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EL-12-2184 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL s Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-201598 Permit Number: EL-11-12-2184 Scheduled Inspection Date: October 21, 2013 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: MACPHAIL,GAVIN AND MARCIA Work Classification: Addition/Alteration Job Address:226 NW 93 Street Miami Shores, FL 33150- Phone Number Parcel Number 1131010331080 Project: <NONE> Contractor: METRO ELECTRIC SERVICE INC Phone: 305-945-1991 Building Department Comments ELECTRICAL WORK FOR GARAGE CONVERSION Infractio Passed comments INSPECTOR COMMENTS False Inspector Comments- Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 21,2013 For Inspections please call: (305)762-4949 Page 27 of 29 rLC -s ` �A,ICORD DATE(MM/DD/YYYI� CERTIFICATE OF LIABILITY INSURANCE 7/10/2013 TE(MM 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(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 endorsemen s. PRODUCER NAME: Patty Carl an Ext 306 BB Insurance Marketing Inc PHON a 4g A/Ac Nr,: 2- 11870 W.State Road 84, C-15 E-MAIL Ft. Lauderdale FL 33324 ADORESS:P imi. OM INSURERS)AFFORDING COVERAGE NAIC# INSURERA:Scottsdale Ins Co INSURED METRO-2 INSURER B Metro Electric Service, Inc. INSURER C: 21407 NE 38th Avenue INSURER D: Aventura FL 33180 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1797537279 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 TYPE OF INSURANCE BR POLICY EFF POLICY EXP LTR INSR WVD POLICYNUMBER MM/DD MM/DD LIMITS A GENERAL LIABILITY Y 31848 1211712012 2117/2013 EACH OCCURRENCE $1,000,000 X DAMA TO RE E COMMERCIAL GENERAL LIABILITY PREMISES(Ea nos) $50,000 CLAIMS-MADE li�OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $1,000,000 X POLICY PRO, LOC $ AUTOMOBILE LIABILITY Ea BCgder- $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per $ i AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION 106-47548 212013 2 12014 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? F7 N/A (Mandatory In NH) E.L DISEASE-EA EMPLOYEli$1,000,000 If yea,deacxlbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more apace is required) Electrical contractor located at 15050 NE 20 Ave. N Miami, FL 33181. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E.2nd Avenue Miami Shores FL 33138 AUTHOR¢EO SENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD OEM= 1 , } AC# 6 2.912 5.7 STAT IF F LORIDA k DEPART OF :BUSINES;S' AND PROFESSIONAL REGULATION ELRCTRICAL:CONTRACTORS LICENSING BOARD SEQ#L1208220302: � • LICENSE NBR... .O 2 X012 127009316 °.EC000085 : ThtC ELECTRICAL CONTRACTOR Namod::be�.ow .IS CI�RfiIF�SD: Under the' f provisions o Chapter 489 :yS Expiration date: AUG .31, 2014 ..SARROW, .:'IYOU'GLAS EL METRO ECTRIC SERVICE,' INC 1885-B NE 149TH STREET NORTH MIAMI FL .33181 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY - AY AS REQURED BY LAW City of North Miami NORTHWIAMI776 N.E.125 Street • North Miami. FL 33161 . 305-893-6511 Business Tax Receipt/Certificate of Use Issued Date: 101112012 ELECTRICAL CONTRACTOR Expiration Date: 9130/2013 Business Tax Receipt#: BT-001900 Business Name/Address: METRO ELECTRIC SERVICE INC 15050 NE 20 AVE,SUITE 111 LAVENTURA,TRO ELECTRIC SERVICE INC NORTH MIAMI,FL 33181 407 NE 38 AVE FL 33180 Michael A.Etienne,Esquire,City Clerk NOTICE: MOVED,iTRANSFERED WHEN BUSINESS IS OR SOLD. NON-TRANSFERABLE POST IN A CONSPICUOUS PLACE NON TRANSFERABLE FIRST-CLASS re �Y 4R tx f� awe U.S.POSTAGE PAID �t MIAMI,FL PERMIT NO.231 OI739x6q—�3c (��► THIS IS NO;A BILL—DG NOT P Y�t�TRENEWAL BURE o EJECT S"SERVICE INC STATEW FUCH-0385 317396-3 15050 NE 20 AVE 331l181 NORTH MIAMI O'MRO ELECTRIC SERVICE INC '1T9�095 CAL CONTRACTOR WORK1A/S THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT.IT DOES NOT PERUIT THE HOLDER TO VIOLATE ANY sNe LLAAWS OFD DO NOT FORWARD COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER REQUIRED OR LICENSE METRO ELECTRIC SERVICE INC NOT REQUIRED BY LAW. F THE HOLDECERTIFICATION A> % ABRAHAM NARKES MGRM TIME. 7 CA=A UC 7n AlIC Miami Shores Village ) s Mme, Buildin g Department -� Nov 1 2O rZ � p -� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 BBC 20 BUILDING Permit No. 1 a— a PERMIT APPLICATION Master Permit NofCA ZJ2 M Permit Type: Electrical JOB ADDRESS: 2ak, �3 w s4 City: Miami Shores County: Miami Dade Zip: �� Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): t° Phone#: l Address:22 ro w City: V Is �� State: Tenant/l.essee Name: Phone#: Email: CONTRACTOR:Company Name: e± `C \u«/119 Q- Phone#: Address: City: State: Zip: 33e Qualifier Name: Phone#: State Certification or Registration p#: /Certificate of Competency#: /' Contact Phone#: � oS--c? l Email Address: �l�l L ic-7 / c ) DESIGNER:Architect/Engineer: Phone#: CeA Value of Work for.this Permit:$ +� � Square/Linear Foot-5w Work: Cy}*.��r Type of Work: DAddress teration ONew epair/Replace ❑Demolition Description of Work: W 1 VI Lau 6 1&1 ' „ 4.4 ifq" '� CO Y U"�►T�. Ve Submittal Fee$ Permit Fee$ ad CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ J J '" 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. 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 feven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a • specti fee will be charged Signature Signature -��Ee g e Contractor The foregoing instrume s know dged before me this The forego i instrument was acknowled ed before me day of ,20_,by o �� >by who is personally wn to me or who has produced who is personally known to or who has produced As entification acid who did take an oath. as identification and who did take an oath. NOTARY P LI NOT AP PUBLIC: t h o Z; W OtO , a: Sign: Slgn. OC o � o ¢ a W Print p •rit. n / � H o My Co`mmissio E i e -y aMe R riguea-Gas passion Expires: ' =�LL+ H My Cammksion EE0643408 � pir � a i bptna Obtl4tBaid E E r o 0 to +QJO i dG,,s APPROVED BY Plans Examiner _ _ o�g Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)