The URL can be used to link to this page

EL-11-1742Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 166186 Permit Number: EL -9 -11 -1742 Scheduled Inspection Date: November 07, 2011 Inspector: Devaney, Michael Owner: Job Address: 10070 N MIAMI Avenue Miami Shores, FL Project: <NONE> Contractor: ROMA ELECTRIC SERVICES CORP Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number (305)220 -6990 Parcel Number 1131010210100 Phone: (305)216 -1164 Building Department Comments 1 GFCI FOR BATHROOM, 2 GFCI FOR KITCHEN 2 REGULAR RECEPTACLES ON LOAD. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments November 04, 2011 For Inspections please call: (305)762 -4949 Page 28 of 42 Plantation g. is r- ,rrrnrr Classification: City of Plantation LOCAL BUSINESS TAX CERTIFICATE Valid from Oct 01, 2011 to Sep 30, 2012 4 -D13 Electrical Contractor Business Name & Address: ROMA ELECTRIC SERVICES CORP.,�i.. RIGOBERTO VAZQUEZ (QUALIFIER) c ce�oNnavaE CITY 8255 W SUNRISE BLVD. #208 PLANTATION, FL 33322 NOTICE: If Business is sold this Certificate must be transferred within 10 days or it becomes null and void. Certificate + 132694 Accounts OC10 -0672 THIS CERTIFICATE MUST BE CONSPICUOUSLY DISPLAYED 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical RECEIVED SEP 2 2011 BY. Permit No. • L 1 I - Master Permit No. OWNER: Name (Fee Simple Titleholder): �/�� /`�'% Phone: �d �c 7 / %© Address: /Po 70 4/ 41 All &' City: / V710 /-�� State: Zip: 3 3 /S-e? Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: /,∎ ;' /v ° M 7 A 2 7 % "4.165- • City: Miami Shores County: Folio/Parcel #: //3/0/g--/.12/ a9 Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: i • City: yam[ /or./ ar J States Qualifier Name: , A.:.= Miami Dade NO 1/ Zip: Flood Zone: , , S State Certification Reg Contact.Phone# 62;41r Phone #: / ,% 47 /�/ti 0,14c?-- Phone #: Zip: tration #: Certificate of Competency #: ®e 3 l / O Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ ,SVA 4947 Type of Work: °Address Description of Work: Ampurammew °Alteration Square/Linear Foo of Work: °New /Re P lace P °Demolition L *x *** ***** ******************+ *** Fees+ x****** ***** ***** ****** ***+x***+x************* Submittal Fee $ Spanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Permit Fee $ "0"e" CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ I I . j 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 AFF'IDAVIT: 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 ust be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the ab /ce of such posted notice, the inspection will not be approved and a rein pecti be charged. 'molar Signature er or Age Signature C' ntractor The foregoing instrument was acknowledged before me this 9 The foregoin instrument was acknowledged before me this l day of , 20 %i , by /na l lam/ , day of , 20, j , b who i ersonally mown to me o o has produced who is personally known to me or who has produced 4) +..! s 1 ' en cation and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: m % � ��iu -' ; _ �® Sign: Print � n ✓�e l-�� i t = c :,;°�~ o4 ,, . r ° °i — \ \ _ �Y Plik DIEZ _ N JEANN o, _•� � � -1. MY CAMMISSION # DD 9146%, a , mmission Expires: �: �� ,.......7.....,..„,,,... � ��h *' • *- EXPIRES: August 16, 201.3" "° ?! ° Bonded Thru Notary Public Undenrmte<s �.�� ,,,c,,..-,,,,,,.- My Commission Expires: APPROVED BY s '- Z 54)7' Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3 /15/09) SEP -16 -2011 10:23 FROM:A PLUS ELECTRICAL TE 052604690 AC# TO:13057568972 P.1 STATE gOFFFFLORIIDA DEPAR�CTR •TCALSCONTRACTORSRLICENSZN( B04114 4r"�iTiON SEQ# nio'ersa9.o c490 LICENSE NBR. 08/29/2010 J107011223 EC13003190 ,* .Bueine 131. 91.7411i ficatioTa, The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of 'Chapier 489 PS. Expiration date: AUG 31, 20121 VAZQUEZ, RIGOBERTO ROMA ELECTRIC SERVICES CORP 10181 NW 21ST ST PEMBROKE PINES FL 33026 CHARLIE CRIST GOVERNOR DISPLAY AS REQUIRED BY LAW'. CHARLIE .ILIEM SECRETARY CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/16/2011 INFORMATION CERTIFICATE EXTEND OR BELOW. PRODUCER FIRST RATE INSURANCE AGENCY INC . 8508 -2 SW 8 ST MIAMI, EL 33144 (305) 266 -9565 THIS CERTIFICATE IS ISSUED AS A MATTER OF ONLY AND CONFERS NO RIGHTS UPON THE HOLDER, THIS CERTIFICATE DOES NOT AMEND, ALTER THE COVERAGE AFFORDED SY THE POLICIES INSURERS AFFORDING COVERAGE - NAIC# 524210 INSURED ROMA ELECTRIC SERVICES CORP. 8255 WEST SUNRISE BLVD 4t208 PLANATION, FL 33322 - I INSURER k. APPALACHIAN UNDERWRITERS INSURER B: ASCENDAT A INSURER C ; _ GENERAL X INSURER D: AGL86943 INSURER E 01/04/12 THE POLICIES OF INSURANCE USTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Use LTR ADOL INSRD TYPE • F .1 RAN E POLICY NUMBER SATE EFFI; TIVE DATE MM/0 • POLL 3 "' ' DATE 141M/D- • IAN LIMITS A . GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY AGL86943 01/04/11 01/04/12 EACH OCCURRENCE S 2,000,000 $ 100,000 S 5,000 PREMISES (� Ea�o once) ICIAIMSMADE X OCCUR MEDEXP (Any one perm) GEWL 7 PERSONAL& ADV INJURY $ 2,000,000 $ 2 000,000 GENERAL AGGREGATE AGGREGATE LIMIT APPLIES PER POLICY II jECT fl LOC PRODUCTS- COMP/OP AGG ( $ 2,000,000 AUTO LIABILITY ALL OWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNEDAUTOS COMBINED SINGLE LIMIT BODILY IN uRY (Per mean) $ — _ (PerDlmLvYd MU)� $ — PROPERTY DAMAGE (Peratttaden$ $ GARAGE LIABILITY ANYAUTO AUTO ONLY- EAACCIDENT $ OTHER THAN EA ACC 8 AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR E CLA114ASMADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ 8 _ _ $ $ H WORKERSCOMPENSATIONAND EvaLOYERS LIABILITY WC- 603363 12/08/10 12/08/11 X TO °YLIMt : [ EL EACH ACCIDENT $ 100 , 000 ANY PROPRRTORJPARTNERSOECUTNE OFFIcERAiEMBER =IUmo? Ify .deacrlbeunder SPECIAL PROVISIONS below E.L DISEASE • EA EMPLOYEE $ 100,000 El, DISEASE - POLICY LIMIT $ 500,000 OTHER • DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONSADDED BY ENDOR$ MENT/ SPECIAL PROVISIONS ELECTRICAL CONTRACTOR CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138 J CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO M,a3,0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO i • N OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRO AUTHOR .!3:i11 ENTATIVE ACORD25(2001!08) ©ACORD CORPORATION 1988 SEP -16 -2011 10:23 FROM:A PLUS ELECTRICAL TE 052604690 • a •,• • ROMA ELECTRIC SERVICES CORP., 8255 SUNRISE BLVD. #208 PLANTATION, FL 33322 PLintatice P son fx Greene Classification: TO: 130575613972 P.2 Detach end display the Local Business Tax Certificate below. Renew and display current Certificate annually. City of Plantation LOCAL BUSINESS TAX CERTIFICATE Valid from Oct 28, 2010 to Sep 30, 2011 4-D13 Electrical Contractor Business Name & Address: ROMA ELECTRIC SERVICES CORP., RIGOBERTO VAZQUEZ (QUALIFIER) 8255 W SUNRISE BLVD. #208 CITY CLERK SIGNATURE PLANTATION, FL 33322 NOTICE: If Business is sold this Certificate must be transferred within 10 days or it becomes null and void. Certfcate # 130479 Account # OC10-0672 THIS CERTIFICATE MUST BE CONSPICUOUSLY DISPLAYED