©RPM State: / Zip: / Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: / C © /) ( 105 City: Miami Shores County: Miami Dade Zip: y i- Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: FOKJ,6( d 1 jp1 Address: $ Phone #: 3 c l cc{ 2 2-- City: Ltit t ft-A*14 1 Qualifier Name: f e.I / S State: L !� (214 04 1 17 ft-- State Certification or Registration #: Q i. C l O r 6 Contact Phone #: 3 ®( 26( P 3 9 -j Email Address: DESIGNER: Architect/Engineer: ®a Value of Work for this Permit: $ !f `6 ®. Type of Work: DAddress UAlteration Description of Work: I. (c f n 't c. u/ G R is Zip: 3 9 ! S r Phone #: r-- 24i'C/V 2 -- Certificate of Competent #: sS 40/011 4ft'IW 400 e (• C') . Phone #: Square/Linear Footage of Work: ONew ❑Repair/Replace ❑Demolition ******** * * * * * * * * * * * * * * * * *** * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ /1 ' " Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 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 posted notice, the inspection will not be approved and a reinspection 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 y day of , 20 , by , day of ( ,20/(,by ,20 who is 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: Sign Print: Print: My Commission Expires: IA HERNANDEZ G1L My Commission Expires: *************************************************** ******************************************************** APPROVED BY %c— - '7 Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) I SEE OTHER SIDE S S POWER & LIGHT ELECTRIC INC SERGIO GIL PRES 7760 SW 26 ST MIAMI FL 33155 I„ 1 1„ Jl,,,, il,i,I„Y,i,,,i,l,Ii,,,+i,l,i,I„ ti „Ii,,,75,1t ECTR: 203 0224.00301 000200.00 -DONOTFORWARD S S POWER & LIGHT ELECTRIC INC SERGIO 6IL PRES 7760 SW 26 ST MIAMI FL 33155 x,.11 „A,,,I1,1 J.A,1,,,1 J,14,,.,1,1 J ►1„!1„11,,,,x1 01 -14 -2010 ALEX STATE . to tt .=DF - FRUNCIAL SIII V1 ► Dom; _MOWERS' IE1SAT10N * CSIMATE OF MU= lilt IN UtliWT. ISOM 111.Eir . N LAW This certifies that the indekbel Mei below has eketed to be exteept fries cheat *atm' Dimming= Wm EFFECTIVE DATE eumMe0 EXP ►TION DATE 01h412012 LOS D F &MGM NAM AND ADIAViSM' SS MAIER & LIGHT IRJCTRIC INC .rmo �1 a'r .. _,.... - - R. saruis-seise - OF. ERHOIESS 4nt TR►1E 1- REUSWERED ELECTRUM CoNtR = *ma *te �r Oft • .t a ae� t Petmst te 0. r440 . 05i4, F.&, ee atoms of . Pat s abeam F of ebalU to bee pt-. apply 9 the oodles f d eel r b ender Ms t t - of spa et the tee �' fisted en Me woe e# � � - yams- � � 44' LS., tikes at e> to- be es sad eferffeeMi be mop shall he - te resecalles 0 st say nue after ae Wag et the nibs or the pasta esmed ea the silks or astfflude an kaiser meets al Ole sagas der boas= el • eestfflate. 7te at say fa false el the puma 1F3 -3� named as to of this sew - {Dc -a2 CONIFICAWOF 10 IW E ' sTATECIFFIXIIW1A OF EFFECTIVE 01/14/2010 EXPIRATi4N : 01/14/2012_ 1 BLISTESS NM* AM MUMS ss POWER & t am= eIC rem SW tom Sr Mk R. 89170 -20Za PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE Std OF OR TAADE 1- oesenoese mamma. anew= -1TANT F f to tie' 440.i5{14L F.S, on off1 r of a aspeelikat who O tram Ids t by t a of L under this secdm ma- not rmo -D Amer. • ...Pursuant to Mohr 440A1121 FS, Certificates of deans to be Iv anti *WILY/hi& t eed- ..0T.0 Brae on 1 the melee at ' exempt E Purulent to Chapter 440 13L ES, Rheims of election 4i be exalt and certificates of election to be e sobaS4e abject to remade It at Erm time otter-the fang of the Mice a Ihe issue= at the the i named a notice or cerdficate onsets the -nopthenents of fer_isithece et 0 Vererakee. The deportnent shell revoke a emanate at any thou for a of the person named on the eertiffeate_to_umet.the requirements of f . . seam. manna 413 -11181 * J H portion co ON tint jqb. keep typer portion for your ACORD— - CERTIFICATE OF LIABILITY INSURANCE DATE 099/006111 6/11Y ) 0 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 poiicy(ies) must be endorsed. If SUBROGATION IS WAIVED, subjectto 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 First Class Insurance Market 392 Minorca Ave. Coral Gables, FL 33134 Phone (305)441 -2997 Fax (305)441 -6443 CONTACT NAME: PHONE (305)441-2997 ENC, No): {305)441.6443 ADpaess, fcimc®aoi.Com INSURER(S) APFORDING COVERAGE $ 1,000,000.00 NAILS INSURER A : NATIONAL INSURANCE COMPANY INSURED SS POWER & ELECTRIC 7760 SW 26 STREET MIAMI, FL 33165 INSURER B MED EXP (Any one person) INSURER C : PERSONAL & ADV INJURY INSURER D : ❑ INSURER E : $ 2,000,000.00 INSURER F : PRODUCTS - COMP/OP AGG 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 TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER 02L000166301 POLICY EFF (MMIDD!YYYY) 04/30/2011 POLICY EXP MMADD1Y ( YY! 04/30/2012 LIMITS EACH OCCURRENCE $ 1,000,000.00 A GENERAL LIABILITY © COMMERCIAL GENERAL LUIBILITY ❑ ■ CLAIMS -MADE 0 OCCUR DAMAGE TO RENTED 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE UMIT APPLIES PER: ❑ POLICY ❑ ,LEST ❑ LOC PRODUCTS - COMP/OP AGG $ 1,000,000.00 CEO aBIIN SINGLE LINUF (BODILY $ $ _ AUTOMOBILE LIABILITY • ANY AUTO • AUTOS ED ❑ AUTODULED II HIRED AUTOS `NON OWNED AUTOS 11 III INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ ❑ UMBRELLA LIAB • OCCUR ❑ EXCESS LUIS ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE 1 $ • DED ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N EXCLUDED? ECUTtVE N 1 A ❑ TORY A HITS - OT ER E.L. EACH ACCIDENT 8 OOFFICERIMEEMBER (Mandatory In NH) E.L DISEASE - EA EMPLOYE $ If yes, describe under DESRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHCCLFS (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION VILALGE OF MIAMI SHORES 10050 NE 2 AVE MIAMI SHORES, FL 33138 ACORD 25 (2010105) QF BOVE DESCRIBED POLICIES BE CANCELLED BEFORE EREOF, NOTICE WILL BE DELIVERED IN LICY PROVISIONS. 1980 -2010 ACORD CORPORATION. Alt rights reserved. he ACORD name and logo are registered marks of ACORD Jul 30 10 10:59a Iuis 3052239521 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING HOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 RAMIREZ LUIS G SS POWER & LIGHT ELECTRIC INC 12069 SW 10TH ST MIAMI FL 33184 Congratulations! With this license you become one of the nearly one minion Floridians licensed by the Depnrtment of Business and Profo;sannl Regulation. Our professionals and businesses range from architects to yacht brokers; from boxers to barbeque restaurants. and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better For information about our services, please log onto www.myfloridalicense.com. Thcrc you can lind moro information about our divisions and tho regulations that impact you, subscribe to department newsletters and loam more about the Department's initiatives. Our mission at the Department is: license Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida. and congratulations on your new license! Ac #._5.0• : ,3 3,. • DETACH HERE p.1 (850) 487 -1395 r wale of FLORIDA AC# 50.333,34 DBPbR'-Titerr B. TS ZON S. :AMA •' ••;;:: • : 'pROF}.'gS.IrO ' •�t$CrOi+ATSON: RAG ELE1Czi•It:AL; •CoigRACTOR.. • .° 8S' PQWBR:c.'. 'r••:T!' gHT; !IINDTVIDLTAL •'MQ Tr:... ET" IU X::,'LQGAL ,. • :.''I XCE%TS N{3. Li Q S' :PRxObt ' : : TO CONTRACTING, ;; :PD17'Y' AREA) Ti1i,5 REO $'1'8RSD -un4ev 't . proviaione ,f cr+_489 8• ppratjae•4atei,•AOG,..31.,••2 72 • ' :x10073.3•,01a?: : • STATE. OF FLORIDA • _ D$PARTME1yT -0i BUS 7 1'Sg•S'' Ai!7D i ROi*B$S t i1vAr,, " tSNG •NLECTR.ICAL:� CONTRACTORS••'74•CENNXI�C}rCiA sEQ# Z.lt >0713Al2Z 9•: -'T a ELEO RICAL CONTRXCTOR Named•` •be1ciw_BAS' .REGISTERED: -: ' ; "'.: ;" >' . :: T�'itder:` )tae prov'iaione oe Chapt. x::48,544..• • f. :, • ' • • Expiration date: AUG . 31, 2012: ,:::•.,...... ..'a 74,0 • • (INDIVIDUAL, .MUST,. MEET. ALL . .:. : • . -- - •• -;iii, r ; .:: .11,kQUIRF:MB'I,1TS• PRIOR TO' •CONTRAG`T;XNG= RAMIREE; LUIS : G • SS POWER :4' LI OHT ELECTRIC 4N.0 ;: 12069• SOUTHWEST 10. ''ST %*, • MIAMI . FL. 33184 :CHARLIE GRIST :GOVERNOR DISPIAI'•AS•REQUIREi BY LAIN • iN'!'ERIM SE,CRETT+MY.; ::_: yob 5z270 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164317 Scheduled Inspection Date: September 12, 2011 Inspector: Devaney, Michael Owner: MILBERG, FREDI Job Address: 464 GRAND Concourse Miami Shores, FL 33138- Project: <NONE> Contractor: MOODY ELECTRIC INC Permit Number: EL -6 -11 -1002 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060170010 Phone: (305)758 -2000 Building Department Comments PANEL CHANGE OUT FUSE TO BRKS NEW SMOKES DETECTORS NOT A SERVICE UPGRADE ALREADY UPGRADED 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- 162154. CREATED AS REINSPECTION FOR INSP- 161564. Check conductors. S'2 20 September 09, 2011 For Inspections please call: (305)762 -4949 Page 33 of 35 • Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305). 70.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: ELECTRICAL ij Owner's Name (Fee Simple Titleholder) .c ` & `o Phone # �Dj' ci JUNO Permit No. Master Permit No. Owner's Address Ako `'\ \x„( -5NtN. rh, State Tenant/Lessee Name V Email 1 e —G\v.:. TWA \\I Q- • (-4e%f, Zip Job Address (where the work is being done) ��...Si.- City Miami Shores Village County Miami -Dad FOLIO / PARCEL # ` I' jo.t L- on -poi o Is Building Historically Designated YES Contractor's Company Name ®p,1'0C)L Contractor's Address 66 9 i W ® ST City 6'1/ / State 13CI Phone # e Zip Phone # 3oc_____115Y-ze900 Flood Zone A. 0 _ �L Qualifier Name 5O RIO ®a State Certificate or Registration No. t G / /ey q Contact Phone Architect/Engineer's Name (if applicable) Value of Work For this Permit Type of Work: ['Addition Describe Work: /9 � ®C) Square / Linear Footage Of Work: ElAlteratiqn ONew Zip 3W.00 Phone # E -mail Certificate of Competency No. Phone # Repair eplace ❑ Demoliti ********* ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * ** * ,�,�,� *,� *,�,r Submittal Fee $ 50 .0 C Permit Fee $ j.-fvt '& Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: CCF $ CO /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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENTS" 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 spection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection it <ot be a'ri •ved and a re- inspection fee will be charged. e foregoing instrument was ac day of ,20,b who is personally known to me or who has produced As identifi'ac lion and who did take an oath. owledged before me thi The foreg day of who is personall My Commission Expires: DORIS C. PAGRECO MY POWISSJON41 DD971715 EXPIRES: 1, 2014 Bonded Thru Notary Underwriters At g instrument was acknowledged bef ,20 / /,by oJ4 known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: „. • Print: My Commissi • MARY PAT BRIGGS • MY COMMISSION 5 DD 979287 EXPIRES: May 11, 2014 Bonded Thru Notary Pu66c Underwriters ** dhde9c**** *> F9eoYah***** rk3e**** 3e4r3r3e9c3ek**** *4r*d: iedrsY3c**** 9t3r4r*9c**** *de9roY**9e* 3e9s3e***** ***9r**k 3: 3c9r** *************s4Ar3e*** ** 1/2/7 Plans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Zoning Clerk checked