EL-11-1470Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 168473
Permit Number: EL -8 -11 -1470
Scheduled Inspection Date: January 11, 2012
Inspector: Devaney, Michael
Owner: CHARLES, R GREGORY
Job Address: 790 NE 91 Street 8
Miami Shores, FL
Project: <NONE>
Contractor: SAL ELECTRICAL CONTRACTORS CORP
Permit Type: Electrical - Residential
Inspection Type: Ro h
Work Classification: Al ation
Phone Number
Parcel Number 1132060390080
Phone: (786)344 -4762
Building Department Comments
ELECTRICAL WORK FOR KITCHEN REMODEL
fi)L)fi
Passed
17
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
January 10, 2012
For Inspections please call: (305)762 -4949
Page 26 of 37
Nov 21 11 09:03a Sal Electrical
I \V v. 1 V. LV 1 1 1 JJI nI
305118290958 p.l
H V• Y J I J. • L
DATE I MIIDOMYYYI
11/1812011Ft
ACORD CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
C & C kura nce
1921 NW 150 AVE SUITE 101
Pembroke Piles FL 33020
THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
INSURERS AFFORDING COVERAGE
NM*
mew=
SAL ELECTRICAL CONTRACTING, CORP
RAMON SALAZrAR
7803 NW 199 STREET
MIAMI FL33015
INSULteR A BMWs IIIMIMRC6 Co
INSURER $ CasSep*ifte Florida Ins Co
INSURER
INSURER D:
INSURER e:
THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSUR6D NAMED ABOVE FOR THE POLICY PERIOD INDICATE° 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 POUCLES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDrrIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLJUMS.
l T'RR
SRI)
TYPE DiEwoRsamIcE
POLICY NUMBER
111Ti 110
Pt1AT£ I
TI
LASTS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL 41BAITY
090005331623202
03114/2011
0311412012
EI1GY1 OCCURRENCE
$ 1,000,000
X
PRFNI Sja • - )
$ 100,000
$
1 CLAM MAO Ili.] OCCUR
MEC E P (Anlroney&wn)
PERSONAJ.$ *DV INJURY
S1000,000
{ ERAJ. AGGREGATE
s 2,000,000
N'L AGGREGATE LIMIT PER:
PROOUC'TS- COMP/OP AGO
3 1,00@,000
I POLICY' J r: LOC
AUTOM0$AE'AMITY
ANY AUTO
ALL OwNEDAUTOS
SCHEDULEDAVTOS
MIRO AUTOS
NON -OWNED AUTOS
COIIIBW4EDSINGLE UMR
(Ea,laeiesnij
8
—
B&ODILYINJ'URY
$
_
BODILY INJURY
(Per ECCldW*)
=
.,
. —
PROPERTY DAMAGE
(Per eaddel I
le
GARAGE
Lt AeIulY
ANY AUTO
AUTO ONLY -EA ACCIDENT
$
R
maw THAN EAACC
S
AUTO ONLY: AGG
$
BAN$IBR LLA LIANA-11Y
OCCUR n CLAIMS MADE
RETPNT+DN s
EACH OCCURREME
$
AGGREGATE
3
�DEOUCTIELE
$
$
8
WORKER8C0>IwENSATION AND
EMPLOYERS' LIAEALGY
ANY OFF mmeosE IEACLUB IVF
OFFICERRIEaA9ER EXCLUDED'? E
If yes. cisaate NON
SPECIAL ITSAO. r1ONS Wow
WCPT80500 00
0912312011
09123/2012
7 WC s ` t
X 11Nrram\Iura l Mr
E L EACMAGCXUENT
*100000
E�L.OISEASE- EAEir1 . E
$ 100000
DI - POLICY LJMR
S 500000
OTHER
_EA_
DHBCRIP110N OP OPBRATNONI I LOCATWN$ /VEHICLES i$XCLUSIONY ADDED my ENDORSEMENT f SPECIAL PROVIBR)NS
ELECTRICAL CONTRACTOR
CERTIFICATE HOLDER
C
CITY OF MIAMI SHORES VILLAGE
10050 NE 2 AVENUE
MIAMI SHORES, FL33138
SHOULD ANY OPINE ABOVE DESCWBIEDPOL.ICI3$ BE CANCELLED DEFORE THE EXPIRATION
DATE T'NEREOP, TM ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS EMMEN
Nonce To THE CERTIPIGATE HOLDER NAMEDTO THE LEFT, DOT FAILURE TO DD Sb SHALL
IMPOSE NO OBLIGATgN OR LIA8IUTY OP ANY Yaw UPON TNL DID ITS AGENTS an
RBPRESENTATNES.
-,
AUTHORS ED REPRP-BENTATNE O
0 ACORD CORPORATION 1909
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 No.
Master Permit No.
•Ipl VINWS
B AUG 1 ?, 2011
Permit Type: Electrical %� OWNER: Name (Fee Simple Titleholder): fRt2 ,010 `p" d r or, Phone# ) E *-725 % 6T1-'8
Address:
q o ,erg. s-t
City: J41.44 -2/44 State:
Zip: 3 -'1 S
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS:
q ® A) 7/ %-t-
City: Miami Shores
Folio/Parcel #:
Is the Building Historically Designated: Yes
County:
Miami Dade
Zip: >3 l -a41
CONTRAC TOR. Company Nam
o
, tate:
17117.7. ts Okt iil
Address:
City:
Qualifier Name:
NO Flood Zone:
747vcrn
T1 ��
Phone #: ■ 5<## <476.2'
Phone #:
State Certification or Registration #: 42-417/Z /3 4 42/04' Certificate of Competency #: e 3 ® 02079
Contact Phone #:
DESIGNER: Architect/Engineer: Phone #:
Email Address:
Value of Work for this Permit: $, `75::3`' 00 Square/Linear Footage of Work:
Type of Work: Address DAlteration
Description of Work: 1 +011(w
ONew )Repair/Replace
ODemolition
******** ** * * ** ** ***** * ******* ***** ***** Fees************* *****$m** * ** **** ** ****m********
Submittal Fee $ Permit Fee $ /.6 -;0',04? CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ I09•
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 : 'ction which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspec on will be approved and a reins• • fee will be charged.
\ \1
Signature
The for ;going ins
day of
identification and who did take an oath.
My Commission Expires:
* * * * * * * * * * * * * **
APPROVED B
< - ,'y
•
.F R�
* * ****x:+x *** *** :**** *+ xx: x: *: xx: *+ x************=i: **: x**+ x* ************** ***+><*******
//
NOTARY PUBLIC:
Sign:
Print:
ELAINE CAItMONA
: *c MY COMMISSION # DD734976
EXPIRES November 18, 2011
83 FlorldallotaryServics.com
$i I „VI...
(Ctl,te frr1G,1(A
My Commission Expires: A.101) f c) L /
Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk
air
74010--
87116.
SEE OTHER SIDE
DO NOT FORWARD
SAL ELECTRICAL CONTRACTORS CORP
RAMON SALAZAR PRES
7803 NW 199 ST
MIAMI FL 33015
1,11111.11.11
02
601401.•-rol*Aki
SAL ELECTRICAL CONTRACTORS CORP,
RAMON SALAZAR PRES
7803 NW 199 ST
MIAMI FL 33015
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4.
STATE OF FLORIDA
DEPARTMENT -OF BUSINESS 'AND PROFESS/ONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395
1940 NORTH MONROE STREET
TAT.T.AWA Rs= FL 32399-0783
SALAZAR. RAMON
aaL ELECTRICAL OMMACTING CORP
7803 NW 199TR ST
MIAMI FL 33015
Compatulationsi WM this game you become one of the nearly one million
Floridians licensed by the Department of Business and Professional Regulation.
Our professionals and businesses range Iran architects to yacht brokers, from
boxers to barbeque restaurants. and they keep Florida's economy strong.
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•
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.myltoridelicense.corn.
There you can find more Infommtion about our divisions and the regulailtursttat
impact you, subscribe to department newsletters and team more about the
Departments Mistimes.
Our mission at the Deperbsterd be Llama Effsierdly, Regulate Fairly. We
constantly strive to serve you befter so that you can serve your crstomers.
Thank you for doing business in Amide, and congratidallons on your new Wens&
DETACH HERE
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Nov 17 11 03:38p Reynaldo Rodriguez
3058166483
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AcO� CERTIFICATE OF LIABLITY INSURANCE
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Silciae Hamm
(.'ITYOF MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
10050 Northeast 2nd Ave
Miami Shores FI,33138