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EL-13-1448 R Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 N -��`�o Tel: (305)795.2204 Fax: (305)756.8972 17 INSPECTION'S PHONE NUMBER:(305)762.4949 1=='O°°° FBC 2010 BUILDING Permit No. Fri,13 14 PERMIT APPLICATION Master Permit No.MC- I Permit Type: Electrical ` JOB ADDRESS: T /�/ E �`�'` SY City: Miami Shores County: Miami Dade -313 Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: /y® OWNER:Name(Fee Simple Titleholder): /V /� Phone#: 9 Address: .5- City: _5 State: F—p Zip: TenanVlxssee Name: /v Phone#: Email: CONTRACTOR:Company Name: Address: ,�911. All, Za .9 15,7" City: 2L State: Qualifier Name: G �� Phone#: _ _ State Certification or Registration#: ��®D/1; C7 L9 Certificate of Competency#: Contact Phone#: AWE—2-i'4?2 0j� Email Address: DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ 704-*�&9L Square/Linear Foot ge of Work• Type of Work: DAddress OAlteration ONew ®Repair/Replace• ODemolition Description of Work: :zp_fc 4A E ` Submittal Fee$ Permit Fee$ 61 D 6' 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 even (7) days after the building permit is issued. In the absence of such posted notice, the inspection will be n roved and inspection fee will be charged.R All I /,Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this��,,e- The forego'in'g instrument was acknowledged before me this Q day of 20�I_J by`U�� day of �i�-`+V ,2d� ,by Ootlk-®C 1-/ who is personally known to me or who has produced �`��197 who is personally known to me or who has produced/I.,-) As identification and who did take an oath. as identificatiox� �� d(g*e an oath. NOTARY PUBLIC: i y �0' 1 NOTARY PUBLIC: Sign: Sign: Print: = ��nd�`� - Print: M Commission Expires: % 910Z� Y P .� sa1�d�'' ��`,r` My Commission Expires: //'�� t, 4'',\\`\ �e:��,��r��a��r��x��r��u�s•��r��,��*�x�x�u,��x��:��:�r�**��r:��r��:��r��r��u��r��x:��a��r��e APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07XRevised 06/10/2009XRevised 3/15/09) _ _ I DATE(MM/DD YY) CERTI FICATE 7F LIABIL ITY I NSURANCE 08/29/12 _ INFORMATION PRODUCER Annette Willis ISISSUED As A MATTER OF ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 18401 N.W.27 Ave HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Miami,FL 33056 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. _ Phone (305)625-2403 Fax (305)625-6472 INSURERS AFFORDING COVERAGE NAIC# SURERA: NOVA CASUALTY INSURANCE_ INSURED LINDMAR ELECTRIC INC M- -- _- - - -- INSURER B. GRANADA INSURNCE COMPANY C/O ORLANDO LIND INSURER C: 496 NE 89 ST _INSURERS-- - -- --- -- -- -- -EL PORTAL, FL 33138 INSURER E: COVERAGES - INSURER F: FTHE POLICIES OF INSURANCE LISTED 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EXPIRATION I LIMITS LTR 1NSRD DATE_(MM/DDIYY) GENERAL LIABILITY POLIO EACH OCCURRENCE 1,000,000 TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) , DAMAGE TO RENTED - COMMERCIAL GENERAL LIABILITY 0 08/26/12 08/26/13 occuren I PREMISES(Ea ce) -- 100,000 ❑❑ CLAIMS MADE [d] OCCUR MED EXP(Any one person) 5,000 A - - — ---— ❑ ❑ PERSONAL&ADV INJURY 1,000,000 GENERAL AGGREGATE 1,000,000 El GEN'LAGGREGATE LIMIT APPLIES PER:I PRODUCTS-COMP/OP AGG 1,000,000 - -- - - - - - POLICY [1 PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT El ANY AUTO E c ( a accident) _ 0110fl00007596 09/06/11 09/06/12 F - ❑ ALL OWNED AUTOS BODILY INJURY 10,000 B E-1 SCHEDULED AUTOS (Per person)- ❑ HIRED AUTOS BODILY INJURY 20,000 ❑ NON OWNED AUTOS (Per accident) ❑ _ PROPERTY DAMAGE 10,000 L (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ❑ ❑ ANY AUTO OTHER THAN ❑ AUTO ONLY AGG I EACH OCCURRENCE EXCESS/UMBRELLA LIABILITY -- - - ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE _ -- - --- ❑ DEDUCTIBLE � ❑ RETENTION $ - - - - - ❑-- EMPLOYERS'LIABILITY TORY LIMITS- �RH _ -- WORKERS COMPENSATION AND ANY PROPRIETOR J PARTNER/EXECUTIVE E.L.EACH ACCIDENT - OFFICER/MEMBER EXCLUDED? E.L.DISEASE EA EMPLOYEE If yes,describe under - - SPECIAL PROVISIONS below E.L.DISEASE POLICY LIMIT OTHER - --- II DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ELECTRICIAN VEH# 1) 99 FORD ECONOLINE VIN # 1FTPE2424XHB39812 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL MIAMI SHORES VILLAGE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 10050 NE 2ND AVENUE OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. MIAMI SHORES, FL 33138 R D - -T VE -- AUTHORI ZED REPRESENTATIVE ACORD 25(2001108)QF ©ACORD CORPORATION 1988 FL PERMFT NO..231 tS L!flT A i Wt3T PAY fit=G 117 No. � 2916659 ::CC NO• 001fl1 545 SC13IN1=SS NAME 1 LOCATION t C13P1 NSJI.. MAY b0 :INDM�R ELECTRIC. INC S!NEsS Bt7 A�..A lo CTOI� AS SAECti=fE1:1 W�tEON SfE �ikC� fly. REf�IfiT �@� ELfC'fRI-CAS. Tom' A LIST tif:;NOT t� tRTICT MUNICII�ALIIS nub DO NOT FORWAFW rjterieY LINDMAR ELECTRIC INC !"► � ORLANDO E LIND PRES 496 NE 89 ST MIAMI FL 33138 _. MIA%It�OADEtXitNIT'[T/tX: . 60040000339 .:..000200:110 trtiirr,11rrrr l�,+�t+�+,�t+��r++1f+�+:i+l+Irlllr++tt++elesif( 3lAS d3Hlo 33S 00'SL0000 13Gi Ltfl�c+l+tr�+r+t++t+l lr++sFt+++ c+lttl++it:+++1�►++3i++ 8£S0000+�009 21.azl.Lz.fb0. .Hojl)3,nc xtli AirtnOa aatlawrtl O3A1303ti 1N3WA1 t��++[[�� 8S T b L l� Itl�V •Vat.Mno 8.H3MOH 3 3O NOLLVOdLLm3O V b IS 69 3N 96t, 91 gin-Mv-1 AiOe 03 wm S3Sd aN11 3 OQNVlSO "i!"3s id 3NI 3IS13313 btlWQNII ma . tlo e No ALOltlltwk w ONLL£ QadMwd 3:(1N JUWH3d ION�8 It'id1303+!xvi 383N1' '+tlOO'1 tl ,JNO SI ! z So.L3VSIN03 lV3. "J3)sA 1xoes S/S3)18014 3NI 3IS13313 SVW(IMAmo AINn03 3oVa NINn 9STS2 ** IS 68 3N 96" :)NI 31 a �r3 S�iS6��o3t� 33 - 6-59916z ION Cat] TilB ION St S1HI -W INMW old Report Viewer Page 2 of 1 do F-111 ? . JEFFA7YV IM CHWFM4NCM0FFM= STATE OF FLORIDA DEPARTlMENT OF F9&WMX4L SENIUMM MV tOF 5 TM ''CERTIFICATE OF EL.ECTM TD BE EXEMPT FROM FLORWA IRS MN LAITY" CONSTRUCTION INDUSTRY EXEMPTION 7'gist 5W5m hiffidduW IsWd bebw bus elacWd W beam*ft FWrift Wadme ConVenss#m low. DATE: 4/t6Wl3 EXPIRATION RATE: 4MMM5 PERSON: LIND ORLANDO E FEIN: 650370= BUSHHMS NAME AND ADDREBIL UNDMAR ELECTRIC MC 49M E.8857: MAAMt FL 33138 SCOPES OF BUSS OR TRADE: ELECTRMAL VWRM - _.. Fwm�tbCr499L�1AF-8..bdam�p�aeb�ds Emm�s tlr�+eam�aYededesBmo�mts�anmeq mlaxruembaeesa to fHsd� PaPa 3bt laf F.Be, ddee8anb6e -�ptl ��opo dOab�Sakaa�i�edea8eo�sdd�trebeeaaflgt. b F-B,Negeadaf�mbbeem+pt aid akeSoabbE6ibao!(eelbaaeWb;atmq baeslowrmo dCwra6eaa d9iobapwmavmedoatrae5ma am�m0awbogerme�ie d�saa�a lmbaawda TbdslWa7ot®acmwmAedimnbi�mdIDe pmama•ns!-mffieabametlbdbb saan CFS+2-DVJC�MCERn TCATEOFELSMMTOBEEKEWT 07-12 "s-Im ill i https://apps8.fldf.com/cnWAviewer/repofViewer aVx?data=Wvpginc9D7Q3gH6TER6... 4/2512013 Inspection Worksheet Miami Shores Village N.E.2nd Avenue Miami Shores L 10050 , F Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-195736 Permit Number: EL-6-13-1448 Scheduled Inspection Date: July 25,2013 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GREENBERG, MARK AND DEBORAH Work Classification: Alteration Job Address:485 NE 94 Street Miami Shores, FL 33138- Phone Number (305)754-2593 Parcel Number 1132060140540 Project: <NONE> Contractor: LINDMAR ELECTRIC INC Phone: (305)756-1075 Building Department Comments INSTALL ONE AC SPLIT UNIT Infractio Passed Comments INSPECTOR COMMENTS False I Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 25,2013 For Inspections please call: (305)762-4949 Page 18 of 33