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EL-12-1493 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax. (306)756-8972 nspection Number: INSP-204489 Permit Number: EL-8-12-1493 Inspection Date: December 13, 2013 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: RODIER,ALEXANDER&EMILIE Work Classification: New Job Address: 1009 NE 104 Street Miami Shores, FL 33138-2655 Phone Number 305-756-6295 Parcel Number 1122320290140 Project: <NONE> Contractor: WEATHERMAKERS ELECTRICAL CONTRACTORS LLC Phone: (786)249-8880 Building Department Comments ELECTRICAL WORK FOR NEW HOUSE Infractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-177038. Need low voltage first. Failed El Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 December 13,2013 Page 1 of 1 Miami �� I � Shores Village AUG q 6 Z012 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 � ` Tel:(305)795.2204 Fax:(305)756.8972 BUILDING Permit No. —' 1 T PERMIT APPLICATION Master Permit FBC 2004 Permit Type: Electrical Owner's Name(Fee Simple Titleholder)k� mnd-m g5c 'er Phone# Owner's Address 23:25 /yagnbfi A Oft. City JU. Mi"k state FL Zip 331 gt Tenant/Lessee Name Phone# E-MAIL: Job Address(where the work is being done) 10 0 g A/E 161 St. City Miami Shores Village County Miami-Dade Zip 3313$ FOLIO/PARCEL# 11-2232-029-01410 Is Building Historically Designated YES NO Contractor's Company Name &h,C.-Phone# Contractor's Address n Yij c5W 9 ?— City�)VIA011 > State Zip ;3 3j Qualifier Name L xe OLS Phone# 7 7o' ®02 WX 3 . State Certificatq or Rpgistration No. Certificate of Competency No. 7 E-MAIL: C.. Architect/Engineer's Name(if applicable) Phone# afiue o 'Vlfi`o�rr is er�ntt Square/Linear Footage Of Work: Q6 7 :s7*( � �.�,a '3'° ' r e of"Wor�C�° ,`[ Adit�on ` ❑Alte tion a ew Re air/Re lace Demolition �� Yp. � t. ❑ p p ❑ �x��X��x�x�x��xx��x��xx��•,rx�xx��xFeesx��x��X�,:xxx��x��*��x� Submittal Fee$ Permit Fee$�,� �o mil? CCF$ CO/CC Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$ n See Reverse side-� i 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. 1 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) ays after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reins on fee will be charged Signature Signature O er or Agent Contractor The foregoing instrument was acknowledged before me this 3r The fore offing instrument as acknowledged before me this day of ;-20 L2,by 47/a-Aa1r 1Pe kaoffer day of ,20 Ak,by )1 41 F-1)/tl� S who is personally known to me or who has produced who personalty known tom or who has produced L ltens ' As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Ana Elizabeth Raiszadeh m°1*"•Y pUS-. NOTARY PUBLI r c COMMISSION#DD895323 �nr�' %9 •. .o EXPIRES: SEP.22,2013 °�'' 14AGGIE LECCO Sign: I 'O WWW.AARONNOTARY.com Si PUNIC-Rate of Flora rrff�� .2018 Print: ^ ff a. RQ?,S7ZadeA Print: „ Commis91on#i EE 1-59389 My Commission Expires: RA2�/3 My Commission Expires: x�cx,Fd:9cxae,Y,YxaYxxxx,Yx,YxY:,Y,Yxxxxse,fx�dexxaYxxx,k aYxxx&icxxxxxic Sc,Yuxxr.iex xxzxx4cxaY9exxr,xa:is 4exxarxaexie d:x,k ie,Y,rzxx&a:acxxi:,Yxx,Y 4:xxxxxx APPLICATION APPROVED �Gv/Z- Plans Examiner Engineer Zoning (Revised 02/08/06) ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM.IF A MASTER PERMIT HAS BEEN OBTAINED,THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. I PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: PERMIT# PLUMBING ELECTRICAL MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS 34 CENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY I IA/C(CENTRAL) GREASE TRAP SERVICE SIZE IN AMPS. -100 d I I DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER JOVEN ABOVE GROUND TANKS SHOWER IWATER HEATER U.F.PRESSURE VESSELS SINK.POT/3 COMP. MOTORS 0-1 HP STEAM BOILERS SINK,RESIDENCE. MOTORS OVER 1-3 HP IHOT WATER BOILERS SINK,SLOP. MOTORS OVER 3-5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5-8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8-10 HP ELEVATORS/ESCALATORS WATER CLOSET I IMOTORS OVER 10-25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES IMOTORS OVER 25-100 HP COOLING TOWERS WATER SUPPLY TO: IMOTORS OVER 100 HP VIOLATION A/C UNIT lAtC WINDOW REINSPECTION FIRE SPRINKLER JAIR CONDITIONERS _ aj 3 HEATER-NEW INST. ISTRIP HEATER 3_10AI -HEATER-REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER-WELL GENERATORS TRANSFORMERS -SWIMMING POOL IGENERATORS TRANSFORMERS WATER SERVICE SPECIAL.PURPOSE SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY-SEWER SIGN TUBES UTILITY-WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY IFIXTURES FAINFIELD,4"TILEIRES. ANTENNA PUMP&ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU.FT. VIOLATION CATCH BASIN REINSPECTION DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET(GAS) GAS PIPING WEATH-2 OP ID:MG CERTIFICATE OF LIABILITY INSURANCE 1 DATE 04102/112 2' 04/02 , 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 COOSTITUTE 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(les)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 305-666-6636 CONTACT Wilson,Washburn and Forster NAME: Suite 300 305-662-7778 PHccO o - FAX No): 10301 South Dbde Highway E-MAIL Pinecrest,FL 33156 ADDRESS: Sarah J.Washburn INSURER(S) AFFORDING COVERAGE NAIC 9 INSURER A:Hanover American Insurance Co. 36064 INSURED Weathermakers Electrical INSURER B:Brid efleld Employers Ins.Co. Contractors,LLC INSURER C: 13955 SW 119th Avenue Miami,FL 33186 INSURER D: INSURER E: INSURER F: COVERAGES 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. WSRR TYPE OF INSURANCE ADDL UB POLICY NUMBER l MPMIUDD EFF POLICY Limits - - GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY LZJ7562104 02126/12 02/26/13 DAM TO SET Ea occurrence $ 100,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ 1,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident) $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per acdderd) $ HIRED AUTOS qlp Ogg � Pe0PcERTM'tDAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X WC STAITU- AND EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNERIEXECUTIVE YIN 830-21007 04/01/12 04/01/13 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? F NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarlm Schedule,H more space is required) Electrical Contractors CERTIFICATE HOLDER CANCELLATION VILLA-5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD