EL-11-1775Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 166472 Permit Number: EL -9 -11 -1775
Scheduled Inspection Date: November 15, 2011
Inspector: Devaney, Michael
Owner:
Job Address: 190 NW 93 Street
Miami Shores, FL
Project: <NONE>
Contractor: MAX ELECTRIC CORPORATION
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1131010330970
Phone: (305)498 -5422
Building Department Comments
REPLACE METER AND PANEL BREAKER 200 AMPS NEW
CONNECTION OF 5 SMOKE DETECTOR AND REPLACE
THE GFI IN THE BATHROOM AND KITCHEN
Passed
LCD
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- 166297. CREATED AS
REINSPECTION FOR INSP- 166240. Smoke detectors are O. K..
Need 100 amp breaker in outside panel.
/1
/J /1/ //
November 14, 2011
For Inspections please call: (305)762 -4949
Page 22 of 34
\AA k1 -0000
BUILDING
PERMIT APPLICATION
FBC 20
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
Permit No. VL1 rr-15
Master Permit No.
RECEIVED
SP JgBY:
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder): N%p,t) v �-d � •S's Phone #: .34.5.--74-1- MS'
Address: /'Q n Ak11.: 93 s4 .
City: 4+;4•411 - Siaa.Q.Es State: /el. Zip: 33/615
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: / 9O AUK 73.ot.
City: Miami Shores County: Miami Dade
Folio/Parcel #: 11-3101-03 -0110
Zip: 3.3/5
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: M Poe '6AX--- Phone #: 3D Ael bS`170Z
Address: 22 it.)0 C.� A e • 4 'L
City: qi 4 State: - Zip: 33‘S
Qualifier Name: 41. 4..C- `moo '� e..-
State Certification or Registration #: Certificate of Competency #: l o . 000 18 2
Contact Phone #: -7 BC, 3�O f®C 2. Email Address: MAa1 E LE CrlC.1GCccti,. Q • 4a40 . ee a.,1 ..
DESIGNER: Architect/Engineer: Phone #:
Phone #: ' 4115`547a'
Value of Work for this Permit: $ 41V ' 0 Square/Linear Footage of Work:
Type of Work: ❑Addr- s ❑Alteratoion
Description of Work: ACkc ' "L
00.x.› earVI VC
$�
❑New 11 Repair/Replace
❑Demolition
®A
* * * * * * * * * * * *, * * **
Submittal Fee $
Scanning Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
* * * * * * * * * * * * * * * *** ** Fees * * * * ** * * * ** ** * * ** ******* *** * * ** * * * * * * * * **
Permit Fee $��i�
13 (04- CC F$ CO/CC $
DBPR $ Bond $
Technology Fee $
Radon Fee $
TOTAL FEE NOW DUE $ t CC p`19
loading 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 o commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issu 1r.,� In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Owner or Ai nt
The foregoing instrument was acknowledged before me this 2-'
day ofd � � , 20 1, by fi e?) s� .
who •
personally known to me
who has produced
As id=` tification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: ��
My Commis ion
•
ih
;'i„
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of ,20 it , by
who i
ersonally known to me }
r who has produced
as identificati n and who did take an oath.
NOTARY PUBLIC,/
MY COMMISSION # EE102454
EXPIRES June 13, 2015
(407) 398-0153 FlorldallotaryServloe.eom
* * * * * * * * * * * * * * * * * * **
APPROVED BY
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
c ' Ians Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
rY„ �i , sion sA• RAMUDO
MY C MMISSION # EE102454
EXPIRES June 13, 2015
(407)398.0153 Plodda
* **
* * * * * * * **
Zoning
Clerk
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
TAX FOLIO NO. 1 1 -3/01 "(:::$33- 42970
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNEDereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1 Legal description of property and street/address: /$1
4) I r - t / ‘ Lai- /3
2. Description of improvement:
3. ner(s) name and address:
Interest in property: -F- -S
Name and address of fee simple titleholder. 5
4. Contractor's name, address and phone number.
0114 .14 % �L 331: - • ?"
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number. F o 1J
Amount of bond $ ^}4 °
6. Lender's name and address: provided by
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as p
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number Na?-) .-
•
r
L
111111111111111111111111111111111111111111111
CFN 2011R0648625
OR Bk 278.9 Ps 3294; (1Ps)
RECORDED 09/27/2011 11:14:21
HARVEY RUVIN, CLERK OF COURT
MIAMI-DACDE COUNTY: FLORIDA
LAST PAGE
Space above reserved for use of recording office
t,o S4 c. P5 /0-39 Lot ♦ z.
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/2548
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8. In addition to himself, Owners designates the following person(s) to d
713.13(1)(b), Florida Statutes.
Name, address and phone number. A) a4-1 _ --
!atlr.
f �� ,t�•_'/ - 7--if� rikmci ,,`lie
9. Expiration date of this Notice of Commencement ( expiration is 1 e , : oats
,n _ erene i`�r,
WARNING TO PAYMENTS OWNER: ANY ER CHAPTER R 713 PART I, SECTION 713.13. F ORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROPER M PAYMTOTS UNDER PROPERTY. IMPROVEMENTS N. YOUR INTEND TO OBTAIN FINANCING, CONSUL WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
FIRST INSPECTION. IF YO i, �
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature(s) of Owner s) oar +wner(s)' Authorized cer/Director Pri artn /Ma f' • Prepared By Prepared
` nt Name
Print Name : • . +� Title /Office
Title /Office
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
The foregoing instrument was�owled before me this day
By for
Individually, or ❑ as of ident
0 Personalty known, or produced the followin g type
Signature of Notary Public:
Print (SEAL)
(SEAL)
VE - IFl A • N RSIJANT TO S CTI • N 92. 25 FL • RIDA TATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the be of my knowledge and beli
ef.
0A;; LUIS A. RAMUDO
-'•'` MY COMMISSION # EE102454
s±�is EXPIRES June 13, 2015
(407) 398-0153 FloritlallotaryService.com
SignaturAe(s) of Ow 'er(s) or Owner(s)'s Authorized Officer /Director /Partner/Manager who signed above:
By
• By
,2„".6'5 -52 PAGE 3 3/1
a1-$ Df1L1s ..7":04-‘0.5.41..)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION FORM
ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS
SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR.
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. COPY OF QUALIFIER'S STATE LIC CARD
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPTI
D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. ✓ COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER
B. o/ COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT
C. ✓ COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPTI
D. ✓ COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION)
YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
COMPLETE CONTRACTOR'S INFORMATION
BUSINESS NAME: 1 4C%( E 6'� C Ct r
BUSINESS ADDRESS: 224o (e4 OVP p CrrY q Arn 1
STATE ZIP CODE EN
BUSINESS PHONE: (_ _) LPI% - 22- FAX NUMBER (3) 2LQ2 ' S'9o1
CELL PHONE (_,?&_) C-S611cis - X22 QUALIFIER'S NAME: R■ r)A03 e2
QUALIFIER'S LIC NUMBER: ib ( C'90
E -MAIL ADDRESS (IF APPLICABLE): I`- We63 ‘ C CDT IYIn � COW/
Created on 3119109 BY MLDV 1 RV 3126109 MLDV
CTQB
Construction Trades Qualifying Board
BUSINESS CERTIFICATE OF COMPETENCY
10E000182
MAX ELECTRIC CORPORATION
D.B.A.:
FERN DEZ MARCELINO
Is certified under the provisions of Chapter 10 of Miami -Dade County
VALID FC)4,Q.DAIiiiirki,ING UNTIL 09130/201 3
7RfVER LICEN "' C . A
yF�+65t�5� -540
idARCELINO
FERNANDEZ
2240 SW 67 AVE APT 7
MIAMI. FL 3315
DOB
02-1? 1%1 SEX
1 411
,. ^320
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
FERNANDEZ, MARCELINO
MAX ELECTRIC CORPORATION
2240 SW 67 AVE APT 7
MIAMI FL 33155
Congratulations! With this license you become one of the nearly one million
Floridians licensed by the Department of Business and Professional 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.myfioriclalicense.com.
There you can find more information about our divisions and the regulations that
impact you, subscribe to department newsletters and learn 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!
DETACH HERE
STATE OF FLORIDA AC1 /4962E-1G
DEPARTMENT OE BUSINESS- AND -`
PROFESSIONAL REGULATION'
13014450 _ 05/13/10 _09-0432832.z-
-
REG ELECTRICAL CONTRACTOR
FERNANDEZ;f MARCELINO
-.. MAX MT.ACTRXC CORPORATION
(INDIVIDUAL ..MUST -:MEET ALL LOCAL
lacKtitsING.'
TO CONTRACTINGT-', T.N.:1071/ AREA)
-
.
HAp-101GIsswrilt) under the provisions of Ch. 48.9'
EXPirntionf:-Omits: AUG 31, 2012 L10051300704 :
-A
Oit.;
A7,1- Nained ,
•Under the provisions o•f
• -
date: .
• MIAMI
•
•
S F8
ENSING
AtIft:,.'Attig2e)
AOL.12.
QUIRE
05 -25 -2010
ALEX SINK STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * 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.
EFFECTIVE DATE:
PERSON:
FEIN:
05/25/2010 EXPIRATION DATE: 05/24/2012
FERNANDEZ MARCELINO
204255061
BUSINESS NAME AND ADDRESS:
MAX ELECTRIC CORPORATION
2240 SW 67TH AVENUE SUITE 7
MIAMI FL 33155
SCOPES OF BUSINESS OR TRADE:
1- REGISTERED ELECTRICAL CONTRACT
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 ender this
section may net recover beast its or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the
scope of 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 he 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 of the person
named on the certificate to meet the requirements of this section.
QUESTIONS? (850) 413-1609
DWC -252 CERTIFICATE OF ELECTW N TO BE EXEMPT REVISED 09 -06
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
tINSTRUCTION INDUSTRY
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS' COMPENSATION LAW
EFFECTIVE 05/25/2010 EXPIRATION DATE: 05/24/2012
PERSON: MARCELINO FERNANDEZ
FEIN: 204255051
BUSINESS NAME AND ADDRESS:
MAX ELECTRIC CORPORATION
2240 SW 67TH AVENUE SUITE 7
MIAMI, FL 33155
SCOPE OF BUSINESS OR TRADE
1- REGISTERED ELECTRICAL CONTRACT
IMPORTANT
Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who
Q elects exemption from this chapter by filing a certificate of election
1- 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 on
E the notice of election to be exempt
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 failure of the
person named on the certificate to meet the requirements of this
section.
QUESTIONS? (850) 413-1609
CUT HERE
* Carry bottom portion on the job, keep upper portion for your records.
OWC -252 CERTIFICATE OF EI.EC11ON TO BE EXEMPT REVISED 09 -06
MAWDADE
DATE: 09/27/2011
TIME 15:33:26
MIAMI - DADE COUNTY, FLORIDA
FINANCE DEPARTMENT
TAX COLLECTION DMS1ON
140 W. FLAGLER STREET 1
MIAMI, FLORIDA 33130
LOCAL BUSINESS TAX LBTR YEAR 2012 OCLM0317
ACCOUNT FILE MAINTENANCE
ACCOUNT : 661598-4 COMM-DATE: 04 2010 ENTRY-TYPE-DTE: W 04/27/2010
B U S I N E S S : DELETE-ST: INSP-ID-DTE: 00/00/0000
NAME: MAX ELECTRIC CORPORATION
ADDR: 2240 SW 67 AVE SUITE: 7
ZIP: 33 155 MUN: 30 ZONE: 07 PHONE: ( 305 ) 498 5422
CORP / OWNER (MAILING) :
NAME: MAX ELECTRIC CORPORATION C/O: MARCELINO FERNANDEZ PRES
ADDR: P 0 BOX 442184 CITY: MIAMI STATE: FL
ZIP: 33144 HOME OFFICE: Y
OTHER INFORMATION:
PP-FOLIO: 00 000000 SSN/EIN: E 204255061 BADCHK:
RE-FOLIO: 30 4011 019 1300 FICTNM: LAST-TRANS-DTE: 04/27/2010
....................................
LBT RCPT SEC TYPE AMOUNT-DUE D/R PD LEGAL INSP-ID INSP-DATE HOLD-LIC
688648-6 196 ELEC P
F1=MENU CLEAR=PREVSCREEN F4=MORERCT ENTER=RCT F9=UPD F12=PAPPL F13=PTX
IMPORTANT: THE INFORMATION HEREIN DOES NOT NECESSARILY CONTAIN ALL PERTINENT FACTS WM REGARDS TO
REAL ESTATE CLOSINGS AND OTHER SIMILAR ACTIVITIES.
1
CERTIFICATE OF LIABILITY INSURANCE
DATE 11m)
PRODUCER United Insurance Group
6741 Coral Way II�59
Miami, FL 33155
Phone (305)261 -1334 Fax (305)261-2329
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIG}ITS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDNNG COVERAGE
NAIC #
INSURED MAX ELECTRIC CORPORATION
PO Box 442184
Miami, FL 33144
1(305) 498-5422
INSURER A NATIONAL GROUP
A
INSURER B:
GENERAL LIABILITY
CCM ERCIAL GENERAL' UABILRY
INSURER C:
09/26/2011
INSURER D
EACH OCCURRENCE
INSURER E:
DAMAGE ( TO RENTE
P occur re
COVERAGES
THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAND ABOVE FOR THE POLICY PERIOD INDICATED. NO1WITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUIVENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE KISUED OR
MY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMMS.
RIVER
_ 11
ADO%
I, ' iL
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE :.. ,..
POLICY EXPIRATION
DATE : „. �,l..� j
LIMITS
A
■
GENERAL LIABILITY
CCM ERCIAL GENERAL' UABILRY
BINDER 110929
09/26/2011
09/26/2012
EACH OCCURRENCE
1,000,000
DAMAGE ( TO RENTE
P occur re
$100,000.00
MED EXP (Any one person)
$5,000.00
• ❑ CLAWS MADE n OCCUR
❑
PERSONAL & ADV INJURY
1,000,000
❑
GENERAL AGGREGATE
2,000,000
GEM_ AGGREGATE MIT APPLIES PER:
❑ POLICY ❑ PROJECT • LOC
STS' �' AGG
2,000,000
AUTOMOBILE LIABILITY
DINED SINGLEUMT
(Ea. rd)
• ANY AUTO
❑ ALL OWNED AUTOS
❑ ' SCHEDULED AUTOS
0 HIRED AUTOS
W.) ll2Y
(Per person)
(Per Pson)
•
BODILY INJURY
(Per accident)
• NON OWNED AUTOS
❑
PROPERTY DAMAGE
(Per
•
•
GARAGE mammy
❑ ANY AUTO
❑
AUTO ONLY- EA ACCIDENT
OTHER THAN EA ACC
AUTO ONLY: AGG
❑
EXCESS! UMBRELLA LIABILITY
❑ OCCUR • CLAIMS MADE
❑ DEDUCTIBLE
❑ RETENTION $
EACH OCCURRENCE .. .
AGGREGATE
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY YRN
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER / MEMBER EXCLUDE)?
(laudatory In NH)
If yes, describe SPECIAL PROVISIONS below
0 WC STAB • OTH-
TORY LIWTN ER
E.L. EACH ACCIDENT
E.L. DISEASE- EA EMPLOYEE
E L DISEASE - POLICY Isar
OTHER '
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVIMNS
CERTIFICATE HOLDER
CANCELLATION
Miami Shores Village Hall
10050 Northeast 2nd Avenue
Miami Shores, Florida 33138
SHOULD ANY OF THE ABOVE DESCRIBED PouC1ES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE ciarnErome HOLDER NAMED TO
THE LEFT, BUT FAILURE To DO so SHAD- IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURBR, ITS AGENTS oR REPRES TATIVES.
AUTHORIZED RITATWE„
ACORD 25 (2009101) OF
1918-2009 ACORD CORPORATION. AB rights reserved.
The ACORD name and logo are registered marks of ACORD
Max fleetrie Corp.
2240 SW 67th AVE Apart# 7.
Miami, Florida 33155
Phone: (305) 498 -5422 FAX: (305) 262 -5401
E -mail: maxelectriccorp@hotmail.com
License #: CC 10E000182
Job Address: 190 NW 93 ST
FPL
3 2/0 THWN Cu
in 2" Rigid
1 - #4 THWN Cu in 1/2"
PVC coed
SEP 2 8 2011
Owner: MANUEIAJE
3 2/0 THWN Cu in 2" EMT COND
01-033-0970
PPfOVED
?D!\?'NG DEPT
DG DEPT
;t i,n c r ro COMPLIANCE WITH ALL FEDERAL
� rl AN1) CouNry RULES AND REGULATIONS
5/8" x 8' Cooper -clad ground
rods minimum 6' apart
To CWP & Fuel pipe
NEC 250.10413
Marcelino Fernandez. Master Electrician.
NOTARY STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Sworn to and subscribed before me this " 6 - o by:
Reinaldo Amador . Pe ' • c, '��