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EL-13-210 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 '' Inspection Number: INSP-198369 Permit Number: EL-2-13-210 Scheduled Inspection Date: October 10, 2013 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: HOLDINGS IV, LLC, HSL PROPERTY Work Classification: Alteration Job Address:766 NE 96 Street Miami Shores, FL Phone Number Parcel Number 1132060142070 Project: <NONE> Contractor: AP POWER ELECTRIC CORP Phone: (954)822-4496 Building Department Comments KITCHEN AND BATH REMODEL . ELECTRICAL UPGRADE Infmctio Passed Comments PROVIDE SMOKE DETECTORS INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-198253.A/C not installed. Screw the cover closed on old panel. All garage 15 and 20 amp. receptacles to be G. F. I. protected. Dryer receptacle to be 4 wire. Failed Install kitchen light fixture. Correction ( /0* Needed ❑ IcI2 Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 09,2013 For Inspections please call: (305)762-4949 Page 6 of 22 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 �E t A p Tel: (305)795.2204 Fag: (305)756.8972 �I _ INSPECTION'S PHONE NUMBER:(305)762.4949 _-''---- FBC 20 kO BUILDING Permit No. 13—"Zvo PERMIT APPLICATION Master Permit No. -r te-'5 — Permit Type: Electrical JOB ADDRESS: '?&& -n( T' City: Miami Shores County: Miami Dade Zip: Foho/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): J)AAAAA Phone#: Address 0 k City: State: Zip: J Tenant/Ussee Name: Phone#: Email: CONTRACTOR:Company Name: 1 f 1' Phone#: Clst Address: No S4 4 City:r--> State: zii�p: ' 6 sz;2'. Qualifier Name: Phone#: t�4 L' t / State Certification or Registration#: �� Certificate of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: Phone#: 00 Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑Address OAler tion ONew 0 epair/R�place OD molitin Description f Work: Y ( S Submittal Fee Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ �% � 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 a absence of such posted notice, the inspection will not be app oved and a reinspection fee will be charged. Signature Signature ��r or Agent Contractor The fore oing instrument was ac ledged be re me this The foregoing instrument was acknowl ged b ore me this day of ,20 3,by C day of ,20� by who i ersonall known own me or who has produced who personally kno o me or who h�� ced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Qsn�w Print: v Print: My p �IkeOt My Commission Expires: �o`F�ora M Commission Expires: g NTo 0J�oti�1�6 Qe��teti rc1�6� N�Q`Se o t Noese�P� ��2 q0 �� APPROVED BY _ Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Miami-Dade County -Building and neighborhood Compliance Office Page 1 of 1 Home I Product Control I Contractors Building Gificials Contact us A Contractor License Information Contractor Number: 1 OE000121 Contractor name: AP POWER ELECTRIC CORP Address: 3758 SW 16 ST City,St,Zip: FT LAUDERDALE FL 33312 Phone: (954) 822-4496 Other Phone: Fax: Email: ARZOLA 1212QHOTMAIL.COM D/B/A: Contractor Status: ACTIVE Class Category Category Description Expiration Date ELEC 1 ELECTRICAL 09/30/2013 CONTRACTOR INQUIRY COMPLETE Contractor Inquiry and Complaint Search I Home Page I State License Search Menu Home Using Our SRe I About I Phone Directory I P Disclaims r E-mail your comments or questions to BLDGDept.Qmiamidade.gov ©2001 Miami-Dade County.All rights reserved. I it i http://egvsys.metro-dade.com:1608/W W WSERV/ggvtBNZAW941.DIA?CNTR=10E000121 2/4/2013 CERTIFICATE OF LIABILITY INSURANCE DATE(Mmearr`m x2/05/2013 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 PRODDER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION 13 WAIVED,subject to the tome and conditions of the policy,certain potic(es may require an endorserrie t. A statement on this certificate does not comer rights to the certificate holder hr lieu of such endorserrmn s. PRODUCER 786-573-4485 786-573-,4486 : Ma teen Blandon Insurance NOW Agency PH 786-573.4485 I M Z 78fi-573-4486 12915 SW 132 Street suite 4-B EMAILmayleenCinsurancenowagency.com Miami, FL 33186 PRODWeR INSURERISIAITORDINGOOVERAGE NAIC o INSURED INSURER A Ken Keftge Insurance AP Power Electric Corp. INLIRERa: 3758 SW 16 Street INSURER C: Fort Lauderdale,FL 33312 WSUPERD: 1NSURER 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, 1LYR TYPEOFINSURANCE POLICYNUr1BER EFF MM LarITS GENERAL LIABILITY EACH OCCURRENCE $ A COMMERCIAL 6'ENERAL LIABILITY DMAAGE Ea scat n s $ CLAIMS-MADE ®OCCUR MED EXP one person $ SCP0836557 0311612012 03/16/2013 PERSONAL&ADVINJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOPAGO S POUCY PRO` LOC $ AUTOMOBILE UASILITY COMBINED SING LIMIT (Ea aoddent) $ ALLOWNE BODILY INJURYTerperson) $ ALLOWNEDA1170S BODILY INJURY(Peramident) $ SCHEDULEDAUT� PROPERTY DAMAGE $ HIRED AUTOS (Per acddeno NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESSUM CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ R $ WORKERS COMPENSAYM I ST T O'14, AND EMPLOYERS'LIABILITY YIN ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT 16 OFFIGEMEMSER EXCLUDED? El NIA Plandabuy in NH) E.L.DISEASE-EA EMPLOYEE $ It yes.de tlbs under DESCRIPTION OF OPERATIONS bOm E.L.DISEASE-POLICY LIMIT I$ MWRWnW OF OPERATIONS 1 LOCATIONS I VEHICLES(Aftab ACORD 10t,AddMotall ttmo is somdule,ff more space is requited) Electrical Contractor. CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF DESCRIBE POLICIES BE CANCELLED BEFORE 1aa5a NE 2 Ave ACCORDANCE EXPIRATION REOF, TICE WILL BE DELIVERED IN ACCORDANCE Miami Shores, FL 33138 AUTHORl2ED 7%*+andon ®1 RD DRPORATION. All rights reserved. ACORD 2S(2009109) The ACORD name and logo are registered of AC 1u