EL-11-1835Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
■ ■ (05
Inspection Number: INSP- 170145 Permit Number: EL -10 -11 -1835
Scheduled Inspection Date: February 23, 2012
Inspector: Devaney, Michael
Owner: BORUCHOW, IRWIN
Job Address: 950 NE 95 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: CALEX ELECTRICAL CORP
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1132050070120
Phone: 305 - 271 -5164
Building Department Comments
NEW BURGLAR ALARM INSTALLATION
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
/z
February 22, 2012
For Inspections please call: (305)762 -4949
Page 23 of 34
ktild ►I
BUILDING
PERMIT APPLICATION
FBC 20
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. LI 11 I
Master. Permit No. M P, C (/'f/'
Permit Type: Electrical % /
OWNER: Name (Fee Simple Titleholder): CIO Al rd j4) r Phone #:
Address: pp�� ?To 4i % S' 3 T
City: *CA &t ,Shr7 State: it Zip:
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 9 S 0 S 'r
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO k- Flood Zone:
CONTRACTOR: Company Name: /V- /P('feC
Address: (C/ S-0 SGT, 6 L Sr
City: 4%/(404 State: 61
Qualifier Name: CiWK/'5 avP-2 =7
Phone#:
7r6 ?(OY7 //
Phone#:
Zip: 53/73
State Certification or Registration #: C - CVO 3 / 0 r Ce fic/ate of Competency #:
Contact Phone #: 7t6 "20 Y 7 / / Email Address: l / : 4 ( fix' Pi AN' e A O L . C A w
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 2 r ( 0 0 . 60
Type of Work: OAddress' OAlteration
Description of Work: K!c /1 rti- 6- R
inear Footage of Work:
ORepair/Replace ODemolition
*** ******** ****** ********** ***+x**+x*** **Feesm*+x+xw******•xx ***.* **** a x� *** * *x:***+x********
Submittal Fee $ Permit Fee $ / ' ez " CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
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. 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 oc _ urs seven (7) days after the building permit is issued. In the Bence of such posted notice, the
inspection will not be approv nd a rei spection fee will be charged.
Signature Signature
Owfier or Agent
The for
day of
who is
4 ► �.
NOT
Sign:
Print:
My Commission Expires:
Contractor c�
The foregoing instrument was acknowledged before me this J
ay of ( , 20 L(, by ALA-VI 5 :1-0E-Zr-
ho is personally known to me or who has producedl�
as identification and who did take an oath.
NOTARY PUBLIC:
ersonall
wn t r e or who has produced
id
ntification and who did take an oath.
PUBLIC:
Sign:
nt:
x‘xo I\ III III
u11,
My Commission Expires:
tZ=8
.71 : — =
O
-.eve
u
iii /9 '' • .....
***********a :************+x*** ****+ x***+ x*s< *+ x* *+ x******** **+ x****+ x****+ x********+x********** +( *
APPROVED BY -7 49�G I Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
10/05/2611 12:29 3056668014 MCCARTNEYINS PAGE 01/01
OP ID: AM
ACC3PRL?
THIS CERTIFICATE IS 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 ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS 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).�
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
10/05/11
PRODUCER
McCartney Insurance Agency,Inc
8739 Bird Road
Miami FL 331554705
Don McCartney
INSURED
Calex Electric Corporation
10150 SW 66 St.
Miami, FL 33173
305466 -4444
CONTACT
NAME
PHONE
_WA ,g�ANL,o. E_t):
ADDRESS:
— PRODUCER �+ALEi� -1
Cjt$!9MER ID N,1
INSURER(s) AFFORDING COVERAGE
INSURER A Nova Casualty Company/
Ftwi IAIC, Noi:
INSURER e : F.U. B.A:
INSURER 0
INSURER 0:
NAIC p
INSURER E
INSURER P:
REVISION NUMBER:
THIS
INDICATED,
CERTIFICATE
EXCLUSIONS
1TR
IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY
MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY
AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN
ISSUED TO
CONTRACT
THE POLICIES
REDUCED BY
GLIWWODtYYVY)
THE INSURED
OR OTHER
DESCRIBED
PAID CLAIMS.
(MMM1UA/Y
NAMED ABOVE FOR THE POLICY PERIOD
DOCUMENT WITH RESPECT TO WHICH THIS
HEREIN IS SUBJECT TO ALL THE TERMS,
MISTS
TYPE OF MSURANCE
AWL
SUS
POLICY NUMBF,(t.
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
OCCUR
09AL062501
03/10/11
03/10/12
EACH OCCURRENCE RRENCrE
3 1,000,000
X
r
sEo o DRMix ience
MED EXP (Any ene person)
100,000
CLAIMS-MADE )S
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENL
AGGREGATE LIMIT APPLIES PER:
POLICY i--- .ROT —140C
PRODUCTS - COMP/OP AGO
$ 2,000,000
3
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
MIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea Accident)
5
BODILY INJURY (Per pereett)
$
„_,
BODILY INJURY (Per acefdent)
$
PROPERTY DAMAGE
(Per acddent)
$
—
$
—
UMBRELLA GAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
_
DEDUCTIBLE
RETENTION $
8
-
$
B
WORKERS COMPENSATION
ANA EMPLOYERS LIABILITY
A�PROPRIETOR/PARTNER/EXECUTIVE A E EXCLUDED?
(Mandatory In NH)
Eyes, dacedbe under
DESL�RIPTJOJV OF OPERATIONS
YIN
N ! A
106 -43068
04/07/11
04/07/12
WC STATU. OTH-
I TORY LIMITS ELI,,,,.„
E,L,, EACH ACCIDENT
$ 600,000
E.L. DISEASE - EA EMPLOYEE
$ 500,000
below
E,L, DISEASE - POLICY LIMIT
5 600,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addmcnal Remarks Sahadulo, N mare spun la raq,drad)
CERTIFICATE HOLDER
CANCELLATION
CITYMIS
CITY OF MIAMI SHORES
10050 N.E. 2ND AVENUE
MIAMI SHORES„ FL 33138
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Don McCartney
ACORD 25 (2009/09)
®1988 -2009 ACORD CORPORATION. All dg ti re erved.
The ACORD name and logo are registered marks of ACORD
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399 -0783.
PEREZ, ALEXIS F
CALEX ELECTRIC CORPORATION
10150 S.W. 66TH STREET
MIAMI FL 33173
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!
DETACH HERE
(850) 487 -1395
MIAMI -DADS COUNTY
TAX COLLEOTOR
140 W. PLAOLER ST,
isf FLOOR
MITI, FL, 33130
234391-1
LOCAL _BUSINESS TAX RECEIPT 2C
�I -DADE 'COUNTY STATE 0F FLORWA
EXPIRES SEPT 30, 2012
MUST BE DISPLAYED AT PLACE O BUSINESS
PURSUANTTO COUNTY CODE CHAPTER BA j ART 9'
2011
10
THIS IS NOT A BILL - DO NOT PAY pptt RENEWAL
STATEIIDIG0n3108 246316 -4
suEXT1+JaMtOOT8NCORP
10150 SW 66 ST
33173 UNIN DADE COUNTY
cnivE..EaXt ELECTRIC CORP
YT EEMICAL 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 CI77ES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERMIT OR LICENSE
REQUIRED BY LAW. THIS Is
NOT A CERTIFICATION OF
THE HOLDER'S QUALIFICA-
TIONS.
PAYMENT RECEIVED
MIAMI -DADE COUNTY TAX
COLLECTOR:
07/20/2011
09010045001
000075.00
SEE OTHER SIDE
FIRST -CLASS
U.S. POSTAGE
PAID
MIAMI, FL
PERMIT NO. 231
WORKER /S
1
DO NOT FORWARD
CALEX ELECTRIC CORP
ALEXIS PEREZ PRES
10150 SW 66 ST
MIAMI FL 33173
49
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