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ELC-12-158Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number. INSP- 169361 Scheduled Inspection Date: May 29, 2012 Inspector. Devaney, Michael Owner: Job Address: 9031 -65 BISCAYNE Boulevard Miami Shores, FL 33138- Project <NONE> Contractor: MESA BROTHERS INC (2_—kc-Se Permit Number: ELC -1 -12 -158 Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)779 -8040 Parcel Number 1132060110051 -31 Phone: (305)345 -1974 Building Department Comments ADD FEW RECEPTACLES AND FIXTURES. NC HOOK UP Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Ste_ A-r6e,/ z -7---- May 25, 2012 For Inspections please call: (305)762 -4949 Page 8 of 30 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit Type: Electrical Owner's Name (Fee Simple Titleholder. Owner's Addrest city "�� �G 1�1f a :Mate Ooi "i'd , zi Q C� Tenant/Lessee Name OPMR, 5A61". 71 f boi/peA ri JP: B`r= - Permit No. 0 1 21l 5 Master Permit No. Cr,/ 1 i� one # , n65t ps.305 -9341 E- MAIL: Job Address (where the work is being done) 9069 9071 aScgyna bi.vv► A 014,4 Shogcr 33137 City Miami Shores Village County Miami -Dade / Zip ,33$ 311 FOLIO / PARCEL # It 3010 , O!( 00 ( J 3c5.513'S ®9 t Is Building Historically Designated YES NO Contractor's Company Name ioe e'2Z 6',12 rr✓. �C° • Phone # ACS 5- 6 3 ®d z-. f' Contractor's Address 52-(6—,„1 a) —,® �°w, City „A1/ P l` / State �A•fa, Zip /6�`- Qualifier Name / 7 'cZ / e v Phone # ?d Ir-- o 9 State Certificate or Registration No. £e l..?•60/ P70 Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ['Addition Describe Work: At 1c/eg Alteration ❑New ❑ Repair/Replace ❑ Demolition ************ **** * *x*KKKKKeYoY7z9G**** **w* *Fees******** **w* * **** Submittal Fee $ Permit Fee $ ' ai � '' CCF $ Notary $ Training /Education Fee $ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ * *KKKKK IF %1t1%1C**** **** *o *** CO /CC Technology Fee $ Zoning $ See Reverse side -+ Bonding Company's Nam$ (if applicable) �c J' Bonding Company's Address City State Zip Mortgage Lender's Name if applicable) Mortgage Lender's Addres 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: !1 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 $2.500, the applicant must promise in good faith that d copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject tt 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 absence of such posted notice, the inspection will not be apprgve• ! d a reinspection fee will be charged. i Signature 1 Signature Owner ant p r �`- The foregoing instrument was ac nowledged before me this a0112, The fore day of( b tee , 20 Vt by Noy c►wt 1-z-hag. , day of who is personally known tome or who has produced who is ersonal y known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. Contractor ng instrument was acknowledged before me this -.ROW , 20 / �' ;by /lir.�� srd9 NOTARY PUBLIC: Sign: Print: ublic State of Florida My Commission Expires: **********************i****....********* My Commission Expires: cos ; Nr,E, LUI§FERNANDEZ * * * * *** *** * * ** ** ** ** **** `t: ;' pi DD 832441 `ltrpoo oo. Bonded TlbuB iNoteryServICS APPLICATION APPROVED (Revised 02/08/06) Plans Examiner Engineer Zoning CERTIFICATE OF LIABILITY INSURANCE OP ID YC DATE(MIWDOIYYYY) 12/19/11 • 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 ISSWNG INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL. INSURED, the policy((es) 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 to lieu of such endorsement(s). PRODUCER BROWN 6 BROWN OF FLORIDA INC 14900 NW 79th Court Suite#200 Miami Lakes FL 33016 -5869 Phone:305- 364 -7800 Fax:305 -714 -4401 GUNIA4r name PfIONENo, EyW: ADDRESS PRODUCER SID #: MESAB- 1 �.No) INSURED Mega SW Brothers p03d. Avenue (Rear) Miami FL 33165 INSURER A : INKS) AFl INGJcOVERAGE FcCI Insvraace Company' NAIL s 10178 INSURER B: INSURER Cr: INSURER D : INSURER E: INSURER P: COVERAGES CERTIFICATE NUMBER: SION NUMBER: THIS Is TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEOTO TIC INSURED NAMED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIBEO HEREIN IS EXCLUSIONS AND CONDITIONS OF SUCH Poucim LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. • :,,., Zi FOR THE POLICY PERIOD NTH RESPECT TO WHICH THIS TO ALL THE TERMS, �LrR TYPE OF INSURANCE 1. WVO POLICY NUS GENERAL UABILnY A X COMMERCIAL GENERAL L BWTY I CLAM -MADE 1E OCCUR GEN'L AGGREGATE ITAPPLIES Pat X Pa-lad-1519i LI n GL00031918 LOOTS 12/18/11 12/18/12 OCCURRENCE by retNI UJJ occurrence) (Amy one person) & ADV INJURY AGGREGATE -COMPI P AGG AUTOMOBILE MAMMY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS _. HIRED AUTOS NON-OWNED AUTOS SINGLE OMIT (Ea Y INJURY (Per person) Y INJURY (Par > nt) UMENNO.LA LIAO EXCESS UAB CLAIMS -MADE DEDUCTIBLE RETENTION S DAMADE OCCURRENCE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNERtEXECUT Mandatory OFFICERIMEMBER y EXCLUDED? VDES RJPTION OF OPERATIONS below NIA EL LI I I ER ACCIDENT x1,000,000 $100,000 $5,000 $1,000,000 $2,000,000 32,000,000 $ $ S s - EA EMPLOYE $ POUCY LOST $ DESCRIPTION OP OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more is required) CERTIFICATE HOLDER CANCELLATION City Of Miami Shores 10050 N.E. 2Nd Ave 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 PRROVIB1ON8. AUTHOR1OS) REPRESENTATIVE /%� ACORD 25 (2009/09) t 1 Z�91988 -2008 ACORp C The ACORD name and logo are registered marks of ACORD RATION. AIi rights reserved. cowl CERTIFICATE OF LIABILITY' INBU. »G N THIS CERTIFICATE IS ISSUED-A8 A MATTER OF: INFORMATION ONLY �NC R ALTER THE PAINTS WONGf CERTIFICATE DOES NOT AFFIRMATIVELY OR•NE6ATIVEI.Y AMEND, BELOW. THIS CERTIFICATE OF INSURANCE ODES NOT CONSYITUIT'E A CONTRACT BETWEEN THE 185 • REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. Intsct he andorsad. I'. • IMPORTANT: If the cattlflcate.haider is an ADDITIONAL INSURED, dorsement. A atateiiienl �tidhl8 iii the tai me i>nd mullions of the polity, certain policies may require an certificate holder in lieu of such end©rgamerd CONTACT NAi : PRIMMER Suez Insurance Company PO DoX 7777 St Petersburg, FL 33731 gyiins4biz.com asugto oyes Staff, LLC 11 00 Pi rkside Dr Suite 600 rase o. Knoxville TN 37934 INSURER F COVERAGES . CERTIF _ YE 118830 4 THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW ttAVE BEEN ISSUED TO THE INStRim itotCA`r norea rnenw6Hvo ANY REQUIREMENT. TERM OR CONDTHON OF BY A POLdC CONTRACT pal R PO CERTIFICATE MAY BE iSSUED OR MAY PERTAIN. THE resunAN OF SUCH POLICIES. MU SHOWN MAY HOB WAN REDUCED BY PAID CLAIMS. EXCLUSIONS AND COMMONS �` �[�ri j� 1 rm?m)ti�'l Yr:'J!3. PiiLiC'rN.:. ._. •.. f &ADV& JURY ASfliiECATE UM9REUAiAN MEM MO � WORStRReGORiPEr19ATIrJ�i A61A EMPIAYiB'ta' ugen.flY YY!—N7 B Workers Compensation C EXPOS Cv ge D EMS CRPVON t}F OPERATIONS l LOCATIONS tYEiitGLeS (Attach WAD ON, Mt, 1aIRa tonaNstil provided for all teased employees hutted subconbaeloro of; Mess Brolliete Inv Location Maw. 1/112011 104 0l2O12 t�.. L L r, EA9E -pULIL TLIM$R o arid thing shun Create any right CE ` F I iQLDvR 6382 Miami Shores Vltlage 1060 NE 2nd Ave # 456 Miami FL 33138 c+A geta ATtii 30OuLLO2tNY OF THE MOW. 8E9C£iI8EO POLICIES BE CANCELED BEFORE • 1.1E EXPIRATION DATE i HEREOF. NONCE W4Lt EE OEL EO . IN . ACCORDANCE iRfiMH THE PD. ICY PRRC3 ATONO. ACOPCI25(2010105) MIT no.. 11692916 Saris medhee 11/21/2011 7.30.11 AK Page 2 of 1 Dien J Di3tefan°. • �i088.261a.AC 4W The ACORD name and.logo are registered mark trf ACOIILI p3RPORATION. AU rights reserved. c RECEIPT �COU r� TE of FLORID; , ApORRIEW 2 DISPLAYED 'NESS O -Affr4 &'10 040577 -9 RUMNESS NAME BRETHECRS N 5215-SW 103 AVE. 33165 UNIX-BADE .COUNTY• FIRST -CLASS U.S. POSTAGE . PAID MAUI, FL PERMIT NO. 251 THIS IS NOT A BILL-- DO NOT PAY RENEWAL. • amain r . . 040577-9 •- STATEB' EC13.001870 OWNER •MESA BROTHERS INC . Sec, of Business 196 'ELECTRICAL CONTRACTOR = THE IS ONLY A LOCAL' ;. RUSX1E88 TAX RECEIPT: IT DOES NOT - PERMIT THE Houma TO VIOLATE ANY norm COMM LAWS ° IRE • DO NOT FORWARD CORM ORCfM.NOR. . GOES ff EXEMPT • THE ANY OTHER' • MEET FOR LONNIE • WOWED A t IT y1OONN OF HOLDER'S WORKER /S 10 MISERY MOWED +TAX • 08/18/2011 60020000105 000075:00. . SEE OTHER SIDE MESA BROTHERS INC RAUL'MESA PRES- 5215 SW 103 AVE. MIANI FL 33165 l rt�1,�•��,,,,�,r��t, tl;�l,rt��ir,rar 13�,11>itt tt • ADDENDUM TO BUILDING PERMIT APP ICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. I A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON S TBSEQUENT AAPPLICATIONS.) PLUMBING ELECTRICAL • MECHANICAL ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS 4 CENTRAL HEATING DISHWASHER RECEPTACLES z ® A/C (Wri ) DISPOSAL SERVICE TEMPORARY A/C (PC •, ) DRINKING FOUNTAIN SERVICE SIZE IN AMPS OLET ,':'', FLOOR GRAIN SERVICE REPAIR/1€TER CHANGE REFRIna•,TION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP ; +VIVI IA TANKS LAVATORY OVEN ABOVE ;.. , ; ;, TANKS LAUNDRY TRAY WATER HEATER / U.F. " SSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM ;+ ILERS SHOWER IvOTORS OVER 1- 3 HP Or HOT WA 3 BOILERS SINK, POT /3 CORP. MOTORS OVER 3- 5 HP MECHANI VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP • ^•'•' ING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVA ' •+i /ESCAL.ATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE ••.INKLER SYSTEMS URINAL -MOTORS OVER 25-100 HP COOING TOWERS WATER CLOSET- .. MOTORS OVER ' 100 HP VIOLATI1' INDIRECT WASTES A/C WINDOW REINSPE ION WATER SLPPLY TO:. - -AIR CONDITIONERS 076el A/C UNIT - - • STRIP HEATER FIRE SPRINKLER .• *GENERATORS TRANSFORMERS ... . HEATER -NEW MST, s . - GENERATORS DIMMERS HEATER- REPLACE ":1%:1- • • GENERATORS TRAMFOINIERS LAWN SPRINKLER- WELL. - SPECIAL PLARPOSE SW1MAINB POOL OUTLETS CIAL WATER SERVICE SIGN TUBES =EWER CONNECTIONS SIGN TRANSFOiS FflLtTY -SEWER - T IL SIGN TIME CLOCK . LTY -WATER EPTIC F IXTI,RES TANK ' ANTENNA FLAY . RAINFIELO, TELEVISION OUTLETS 4' TILE/RES. U P VIOLATION & ABANDON SEPTIC TANK -• OAKAGE PIT RE INSPECT ION CU. FT. ATCH BASIN ISCNARGE WELL MIESTIC WELL )EA DRAIN )0F INLET ■ )LAR WATER HEATER RE STANDPIPE DI. PIPING am SPRINKLER SYSTEM S RANGE TER SET (GAS) S 1 PIPING