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ELC-11-1749Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164774 Scheduled Inspection Date: December 19, 2011 Inspector: Devaney, Michael Owner: Permit Number: ELC -9 -11 -1749 Job Address: 10500 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: AMENGUAL ELECTRIC INC Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1122300010500 Phone: 786 - 344 -6710 Building Department Comments BRING UP TO CODE EXISTING LIGHT FIXTURES Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments // December 16, 2011 For Inspections please call: (305)762 -4949 Page 9 of 34 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 SEP 2 3 2011 BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 20 ov-iseAgrip,t. 1149--avvia\g- Permit Type: Electrical ,�.� j�� OWNER: Name (Fee Simple Titleholder): I)s( :41W/' Phone#:L ` 4S S# 19151C. Address: /0 -Dt #8 ' At 6.10 City: State: Zip: I1OS Tenant/Lessee Name: Email: I�yN�'e leryneq- Phone #: geff JOB ADDRESS: /t P 1/11M Y /`'r 6 'te/i‘ , City: Miami Shores County: Miami Dade Zip: ,TI Folio/Parcel #: oz. 3too 10 Sao Is the Building Historically Designated: Yes NO Flood Zone: iefue giereiroo ive: Phone #: 7 424 . CONTRACTOR: Comp N f t/f me: 44' Address: $ " City: % ��SSt'tate: 7"`� Zip: Qualifier Nam' ame: =�'' t . ✓ ti Phone #: % '°1�y�fe State Certification or Registration.,#x We &Of,. ' Certificate of CCompetenc #: ee,.0,,717�!�"Jr ►1 Contact Phone #: 7ft sr '0 � ' Email Address: a 144 "4'�� '+�7 • Ake' DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ /40 ''tea Square/Linear Footage of Work: Type of Work: ❑Address n ❑Alteeratiioon ❑New • ❑Repair/Replace •, r❑Deemmolliitioonn Description of Work: ,�J�"/ '!r f6 T O ",11,' `� T i =�" ************* ****** ***********+x ******** Fees**** *****+ x******** *** *****a:***************** Submittal Fee $ Permit Fee $ di '—e<E't°' CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 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. 1, certify that no work or installation has commenced prior to the issuance of a ;permit and that _ All work will be performeA to met the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit'mustbe 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. Ii the absen such posted notice, the Signature inspection will not be approved and a reinspectiorffee will be charged Signature Owner'or Agent Contrac The,foxegoing instrument was-acknowledged before me this lel The foregoing instrument was acknowledg day of > �1, by day of 5I „20 elf, b, who . personally known fine or who has produced who i ersonally kno to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: before My Commission Expires: NOTARY "PUBLIC: , ,.4 CoMMISSI0 #DD883668 My Commission E ►iris. : Q ?EXPIRES: APR 26 2013 >i�a '•r o ° www.AARONNOTARY.com tnno ** * * * * * * * * * * * ** k**** **+ k**** *Ni******** ***K= ******* *+ k* ***+ k*** * ******>k+A*KiBge,kih** NQ* Na**>N+k** ** * * * * * *** * * * * *** **+kK *** Zm // SI2 Plans Examiner Zoning APPROVED BY Structural Review (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) Clerk ut CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self- performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: i PERMIT # L 1 .1— 1149 ADDRESS: 70n0 r4'/c r / , i'b FOLIO NUMBER: HR 23 FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): COST OF PROPOSED IMPROVEMENTS: (ATTACH COPY OF CONTRACT) try ortik P%-r cos-( TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): 41)61 VALUE OF PRINCIPAL STRUCTURE (attach appraisal): I I OWNERS SIGNATURE: PLANREVIEWER: PLAN REVIEWER SIGNATURE: DATE: 01 DATE: Created on June 2009 SUBSTANTIAL IMPROVEMENT / DAMAGE LIST (NOTE: THIS LIST IS INTENDED FOR GUIDANCE ONLY, AND IS NOT ALL INCLUSIVE) ITEMS TO BE INCLUDED ALL STRUCTUAL ELEMENTS, INCLUDING Foundations including; Spread footing, Continuous footing, isolated footing, piles and pile caps Slabs including; Monolithic, floating, elevated Walls including; Exterior walls, Bearing walls, Shear walls Beams, Tie Beams, Columns and Posts Wood decking, Floor and Roof Sheathing Trusses, Joist Windows /Doors ALL BUILDING ELEMENTS, INCLUDING Interior Partitions, Walls, Columns Drywall, Ceilings, Built in Furniture, Cabinets, Vanities All Fixtures Flooring, Tile, Carpet, Stone, Linoleum, ect. All Finishes including Drywall, Paint, Stucco Plaster, Paneling, Tile, Marble, and Moldings Roofing Material ALL HARDWARE ALL UTILITY and SERVICE EQUIPMENT HVAC Electrical System and Equipment Plumbing System and Equipment Security System and Equipment Central Vacuum System Plumbing Fixtures Lighting Fixtures and Ceiling Fans Water Systems including Softeners /Filtration Created on June 2009 ALSO: All Labor and other Costs associated with Demolition, Removing, Replacing, Installing Building or Altering Building Components Construction Management / Supervision Overhead and Profit Equivalent cost for: Donated Materials Volunteer Labor (including owners and friends) Any Improvements Beyond Pre - damaged Condition, including; Utility Upgrades Code Upgrades ITEMS TO BE EXCLUDED Plans and Specifications Survey Costs Elevation Certificate Costs Permit fees Debris Removal Items not considered to be REAL Property Rugs, Furniture, Refrigerator, Appliances not Built -in Outside Improvements, Including; Landscaping Sidewalks Patios Fences Yard lights Sheds Gazebos Irrigation Pool Miami -Dade My Home Page 1 of 2 My Home min rr7id1d ?.gov Show Me: Property Information Search By: ...._ ..............__. Select Item IN Text only Property Appraiser Tax Estimator Property Appraiser Tax Comparison Summary Details: Folio No.: 11,2230 -001 -0.540 Property: 10500 BISC BLVD Mailing SHORES AT BISCAYNE LLC Address: 1 Living Units: 4815 AVENUE N Adj Sq Footage: BROOKLYN NY Lot Size: 11234- Property Information: Primary Zone: 15000 MULTI - FAMILY, HIGH DENSITY RESIDENTIAL CLUC: 0022 MOTEL Beds/Baths: 58/58 Floors: 1 Living Units: 58 Adj Sq Footage: 15,248 Lot Size: 47,254 SQ FT Year Built: 1950 $0/ $1,658,468 JULIA D TUTTLE PB B-4 City: N335FT OF S1/2 OF $1,658,480 SE1 /4 OF SW1 /4 LYG W Legal OF FEDL HWY LESS Description: S37.5FT FOR CANAL R/W & LESS NE105ST LOT SIZE IRREGULAR OR 18992-0301 01001 Assessment Information: UTI 2011 2010 2011 $477 130 M= ,1 -,48' Applied Taxable Value Information: Year: 2011 2010 Applied Applied Taxing Authority: Exemption/ Taxable Exemption/ Taxable Value: Value: Regional: $0/ $1,658,468 $0/ $1,658,480 County: $0/ $1,658,468 $0/ $1,658,480 City: $1,658,468 $1,658,480 School Board: $0/ $1,658,468 $0/ $1,658480 Sale Information: es ualiflxation : es which are qualified mnrintinn• ACTIVE TOOL: SELECT nOME Aerial Photography - 2009 0 137ft My Home Property Information 1 Property Taxes � My Nelahborhood j Property Appraiser Boma 1 'Mina Our Site 1 Phone Directory I the21L 1 Disclaimer It you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site © 2002 Miami -Dade County. All rights reserved. MIAMPDADE Legend Property Boundary Selected 'N Property Street Highway Miami -Dade County Water W e http: / /gisims2 miamidade gov/MyHome /propmap.asp 9/26/2011 1 AC(3Rt?e CERTIFICATE OF LIABILITY INSURANCE DATE (Wa VDIYYYYI 02/14/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORM ZION 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 POLICES 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 AOD TIONAL INSURED, the pollcy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the tonne and conditions of tip certain policies may require an endorsement A statement on tides certificate does not corder rights to the certificate holder hr lieu of such endorsement(s). mumucrat 305 -639- 2425 305 -839 -2427 C, Jimenez J.C.A. Consultant, Inc 4615 NW 72nd Avenue #110 Miami. Florida 33166 INSURED Amengual Electronic Inc. 3851 NW 12 Terrace Miami, Florida 33126 PEEL E:ltt 3067639-2425 At171@O�S& INSURERISI APFOROSIO COVERAGE tAJC.No1 X89 -2427 ti¢4URMT A : Scoitsdaie tnsuranr„e Company INSURER B ; MSURgIC: INBURERLi: HAW COVERAGES • ORTUAER E : MINTER f • Mr.... ,. fl Ws n. 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 WTH RESPECT TO WHICH TICS 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 PPO�LLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OP INSURANCE auSttlwan POLICY MOANER 2011035 � `µ4- wen A GENERAL LAM Y/ ✓ cowman!. GENEik-AL�LWBILM' F EACH L NCE . ;ammo! �aat l _0,0130,000 ._.J CLAIMS-MADE `r ] occuR 021t4/2011 02/1412012 ExiAnh one prose) $ .000OI�. - - $ 5.000 pERsomtat ADy y $ 500.000 $ 1.000 000 s500.000 $ GENERALAGGREGATE GEHL AGGREGATE UWTAPPLIES PER: PRODUCTS- 7 mucr Cl p �Lo AUTINENTILE LMt39JTY COMBINED SINGLE LILT Amebas!) I _ _ AAA{NL�Y AUTO BOOLY INJURY (Pet person) 1 Wrap TEREDAUTO$ — AUTOS AUTO SODAS INJURY ate 8 DAMAGE i _ _ $ UPSEIRELLA LIA8 MESS LIAR i OCCUR I cuAILLSaADi EACH OCCURRENCE a AGGREGATrE s- DED RETENTIONS i WORXENSCONPENSATION AND ELiPLOYERS LIAaBJTY Y I N OPROEMNESMER OCCLUDED? N OF TTONS Wow NIA TAT SU- T 'S E.L EACH AtxlOEtdt S EL DISEASE • EA EIIPLQYEE S EA- DISEASE - POLICY LSAT S oescia noir OF OPERATIONS T LOCATIONS! VDUs E$ Wine AOORD on. Aers000m Ramada Schedule. if mom spoor lseeg edl Schedule In master policy: CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 N E 2ND. AVE. MIAMI SHORES, FLORIDA 33138 SHOULD ANY OF THE ABOVE DUMBED POLES BE CANCELLED BEFORE 7HE EXPIRATION DATE THEREOF. NOTE WILL BE DB.IVERED IN ACCORDANCE W1TH 114E POLICY PSIS. AUTHORIZED REPRESEdrrAIIVE Jose C. Jimenez ACORD 28 (201010S) 1888•2010 ACORD CORPORATION. At! rights rest. The ACORD name and too are registered marks of ACORD 03 -08 -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. rJ EFFECTIVE DATE: 03/08/2010 EXPIRATION DATE: 03/07/2012 PERSON: AMENGUAL BERNARD FEIN: 591654275 BUSINESS NAME Ate ADDRESS: AMENGUAL ELECTRIC INC 3851 NW 12TH TERRACE MIAMI FL 33126 SCOPES OF BUSINESS OR TRADE: 1— GENERAL CONTRACTOR 2— ELECTRICAL CONTRACTOR 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 under this section may not recover benefis or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Cortificatea of election to be exempt... apply only within the scope of the business or trade listed an the notice of election to be exempt. Pursuant to Chapter 440:05113), F.S., Notices of election to be exempt and certificates of election to he 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 issnence of a certtficote. 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 rnetr_fc') rcRTI If'ATP (IF Fl F1 TIfRt Tn RF EXEMPT REVISED 09 -06