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EL-13-1108Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 192587 Permit Number: EL -5 -13 -1108 Scheduled Inspection Date: June 03, 2013 Inspector: Devaney, Michael Owner: WILLIAMS, JOYCE Job Address: 246 NW 93 Street Miami Shores, FL 33150- Project: <NONE> Contractor: AAA ON TIME ELECTRIC, INC. Permit Type: Electrical - Residential Inspection Type: R gh Work Classification: Alteration Phone Number Parcel Number 1131010331100 Phone: 305 -308 -7333 Building Department Comments 200 AMP SERGVICE REPAIR Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 29 May 31, 2013 For Inspections please call: (305)762 -4949 Page 25 of 27 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 Permit Type: Electrical JOB ADDRESS: 246 NW 93 Street FBC 20 Permit No. Master Permit No. City: Miami Shores County: Miami Dade zip: 33150 -2236 Folio/Parcel #: 11 -3101- 033 -1100 Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): Joyce Williams Phone #: Address: 246 NW 93 St City: Miami State: FL zip: 33150 -2236 Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: AAA On Time Electric Inc. Phone#: 305 -655 -0972 Address: 19710 NW 6 Place City: Miami Zip: 33169 Qualifier Name: Robert Katzman Phone #: 305 -655 -0972 State Certification or Registration #: EC13002896 Certificate of Competency #: Contact Phone#: 786- 236 -4146 State: FL Email Address: pmyland©bellsouth.net DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ $800.00 Square/Linear Foo of Work: Type of Work: ClAddress DAlteration New epair/Replace DDemolition Description of Work: 200 Amp Service Repair *************** * * *******+r******* *******Fees********** * * *** **** ** ***** * * * * * ** *,x*w* ** Submittal Fee $� "-a), Permit Fee $ /370' ' O CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Technology Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ J Vel `10 ' f 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 reinspection fee will be charged. Signatuu S ti�v Signature 1/12111)—cr Owner or Agent The foregoing instrument was acknowledged before me this The The foregoing instrument was acknowledged before me this 16 day of 144 i'1)1 1 , 20 , by b7 e,. l I t rn , day of May , 20 _, by Robert Katzman 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. as identification and who did take an oath. Contractor My Commission NOTARY PUBLIC: Sign: 5a' (� l S Print: My Commission *************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * APPROVED BY % %f� -076 /4°037 Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk ACCPRL AAAONTI -01 SGODDE CERTIFICATE OF LIABILITY INSURANCE DATE (MMVDDIYYYY) 1/7/2013 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(tes) 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). PRODUCER Ali Lines Insurance Group, Inc 1345 S Missouri Avenue Clearwater, FL 33756 INSURED AAA On Time Electric Inc, 681 Blue Heron Dr 304B Haltendale, FL 33009 NAME: AM: PHONE o't)•d727) 446 -5721 ADDRESS: (AIC, Nok (727) 443-2479 INSURERS) AFFORDING COVERAGE NAIL 9 INSURER A: Accident Insurance Company INSURER 61: INSURER C : INSURERD : INSURER E : INSURER F : CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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. ')}(SR LTR TYPE OF INSURANCE ADDL 113SR SUBR pJ POLICY NUMBER POLICYEFF NYYYI (MMAY POLICYEXP (MMIDDIYY(Y) LIMITS A GENERAL LIABILITY CPP CPP0006752 00 9/26/2012 9/26/2013 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY PP 0E E enca) $ 900,000 CLAIMS -MADE l X, OCCUR MED EXP (My one person) $ 6,000 PERSONAL B ADV INJURY S 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OPAGG $ 1,000,000 POLICY n swi — LOC COMBINED 1NGLE NIT $ $ $ AUTOMOBILE LIABILITY ANY AUTO BODILY INJURY (Per person) ALL OWNED AUTOS HIRED AUTOS SCHEDULED NOON - OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE SPERACCIDENT) $ S UMBRELLA LIAB EXCESS LIAB ~ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED 1 1 RETENT OjJ $ WORKERS COMPENSATION WC STATU- TORY LIMITS I OTH- ER ANDEMPLOYERS' LIABILITY ANY OFFICER IMEh1BEREEXCCLUbDED1XECUnVE i 1N (Myyaaendatory In NH) N 1 A E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYES S describe DESCRIPTION OF OPERATIONS beau E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space Is required) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building and Zoning 10050 NE 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 01988 -2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/06) The ACORD name and logo are registered marks of ACORD Ate: °a CERTIFICATE OF LIABILITY INSURANCE o 3/1""' 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: I: the certificate holder is an ADDITIONAL INSURED, the policyQes) 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 IIeu of such endorsement(s). PRODUCER Maneri Assurance Agency 2503 S.W. 8th St. Miami, FL 33135 Phone (305)541 -8456 Fax (305)643 -1188 INSURED AAA -ON TIME ELECTRIC, INC. 581 Blue Heron Dr #304 B Hallandale, FL 33009- COVERAGES CONTACT NAME: PHONE ,F40, (305)451 -8456 ADDRESS: {aI , NoA (305)643 -1188 INSURERA: INSURERS) AFFORDING COVERAGE NAIC o RETAIN FIRST INSURANCE COMPANY INSURERS : INSURER C : INSURER D : INSURER E : INSURER F : CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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 ViHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIO ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS BISR LTR TYPE OF INSURANCE ADDL MR SUER mai POLICY NUMBER POLICYEFF {MM1DD'YYYY1 POLICY EXP (MMIDDIYYYY) LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES0(Ea occurrence) $ CLAIMS -MADE I J OCCUR MED EXP (Any one person) $ PERSONAL a, ADV INJURY $ GENERAL AGGREGATE $ GERI. AGGREGATE LIMIT APPLIES PER: POLICY n JECT LOC e PRODUCTS -COMP/OP AGG $ WMBIINN BDDSINGLE LIMIT (Ea $ AUTOMOBILE LIABILITY ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS HIRED AUTOS SCHEDULED NOON -OWNED AUTOS BODILY INJURY (Pet accident) S PROPERTY DAMAGE (PER ACCIDENT) $ $ UMBRELtAI.TAB EXCESS LIAS OCCUR CLAIMS -MADE N/A j N 520 -42480 EACH OCCURRENCE S AGGREGATE $ DED 1 1 RETENTION $ $ WORKERS COMPENSATION AN ANY PROPRIETORJPARTNER/EXECUTIYE Yi N OFFICER/MEMBER EXCLUDED? (Mandatory In NIG Iv DESCRI N OF OPERATIONS Worm 07/18/2012 07/18/2013 ./j To iNA l rS 1R- E L EACH $ 500,000.00 E.L DISEASE - EA EMPLOYE£ $ 500,000.00 EL DISEASE - POLICY LIMIT $ Ste' '� DESCRIPTION OF OPERATIONS ! LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space is required) t CERTIFICATE HOLDER Miami Shores Village Building and Zoning 10050 NE 2nd Avenue Miami Shores, FL 33138 1 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE MTH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 05 -12-2 011 STATE OF FLORIDA EP P'NANC1AL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * CERTIFICATE OF ELECTION TO BE EXEIVIPT PROM FLORIOA VI/ORKERS COMPENSATION LAW * CONSTRUCTION 110USTRY EXEMPTION 7" c certifies that the lndiwdua, itsted ne,e,vv - Markers Comper,sal,o-, .av= EFFECTIVE DATE: 07 /11 2011 EXPlPATiON DATE. 07:1bY2013 PERSON: KATZMAN ROBERT' 331073683 BUSINESS NAME AND ADDRESS: AAA ON TIME ELECTRIC INC 58' BLUE HERON DR #304-S ka.....ANDALE F; 33009 SCOPES OF BUSINESS OR TRADE. CERTIFIED ELECtRICAL CONTRACT° • orl 4, 4-0 LICENSE C . SLUE HERON OR AR* DALE SEAC PL. MOS-516:: o06.214947 sEx * -,off954; MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI. FL 33130 2012 LOCAL BUSINESS TAX RECEIPT 2013 MIAMI -DADE COUNTY - STATE OF FLORIDA EXPRES MUST BE SEPT. PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER SA - ART. 9 & 10 .4iISINE SS NAME / LOCATION AAA ON TIME ELECTRIC INC 12865 W DIXIE HWY 33161 NORTH MIAMI t IWNFi AAA ON TIME ELECTRIC INC ^ac Type of Business IH11 44R6A F,laCTRICAL CONTRACTOR :1I/SINESS TAX RECEIPT IT DOES NCH PERMIT THE HOLDER TO VIOLA f[ ANv EXISTING AEGUI ATORY OR ZONING. LAWS Or THE COUNTY OR CITIES. NOR DOES H EXE&WT THE HOLIIEA FROM AMY OTHER PERM OR UCL-NSE REWIRED UY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S OUAIJFIC4 ru,Ns RAYA1tN', NLC4VL, NIAYI.OADE COUNT', It., COLLFCYOC 07/13/2012 60040000543 000045.00 stf' irtricsi SIf)i FIRST. LLAL;S U.S. POSTAGt.. PAID MIAMI, FI. PERMIT NO 23'1 RECEIPT NO NEWAL 362975 -6 STATE* EC13002896 101B WORKER /S 1 DO NOT FORWARD AAA ON TIME ELECTRIC INC ROBERT KATZMAN PRES 581 BLUE HERON DR APT 304B HAI.LANDALE BEACH FL 33009 10 (\�' Qn 1 one E t ec -tr‘ c lr c• t0(l.o My (0 place, FL 33lbg otery Pu . to State of Fonda ? `. I' use L Salatfin Y Commission EE125297 1$ torR c 3 /0 Iklme t/z rT1C X44- /�O LU1RE_ m 0 SID E RECEIVED AY 3 0 ,Z013 u,o(sR M,,} 2Q©A�Q� m ittL14 On 0 1 SHORES VIL...GE DATE t,akotkt-ttoAte. ‘`eiguei 1" . `Yv(G PLUMBING SUBJECT TO COMPLIANCE WITH ALL FEDERAL :iTATE ,•NB COUNTY RULES ANt GULATIC)t L. AAA ON TIME ELECTRIC INC. 19710 NW 6 PLACE MIAMI, FL 33169 ELECTRICAL SCHEDULE JOB: 246 NW 93 St, Miami FL 33150 PNL AMPS VOLTAGE CKTS WIRE PHASE MAIN MOUNT MANUFACTURER TYPE A 200 120/240 24 3 1 LUGS FLUSH G.E. LOAD CENTER CKT. NO. WIRE COND. INCH CKT. BRK SERVING WATT S REMKS CKT. NO. WIRE COND. INCH CKT. BKR SERVING WATTS RMKS POLE AMPS POLE AMPS 1 6 1 2 50 RANGE 12000 2 12 % 1 20 SMALL APPL 1500 3 4 12 '/2 1 20 SMALL APPL 1500 5 10 '/2 '/2 2 30 DRYER 5000 6 14 '/2 1 15 A/F BREAKER 1500 7 8 12 '/2 1 20 G.F.I. 1500 9 6 '/2 % 2 60 WATER HEATER 10000 10 12 '/2 1 20 DISH WASHER 1500 11 12 12 '/2 1 20 REFRIG. 1500 13 12 '/2 1 20 WASHER 1500 14 12 '/2 1 20 SPARE 1500 15 12 '/2 1 20 LIGHTING 6154 16 12 '/2 1 20 RECEPT 17 12 '/2 1 20 LIGHTING 18 12 '/2 1 20 RECEPT — --- 19 12 '/2 1 20 LIGHTING 20 12 '/2 1 20 RECEPT ----- ---- 21 12 '/2 1 20 SPARE 1500 22 12 '/2 1 20 RECEPT --- 23 12 '/2 1 20 EXH. FAN 1500 24 12 '/2 1 20 RECEPT 25 6 1 2 60 A/C 10000 26 12 '/2 1 20 RECEPT — 27 28 12 '/2 1 20 RECEPT ----- 29 30 31 32 TOTAL: 58,154 WATTS LOAD SUMMARY: 1sT 10,000 WATTS @ 100% 38,154 WATTS @ 40% NC 10.000 WATTS @ 125% TOTAL = 10,000 15,262 12.500 37,762 / 240 157.34 AMPS Parcel Owner Report Parcel Number: 1131010331100 246 NW 93 Street Miami Shores FL 33150- Tax ID: 1131010331100 Owner Information JOYCE WILLIAMS Phone: Current Owner: Yes Related Permits Electrical - Residential Fence/Wall Imported Permit Imported Permit Plumbing - Residential Roof Permit Number Application Date Expiration Date_ Status 12/27/2007 07/12/200( EXPIRED 07/13/2006 01/01/2999 CLOSED 12/10/2004 01/01/2999 CLOSED 12/31/2002 01/01/2999 CLOSED 10/18/2005 01/01/2999 CLOSED 07/31/2006 01/01/2999 CLOSED EL -12 -07 -2533 FW -7 -06 -1881 BP2004 -1618 BP2002 -2227 PL2005 -337 RF -7 -06 -2025 Related Code Cases IMPORT IMPORT IMPORT Ordinance Violation Ordinance Violation Ordinance Violation Case Number Case Status Case Date CASE- 12- 11- 9372Notice of Lien - Fines Accruing /Lien file 04 /13/2006 CASE- 12- 11- 9370Notice of Lien - Fines Accruing /Lien file 08 /16/2004 CASE- 12- 11- 9371Notice of Lien - Fines Accruing /Lien file 08/16/2004 CASE -6 -08 -4383 Case Closed 05/31/2008 CASE -3 -08 -3853 Notice of Lien - Fines Accruing /Lien file 03/12/2008 CASE- 5- 13- 11346Courtesy Notice 05/09/2013 Compliance Date Not Compliant Not Compliant Not Compliant 6/14/2008 Not Compliant Not Compliant —1O rs I c cr\ko -&. vh (C- - - Monday, May 20, 2013 Page 1 of 1