EL-13-151 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 ��' 4
Inspection Number: INSP-198120. Permit Number: EL-1-13-151
Scheduled Inspection Date: August 30,2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: , Work Classification: Addition/Alteration
Job Address:9500 N MIAMI Avenue
Miami Shores, FL Phone Number
Parcel Number 1131010330470
Project: <NONE>
Contractor: ELECTRICAL MASTERS INC Phone: 305-265-7996
Building Department Comments
REPLACE PANELS, CIRCUIT AND GFI'S Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-184791. Receptacles to be
tamper resistant.
Range to have 4 wire cord and receptacle.
Peninsular receptacle to be no more than 12 inches below the counter top.
Failed ❑ Garage receptacles to be G. F. I. protected.
All work is to be completed.
Correction
Needed
Re-Inspection <�
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 29,2013 For Inspections please call: (305)762-4949 Page 20 of 30
Miami Shores v Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 1 A N 2 9 ZOO
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949 0
F'BC 20
BUILDING Permit No. r
PERMIT APPLICATION Master Permit No. —I 9 c°
Permit Type:Electrical
JOB ADDRESS; 9.f"O4'� z/44t-shs �'
City: Miami Shores _�— County:_ Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes NO I Flood Zone:
, �j�lA�
OWNER:Name(Fee Simple Titleholder):W,—+�!OW—f k lki• ewe Phon #
:_474f {24 3Si`W
Address:,f"00 /l - *1/��2/
City: / - e*0 State z- Zip: J31$'O
Tenant/Lessee Name: Phone#:
Email:_ /K�TfJ�9G �1�hfl�• eO
CONTRACTOR:Company Name: E � -70 Z w C3c)--))
Address: 9C100 SW L q 54
city: /•3✓h 1 State: j` zip: 3-31
Qualifier.Name: e` �f /�l ���'[r��.�e Z Phone#:
State Certification or Registration#: i45 Q C 13 Q c-, 7 certificate of Competency#: cl 7ZF0CXD0037
Contact Phone#: � 7 7QZ'7 Email Address oz-zy�r®da" �"er
a
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit;$ S:rJO SgnareJLinear Footage of Work: 1$
Type of Work- (]Address Wdteration ONew A*epa /Replace UDemolition
Description of Work: RCAM ce P*,4-, zGd
Submittal Fee$ Permit Fee$ CCF$ GO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Tratining(Education Foe$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$,
Bow Company's Name(if applicable)
Bonding Company's Address
city state Zip
Mortgage Lender's Name(if applicable) N�
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
cornmenc�d 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,BOMERS,HEATERS,TANKS and AIR CONDITIONERS,ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is agate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAII,URE TO` PMORD A; b NOTICE OF
COIVIlVIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
BIPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COADMNICEMENT."
.Notice to Applicant. As a condition to the issuance of a building permit with an estimated value ezceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure*U be delivered to the person
whose property is subject to attachment. Also,a cert�%d copy of the recorded notice of commencmewmust be posted at the job site
Pr 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
signature � Signahrrr;
Owner orAgent Contractor
The foregoing instrument was acknowledged before me this /- The foregoing instrument was acknowledged.before=this
day of 20�L by 1 Ate' l/yf":i day of eo7/ 204''by &��°who is personally known to me or who has produced ��� who is personally known to me or who has produced
13.E '�� 2-5 As identification and who did take an oath as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
sign- sign:
G o
Print: p &
e�� A RODRI I PE NA
My Commission Expires: 4f * rA ct;tr of Fonda
. : Notary Public-State of Florida My $F
Z.
*'
M Comm.Expires Apr 24,2015 a. n�_�a ez
yF, aQ y P P anyGor:^i+_s•q cc0133B8
;F�FYZp�' Commission#EE 87255 �6o' efoKes es;01:2c14
APPROVED BY - l� �l�TBd� Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12fiZU12)Wevised0711M)(xevisad0finW )Wxv=d3/l")
To: P®ga a oP a Z0�3-01-17'17: 8:5'1 (D MT) Prom: .
AC R OP ID: TC
CERTIFICATE OF LIABILITY INSURANCE °A0117/2013
01!17!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 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 in lieu of such endorsement(s).
PRODUCER Phone:305-223-2633 NAME:
iSure Insurance Brokers PHONE
2700 SW 137 AVE Fax:305-220-0765 c No E C No
Miami,FL 33175
Teresa R. Carmona, Agent ADDRESS:
CUSTOMER ID 1R:ELECT-1
INSURERS)AFFORDING COVERAGE NAIC 9
INSURED e r Ca masters Inc. INSURERA:Florida Citrus, Business FUB
8400 SW 14TH Street
Miami, FL 33144 INSURERS:Travelers Insurance Co.
INSURER C:
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.
INSR LTR TYPE OF INSURANCE POLICY NUMBER 099W MIOD LIMBS
GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
B X COMMERCIAL GENERAL LIABILITY 660-7AB46384 10/09/2012 10/09/2013 PREMISES Ea occurrence $ 50,000
CLAIMS MADE OCCUR MED EXP(Any one person) $ 1,000
PERSONAL&ADV INJURY $ 1,000,000
X BLANKET ADD'L INSURED GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 1,000,000
POLICY PRO- LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $
ALL OWNED AUTOS BODILY INJURY(Per person) $
SCHEDULED AUTOS BODILY INJURY(Per accident) $
HIRED AUTOS
PROPERTY DAMAGE $
(Per accident)
NON-OWNED AUTOS $
UMBRELLA LIAB HOCCUR EACH OCCURRENCE $
EXCESSLIAB CLAIMS-MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $
WORKERS COMPENSATION $
AND EMPLOYERS'LIABILITY X TORY LIMITS ER
I WC STATU- H-
A ANY PERtME TDREXCLUDE/EXECUTIVEYlN 10640035 04/01/2012 04/01/2013 E.L.EACH ACCIDENT $ 1,000,000
(Mandatory In ER EXCLUDED? ❑ NIA
(MandatscylnNH) E.L.DISEASE-EA EMPLOYE $ 1,000,000
ff yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,K more space Is required)
lectrical Contractor
CERTIFICATE HOLDER CANCELLATION
VILLAMS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS.
Fax:306-766-8972
10050 NE 2 Ave. AUTHORIZED REPRESENTATIVE
Miami Shores, FL 33138 �"'��"�4"/ �.�d�''7►�'Ot�.Eti
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD
FIRST-CLASS
U.S.POSTAME
PAID
VIA11111111,PL
PERMI1'NO.231
THIS IS NOT A BILL—00 WT PAY
30-3857902 CC Nlir 47090803
j HECEIPT NM RrgMWr HOLM MAY 00
BUSINESS N"/LOCATION SUSINSM)ASA LONTRACTOR
MASTERS INC MAST ED HEREON.
ELECTRICAL A8 SP�CiFl
84E10 5ii 14 S'C
OWNER ,ELECTRRICAL MASTERS INC
E 6JA K V RECEIPT FAIR I ELECTRICAL CONTRACTOR
A LIST OF 1t70R-PARIICIPATINfl
E MUNICIPALITIES
a
i
Feaelpt holder mwt 00 NOT FORWARD
iev llarin6nealgl ELECTRICAL MASTERS INC
Am work is iobe OSVALDO RODRtGUEL► SR PRES
0400 SW 14 S1
MIAMI FL 33144
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!! THIS 18 NOT A BILL—DO NOT PAY
RENEWAL
BUBM�II<86 fIARAIEOM AWRIPTNO. 383790-2
ELECT kL MASTERS INC CC # 97114001111,1113 6400 SW 14 ST
33144 UNIN CAGE COUNTY
OWNS
} ELECTRICAL MASTERS INC WORKER/S
j TAICAL CONTRACTOR
00 liOT FORWARD
ELECTRICAL MASTERS INC
. v OSVALDO RODRIgUEY SR PRES
8400 SW 14 3T
PAYMRir Tex MIAMI FL 33144
09/17/2012 jn�lf„!! }�ri�E�rrirli�ial��lF�� lnl�il�iE�ilin�f+nl�li��
STATE OF FLORIDA
DEPARMWIM OF BUSINESS AM PROFESSIONAL REGULATION
ELEC`.[`RICAL CONTRACTORS LICENSING BOARD ($S0) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE M 32399-0783
RODRIGUEZ, OSVALDO
FI,ECTRtCAL MASTERS INC
8400 SW 14TH 9T FL 33144
7.
:ongratirlationsl With this license .•: s�rn�vF Fcoe�i► :. •• ACS°' 63.3 5:'6!4 4
7addians ticen�d b You
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)ur bps range from architects to yacht brokers,from :. •'
►oxen to barbeWe re$taura and trey keep Florida's economy strong.
SRO 013057•' O'9`/0+�r '12 127009317
:very day we work to improve the way we do business in order to serve you better-:
or rrrfixmatson at�out our services,please log onto www.rnyttoddallcensectim. R8G Si;EC ;`:EA1WAB":•.:. :.
here you can find more infuml2rtion about our divisions and the reguk that ROD=C•,UBz;"•' Qb�C �
mpm you,subscn'be W department newsle#em and learn more about the
)epartm e s initiatives. gt,:'Y:.WdAL
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)ur rnisdon at the Depar"ent Is:License Sf6clently,l egulats Fauiy-We Ta CODING.'-IN ANY. ARLA)
anskintty strive to serve you better so float you car+serve your customers. t .,r x .msa •pro..s�,.�.:� oE;i�.4S9 }
'hank you far doing business in Florida,and congratulatlons on your new licensel
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RN Rte' ;. KEN LAWSON
a0vP I
'` SECRETARY
DISPLAY AS REQUIRED BY LAW "