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EL-12-120Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 169145 Permit Number: EL -1 -12 -120 Scheduled Inspection Date: March 01, 2012 Inspector: Devaney, Michael Owner: WENSJOE, THOMAS Job Address: 1135 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: EXCEL -O CORP INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132050340050 Phone: (305)970 -2260 Building Department Comments ELECTRICAL FOR BBQ AREA Passed C� Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments //7-k / frA 'ebruary 29, 2012 For Inspections please call: (305)762 -4949 Page 7 of 21 I i 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 `F, JAN ti BY: Permit No. , '-'`l (fa Master Permit No. is' "— OWNER: Name (Fee Simple Titleholder): /`/ l8 et Honk, 0 e4 5 Address: /4-3. 5 /L &700 sr- City: /t iifiW1( S Ll d res Tenant/Lessee Name: Phone #: 305 ' 155-//3 6 State: Zip: 3 3 (3 cr Phone #: \ Email: *JOB ADDRESS: / (35 ,4J /Q( City: Miami Shores County: Miami Dade Zip: J 313S Folio/Parcel #: Is the Building Historically Designated: Yes NO CONTRACTOR: Company Name: Z-)(66 AD ' 7/ Address: /It 320 SW IF/ re'.// City: I • / IA State: �L► Qualifier Name: if i74iU /D 405,4 Flood Zone: Phone #: Zip: 33 I7) Phone #: 3o% 97o -2.26e State Certification or Registration #: .- /100 AOVo Certificate of Competency #: Contact Phone #: 3os - '770 -22 %O Email Address: c>�cehyeo*• Ro /• ego wt.— DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ /)OQ. c---C-= Square/Linear Footage of Work: Type of Work: Address ❑Alteration New ❑Repair/Replace ❑Demolition - Description of Work: j3J3 q et. Gaps k **+x+x********+x **: *** * **** * * * **** *** ***** Fees : * ****:x******** * *** ** * * *** **** **** *** * * * ** Submittal Fee $ 3 Py Permit Fee $ % r ��' CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 4 d 0 '10 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 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 rei spection fee wipe charged.. The fore day of Owner or gent ment was ac wleddged befo a this ,20/2, by, /! s � Sjgnature L C • 4 F CoOtraoor g The foregoing jnstrument was acknowledged before me this /� -.,,� -dday of , 20 —s by- 1"�' Who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Exp * MY ' + MISSION # DD 844032 EXPIRES: February 15, 2013 Bonded Dm &ngetNotwq Sys as identification and who did take an oath. NOTAR _ ' UBLIC: Sign: Print: 1?-41 41'314 My Commission Exp jo .n. .. Fernando Alcantar® Al My Commission DD961921 4 or Expires 02/15/2014 **** ** ******e* **** ** , . , *:x,x*,x***,w*:x ******* *** * *** ******,x,x******* * * * ****** , a,******** ***,zu:**,x*************** APPROVED BY ✓-1'A/ Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk ACOSTA., ANTONIO EXCRL-O CORP INC. 7940 NW 185TH STREET FITAT.RATF FL 33015 Cmignitu lationd WWithS liainii-YOU bacon* oneigdthe nearly one million Floridan licensed by the Department of Business Professional Regulation. Our professionals and bustnetses range *con architeds 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 beam For information about our services. please lc* onto itnsw.nwitoridelicense.coin. There you can find more information about our clivislons and the regulations that Impact you, subscribe to departineM newsletters and team more about the Departments initiatives. 11 Our mission at the Department is: License EfficientlY. Regulate Fairly. We constantly strive to serve you better so that you conserve your customers. Thank you for doing business in Florida, and congratulations on your new license' DETACH HERE 1 . • , 100075S T.21414t6vglth"s: E.Irtitratav Alta ,4,4. • , - - • - ACE FL 33177 itad tcrAmt -• • ••• • . • - - . - - - goiwttks-RiQuIREb-Eti 2011 LOCAL BUSIRESSTi MIAMI•DADE.00UM EXPIRES -BE MUST BOSE0i! A URS #1 iT TO cd0 530570-1 EuveLNArawilfik 14320 SW 181 TERR 33177 UNIN DADE COUNTY THIS IS NOT A BILL - 00 NOT PAY RENEWAL STATEEgI3gb4540 OR EXCEL 0 CORP INC Sec. Type of B sine WORKER /S 1 96 ELECTRICAL CONTRACTOR _ ___ 2 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 REOUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE NOLDERB OUAUFICA- TIONS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 08/11/2011 09010019001 000075.00 SEE OTHER SIDE DO NOT FORWARD EXCEL 0 CORP INC JUBERT LOWE PRES 14320 SW 181 TERR MIAMI FL 33177 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 554326 -0 30 6,446414 ACCPRD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 1/20/12 PRODUCER Emmanuel Insurance Angency Sarni Medina 2370 E 8 Avenue Hialeah FL 33013 Phone: 305 693-0003 Fax: 305 691 -4381 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC 0 INSURED Excel-0 Corp Inc 14320 SW 181 Terrace Miami FL 33177 INSURER A Ascendant Ins. Co. 13683 INSURER B: BRIDGEFIELD EMPLOYERS INS INSURER C: INSURER 0: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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. NSA LTR 11R TYPE OF INSURANCE POLICY NUMBER DATE I(N POLICY (M� )N LIMITS A ❑ GENERAL LIABILITY 0.. COMMERICAL. GENERAL LIABRITY GL - 65628 -1 01/05/2012 01/05/2013 EACH OCCURENCE $1,000,000 DAMAGE TO RENTED (Ea ocaarenoe) $100, ❑❑PREMISES CLAIMS MADE @ OCCUR EXP (Any one Person) $5,000 ❑MED PERSONAL & ADV INJURY s2,000,000 ❑ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PROJECT LOC ❑❑ ❑ PRODUCTS - COMP/OP AGG 01,x,000 $ A ❑AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON -OWNED AUTOS ❑ COMBINED SINGLE LIMIT (Each Occurrence) $ BODILY INJURY (Per Pew) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ L ^J A ❑ GARAGE LIABILITY ❑ ANY AUTO ❑ AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ A ❑ EXCESSIUMBRELL A LIABILITY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ $ A ORKEYE S' LIABILITY COMPENSATION AND ANY PROPRIETORIPARTNER/EXECU- TIVE OFFICER/MEMBER EXCLUDED? I yes, 'alder SPECIAL PROVISIONS below 830 - 791 14 00 SE 01/05/2012 01/05/2013 Al TORY Ti IT ITS ❑ ER O. EL EACH ACCIDENT $1,000,000.00 EL DISEASE - EA EMPLOYEE $1,000,000.00 EL DISEASE - POLICY LIMIT $1,000,000.00 ❑ OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Electrical Contractor CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 N E 2ND Ave Miami Shores Florida 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Sarai Medina ACORD 2612001/081 © ACORD COR M #5 rebar every 4ft with poured concrete cell All comers and openinings for appliances to tob be filled with 1 *5 rebar at no less than 48" oc float stucco on block system Grade concrete block system 4 *8 *16 32" footer G" w #5 rebar criss cross 12" oc Grade r 1 B B 1 B 0 1 1 8 0 1 1 1 1 0 B B 1 1 1 0 1 1 8 1 1 1 1 1 B 1 0 B ®. I�m�. oo�1. A..@....mmBmoml. ® ®I.m ®Bm�B - ®mgm ®gym B 1 1 0 1 0 1 1 B B B 0 1 1 1 1 1 1 pB 80 B m B• m v� m m� m m �O m m it ®m 4:m m m� .v m 1• m ml~ m .l s m 1 8 1 0 1 1 1 1 1 1 1 Kitchen footer General Notes: All appliances including draws, doors are to be done to manufacture specs All walls are to be done with stucco to match existing house Concrete shall conform to ACI 301 and shall hav, 2000 psi compresslon strength Is 28 14'.0" All fill shall be clean sand and free from deleterous materall and well graded. Footings are designed for 2000 psi soil compaction. Rear Elevation 1 Stucco finish 1 Front Elevation grill 38" Stucco finish ko T door 14 Thomas Wensjoe 1135 ne 100th street Miami Shores