Loading...
EL-11-1545Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 171176 Permit Number: EL -8 -11 -1545 Scheduled Inspection Date: March 15, 2012 Inspector: Devaney, Michael Owner: PACE, BRUCE Job Address: 69 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Contractor: GARY B ELECTRIC & CONSTRUCTION CONSULTANT INC Phone Number Parcel Number 1132060131150 Phone: (305)259 -8790 Building Department Comments RE -WIRE HOUSE SERVICE REPAIR Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments it(,./2._ 4 -4'1(0 -1°3 March 15, 2012 For Inspections please call: (305)762 -4949 Page 10 of 14 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. VHS-IS Master Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical Phone#: slit 7 - 7 y' OWNER: Name (Fee Simple Titleholder ) : ebi r Address: 62e N L 1 r S City: oiU'ik.0 zj LJ2)V G) State: FL"-- Zip: nn�l� Email: ki�UCE ct U A14.[L- • a Ark JOB ADDRESS: V h9 E 1 Tenant/Lessee Name: City: Miami Shores Folio/Parcel #: Phone#: County: Miami Dade Is the Building Historically Designated: Yes CONTRACTOR: Company Name: /f Address: ! 4 2 / 41 ` / tJ NO Zip: '17/171 Flood Zone: Phon4l ®fl a s (' P 7 / O City: I% I State: a4 Qualifier Name: f E /vd''r A P IV /4 L/ State Certification or Registration #: r!?, 62/ Contact Phone# (7 /C/ yet -0 /91' Email Address: IM y 4 &,If f %1 Ac_ ci- �/e o C 9 n DESIGNER: Architect/Engineer: / zip: 7 f 7 q Phone#'% f12S7 ' e i 2 r Certificate of Competency #: !B 61 H/ Phone#: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address A ❑Alteration ❑New Repair/Replace ❑Demolition / Description of Work: * ** * * * **** **** ********* * ***************Fees********* *********************x *** **+x***** ** Submittal Fee $ ) Permit Fee $ /1;0 ' 6.4. CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Nl 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Own + or ent owledged before me this Si� , 20 /L, by Aran,- tn. c -t The foregoing instrument w day of who is personally known to me or who has produced .vvs Sr: As identification and who did take an oath. NOTARY PUBLIC: Sign: a Print: 1-e 4 4. /1/u r- My Commission Expires: n W A, NuTi JUN Note Public, State of Now If 4 I* Qualified in Columbia County 0D106013738 ecnsmission Expires hmuary 19, 2007 Con i act +r The foregoing instrument was acknowledged before me this I i day of , 20 14_, by Ben 9 My: -k p who is p sonal1y'kno o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Prin (A y\ da L.L`aLt My Commission Expires: ,.``111!' ?���% -inda Bruscla _$• .., ( COMMISSION #DD976748 • Si EXPIRES: MAY30,2014 y it iF wIw.AARONNoTAE m >H**=K=k*****>k***=km:x * ** * ** *** * **a:> *** * * * ** ***** ex*****> x****e************** *> k**** *,x *****>H** **:x***** * *** **** x***** APPROVED BY 4 kiiI-6,131ans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk Construction Trades Board USINESS CERTIFICR —OF-COMPETE NCY H rPF BENJAMIN A 10 of ���, Is certified cinder the proms of Chapter 0001 —qt IAI 1FYING TRADE(S) ELECTRICAL 1L.+q @ec�slc P.E. � S�etary ar Board taia3 -112de 6=4 teta!m ai stydam• r-wo w.inisnrldada 1 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 DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION1 IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. .,/ COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. / COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. _a COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. J 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: 0) Ole- r - C uri i-t1 L Ul s ( y-i t Lf7r BUSINESS ADDRESS: C� (7 (�` ; SUS 9 . CITY rn i ( 1Y \ t STATE Fl _ ZIP CODE 3 -3 I BUSINESS PHONE: (3c 5) 5 9 °6 l9c FAX NUMBER (2 ) 2 3 1- 5"/ CELL PHONE ('J L ) 3 0(0 -01 '=d c) QUALIFIER'S NAME: +`Y' 1� l_ro p QUALIFIER'S LIC NUMBER: 0 G., 0 (I 3 I E -MAIL ADDRESS (IF APPLICABLE): C1 1 b t C) c (t' V 6 e( C'_ -- (t c- 0 e Created on 3119109 BY MLDV I RV 3126109 MLDV MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 585150 -7 BUSINESS NAME / LOCATION GARY B ELECTRIC & CONSTRUCTION CONSULTANT INC 9762 SW 190 ST 33157 CUTLER BAY OWNER GARY B ELEC & CONSTRUCT CON INC Sec. Type of Business 196 ELECTRICAL CONTRACTOR THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDERS QUALIFICA- TIONS. 2011 LOCAL BUSINESS TAX RECEIPT 2012 MIAMI -DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2012 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 &,1D THIS IS NOT A BILL — DO NOT PAY RENEWAL RECEIPT NO. 610183 -6 CC # 06E001031 PAYMENT RECEIVED MIAMI -DADS COUNTY TAX COLLECTOR: 07/13/2011 60080000275 000045.00 SEE OTHER SIDE FIRST -CLASS • U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 WORKER /S 1 DO NOT FORWARD GARY B ELECTRIC & CONSTRUCTION CONSULTANT INC GARY BRUSCIA PRES 9762 SW 190 ST CUTLER BAY FL 33157 I{ I ill t/ iit IIVIIIilti1IItit /lIIIIS1i1111111111it111i/dlil Ji MIAMI -DADE COUNTY 2010 LOCAL BUSINESS TAX RECEIPT, 2011 TAX COLLECTOR MIAMI -DADE COUNTY - STATE OF FLORIDA 140 W. FLAGLER ST. EXPIRES SEPT. 30, 2011 ist FLOOFI .. MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL 33130 PURSUANT TO COUNTY CODE CHAPTER 8A -ART. 9 & 10 585150 -7 BUSINESS NAME(r LOCATION GARY B ELECTRIC & CONSTRUCTION CONSULTANT INC 9762 SW 190 ST 33157 CUTLER BAY OWNER GARY B ELEC & CONSTRUCT CON INC WORKER /S Sec. Type of Business 1 THIS IS NOT A BILL — DO NOT PAY RENEWAL RECEIPT NO. 610183 -6 CC B 06E001031 FIRST - CLASS U.S. POSTAGE -� PAID MIAMI, FL PERMIT NO. 231 196 A ELECTRICAL CONTRACTOR THIS IS BUSINESS TAX RECEIPT. IT DOES NOT PERIUI THE HOLDER TO - VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS I5 NOT A. OERTIPICAT4ON. OF THE HOLDER'SOUAUFICA- 1105S. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX -COLLECTOR: 08/24/2010 09010090001 000045.100 SEE OTHER SIDE DO NOT FORWARD GARY B ELECTRIC & CONSTRUCTION CONSULTANT INC • GARY BRUSCIA PRES 9762 SW 190 ST CUTLER BAY FL 33157 { t1i1II1 i1111III111111I1i1I1 liillilli !{i11II:11i1I11I110a9I1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 HUPF, BENJAMIN A GARY B. ELECTRIC & CONSTRUCTION CONSULTANT INC 26465 SW 124TH CT HOMESTEAD FL 33032 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.myfloridalicense.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! (850) 487 -1395 DETACH HERE DATE BATCH NUMBER y 7 ® A� ° CERTIFICATE OF LIABILITY INSURANCE R054 DATE (NIM/DD/YYYYI o8 -01 -2011 THIS CERTIFICATEIS 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 ADDITIONALINSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, subject to 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). PROS PAYCHEX INSURANCE AGENCY INC 210705 P:()- F:(888)443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: PHONE FAX (A/C No,Ext): (A/C, No): (888)443 -6112 E -MAIL PI°ODOUC CUSTOMER ID //: INSURER(S) AFFORDING COVERAGE NAIC d INSURED GARY B ELECTRIC & CONSTRUCTION COSULTANT INC 9762 SW 190TH ST MIAMI FL 33157 INSURER A : Twin City Fire Iris Co INSURER B: INSURER C: INSURER D : 8 INSURER E : DAMGE TO PR MIS S (Ea Roccurrence) INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L R TYPE OF INSWfAN E Sri , INSR SUBR WIND POLICY NUMBER POLICY EFF (MM/DD/YYYY) POUCY EXP (MM /DD/YYYYJ UMITS MIAMI SHORES, FL 33138 G&IERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR • EACH OCCURRENCE 8 DAMGE TO PR MIS S (Ea Roccurrence) 8 CLAIMS -MADE MED EXP (Any one person) 8 PERSONAL & ADV INJURY $ GENERAL AGGREGATE 8 GENT AGGR GATE LIMIT TMIIS PER: LOC PRODUCTS - COMP /OP AGG 8 POLICY JEC 8 AUTOMOBILE L/ABBAY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) 9 BODILY INJURY (Per accident) 9 PROPERTY DAMAGE (Per accident) 8 9 UMBRELLA LMB EXCE&4LL4B OCCUR CLAIMS -MADE EACH OCCURRENCE 8 AGGREGATE 8 DEDUCTIBLE RETENTION 8 8 8 A WORKERS COMPENSATION AND EMPLOYERS' (LABILITY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER atwy in NHI EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS Y/ N N/A 76 WEG TQ7182 03/01/2011 03/01/2012 WC STATU- OTH- X I TORY LIMITS I ER E.L EACH ACCIDENT 0100,000 E.L DISEASE - EA EMPLOYE9 8 100 , 000 below E.L DISEASE - POLICY LIMIT I 8500,000 DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 909, Additional Remarks Schedule, femme space is mqubr I) Those usual to the Insured's Operations. CANCELLATION ACORD 25 (2009/09) ®1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Miami Shores Village BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Building Department DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE - 10050 NE 2ND AVE MIAMI SHORES, FL 33138 7,.- _ 51-.c t • ACORD 25 (2009/09) ®1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD .....,...—.N 0 „AMR CI, CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YY) 08/01/11 PRODUCER Alliance Insurance Agency, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 4i......---' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3339 Virginia St Suite 137 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Coconut Grove, FL 33133 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (305)4'14 8000 Fax (305)444-8020 INSURERS AFFORDING COVERAGE • : NAIC # INSURER A ASCENDANT UNDERWRITERS INSURED Gary B Electric Construction Consultant 9762 SW 190 Street CUTLER BAY, FL 33157- (305) 259 8790 • INSURER 9. INSURER C: INSURER a INSURER E. COVERAGES THE POLICES OF INSURANCE LISTED 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 INSR Arm POLICY EFFECTIVE IPOLICY EXPIRATION LTR 11,18R0 TYPE OF INSURANCE POLICY NUMBER ;DATE f PahlrOWTYYY1; DATE (RIMIDEVYYYT):, LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED Lyn COMMERCIAL GENERAL LABILITY GL-55222 10/14/2010 10/14/2011 , PREMISES (Ea occurrence) $100,000. 1 CLAIMS MADE l OCCUR MED EXP (Any one person) $5,000. _ Ise A [11 c-- . PERSONAL & ADV INJURY $1,000,000. GENERAL AGGREGATE $1,000,000' PRODUCTS - COMP/OP AGG : $1,000,000: GEN'L AGGREGATE LIMIT APPLIES PER: El POLICY Li PROJECT r-i LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 ANY AUTO (Ea accident) I ALL OWNED AUTOS BODILY INJURY .1 1- SCHEDULED AUTOS (Per person) L HIRED AUTOS NON OWNED AUTOS r— I _I GARAGE LIABILITY H ANY AUTO 1 EXCESS / UMBRELLA LIABILITY OCCUR ri CLAIMS MADE H DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below OTHER Y/N BODILY INJURY (Per ao:ident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY AGG EACH OCCURRENCE AGGREGATE . E WC STATU- 172.1 OTH- TORY LIMITS ER EL EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE, E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS/ LOCATIONS ! VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS ELECTRICAL SERVICE AND INSTALLATION CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 ACORD 25 (2009/01) CIF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TI-IE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE -) 1988-2009 ACORD All rights reserved. The ACORD name and I regis marks of ACORD