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EL-10-56Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 133309 Permit Number: EL- 1 -10 -56 Scheduled Inspection Date: October 24, 2011 Inspector: Devaney, Michael Owner: LEE, PATRICK Job Address: 1122 NE 97 Street Miami Shores, FL 33138- Project <NONE> Contractor: HI TECH ELECTRICAL INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050170170 Building Department Comments LOW VOLTAGE PERMIT (CABLE, TV, PHONES SYSTEM INST) Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments /1/ October 21, 2011 For Inspections please call: (305)762 -4949 Page 1 of 22 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972. INSPE,CTION'S PHONE NUMBER: (305). 762.4949 Permit No. E 110 'Q BUILDING PERMIT APPLICATION FBC 20 RMOMEWM1 at JAW 12 2010 BY: Master Permit No. Permit Type: ELECTRICAL Name (Fee Simple Titleholder) P4-1 Phone (25-Ownerj 's Owner's Address V\ 2Z.. C171 T. City ,A lue State .- Tenant/Lessee Name Email 3373f Zip 3338 Phone # Job Address (where the work is being done) &)E., `f`fit . City Miami Shores Village County Miami -Dade FOLIO / PARCEL # \ VS 7...._e75-0 C? o -70 Zip Is Building Historically Designated YES NO Flood Zone Contractor's Company Name i ' bk4-Meite Phone # Contractor's Address ( \Q pto City ® State (X-C- Zip 3 (7 Qualifier Name4,,0` .1,42v Phone # 3 ©S .i - f S - 2. State Certificate or Registration go. EC ( 3 O) .K 6 9 3 Certificate of Competency No. Contact Phone 30r- s9 3 " SS2 Z E -mail 305- .-13-- Architect/Engineer's Name (if applicable) Value of Work For this Permit $ , 00"Z) Type of Work: ❑Addition adteration ❑New ❑ Repair/Replace Phone # Square / Linear Footage Of Work: Describe Work: ❑ Demolition * **, ter*** ** * ** * * ** * ** * *** * * * * * * ** * * * * * ** Fees * ** * * * * ** x** **** * * * * * * ** * **** ** **** * * * * * * ** x Submittal Fee $ Permit Fee $ %Elm ®® Notary $ Training/Education Fee $ 0 CCF $ • OD CO /CC $ Technology Fee $ ' Vl i Scanning $ ,D° Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ See Reverse side - 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 seven (7) s after the building permit is issued. In the absence of such posted notice, the inspection will not be appro j # nd % re -ins on fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this , 2_ day of 41 t71, 20110 , by TOCC who is personally known to me or who has produced PL ti") As identification and who did take an oath. NOTARY PUBLIC: 11111111,, Sign: 'y Print: _ i�`ra - <IP e- y p' Jew ° "► M Commission Ex Tres f •• o . • z ✓�.,I........ Contractor The foregoing instrument was acknowledged before me this 11 day of tt C�11 , 201 Q, by �I�W(} t -S J_ kBC who is personally known to me or who has produced as identification and who did take an oath. ission Expir *** * *' ** * * * * * * * *, *** ** * *40 FYyiO4, ********* ** * * * * * *** * ** * *** ** * *** * * ** ** ** cam es: na '4p74 Liils C. Guerra awes: tui. 5, i011 APPROVED BY /�- f 3 Plans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) WWW.AARONNOTARY.co `coning Clerk checked MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1s! FLOOR MIAMI, FL 33130 2009 LOCAL BUSINESS TAX RECEIPT 2010 MIAMI -C ADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2010 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER HA - ART. 9 & 10 THIS IS I.1O T A BILL - DO IT,DT Pis' RENEWAL 462914 -4 BU NES NAME / LOCATION HI TECH ELECTRICAL INC 11003 NW 33 ST 33172 DORAL OwHIR TECH ELECTRICAL INC SeciT1ge4ft,g5Cin §41CAL TICS IS ONLY A LOC BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REOULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR UCENSE REQUIRED BY LAW. THIS 1S NOT A CERTIFICATION OF THE HOLDER'S OUALIFICA• TIONS. PAYMENT RECEIVED MOL££.ECADE COUNTY TAX 07!10!2009 60000000385 000045.00 SEE OTHER SIDE CONTRACTOR FIRST -CLASS U.S. POSTAGE • PAID MIAMI, FL PERMIT NO. 231 RECEIPT NO. 483296-1 STATE# EC13003893 • WORKER/S 1 DO NOT FORWARD HI TECH ELECTRICAL INC EDUARDO GARCIA PRES 11003 NW 33 ST DORAL FL. 33172 1££111£:£1111£iU ii I1I1111II££1II£1£111£1£££JIP 11111£1}£7. tl ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER Brown & Brown of Florida, Inc. 5900 N. Andrews Ave. #300 P.'' Box 5727 Ft auderdale FL 33310 -5727 Phone:954- 776 -2222 Fax:954 -776 -4446 INSURED OP ID J9 HITEC -7 TH @3 CERTIFICATE IS ISSUED AS A MATTER OF NFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL'T'ER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DATE (MM/DDIYYYY) 10/01/09 INSURERS AFFORDING COVERAGE Hi -Tech Electrical, Inc. Attn: Mr. E Garcia 11003 NW 33 Street Miami FL 33172 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FO 7 THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 10 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 'HE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AUDI. LTR INSRC INSURER A: INSURE R B: •Amerisure Insurance Company NAIC # 19488 Amerisure Mutual Ins. Co.+ 23396 INSURE R C: INSURER D: INSURE R E: INbN TYPE OF INSURANCE POLICY NUMBER A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR X Contractual Liab GEN'L AGGREGATE LIMIT APPLIES PER: POLICY IX JECT I I LOG GL2032418030 POLICY EFI'ECTIVE DATE (MMiDD/YY) 10/01/09 A XAUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS X NON -OWNED AUTOS CA2032416020 POLICY EXPIRATION DATE (MM /DD/YY) 10/01/10 LIMITS EACH OCCURRENCE UAMAGEIU HEN IEU PREMISES (Ea occurence) $1,000,000 $300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE PRODUCTS - COMP /OP AGG Emp Ben. $2,000,000 $2,000,000 10/01/09 10/01/10 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ CU203286602 10/0L/09 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER WC203241900 10/01/10 EACH OCCURRENCE EA ACC AGG AGGREGATE $5,000,000 $5,000,000 $ 10/0:1./09 10/01/10 WC STATU- OTH- TORY LIMITS A. I ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE Equipment Floater E.L. DISEASE - POLICY LIMIT CPP2032417030008 10/0 :1/08 DEDUCTIBLE: $500 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPEC:IAL PROVISIONS 10/01/09 CERTIFICATE HOLDER $1,000,000 $1,000,000 $1,000,000 Rented /Le $25,000 Schedule $51,510 CANCELLATION Miami Shores Village Attn: Building Dept. 10050 NE 2nd Avenue Miami Shores FL 33138 ACORD 25 (2001/08) MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE 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 REPREI: ENTATIVES. AUTHOR! RES- ' •TIVE 0 ACORD CORPORATION 1988 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 IGLESIAS, THOMAS JOSE HI TECH ELECTRICAL INC 12381 SW 39 STREET MIAMI FL 33175 (850) 487-1395 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 T-012S4, ,--3•e4* . . 06/,06/2,008 070416733 EC130.0389.3: Additional The ELECTRICAL C6NTRIeToR Named_ ,p.yp29ng2,--0halst... 489 Expiration FS INC 1 TES=T -4772, OW4FNTOR , !;,■■ , 13 00 6 0 014. • Business , Qualif ication, CHUCKiJRCO:/ • -•