The URL can be used to link to this page

EL-13-846 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-198736 Permit Number: EL-4-13-846 Scheduled Inspection Date: September 10,2013 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: MACHEV, LUANN Work Classification: Alteration Job Address:1700 NE 105 Street 312 Miami Shores, FL Phone Number (305)310-5774 Parcel Number 1122300500500 Project: <NONE> Contractor: LS CURTIS INC Phone: 305-892-0115 Building Department Comments ADD 2 GFI RECEPTACLE Infractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed �f Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 09,2013 For Inspections please call: (305)762-4949 Page 23 of 31 ftami Shores Villa P g Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 f' Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. (D PERMIT APPLICATION Master Permit No.QC a 11 Permit Type:Electrical JOBADDRESS: /700 �j /��'� S' ree� qpk�) a City: Miami Shores county: Miami Da_ ee Zip: Folio/Parcel#: ,U• a o2 3 d —OCLO —66D6 Is the Building Historically Designated:Yes / NO X Flood Zone: OWNER:Name(Fee Simple Titleholder):1 k 4iAW Phone#: 91)6 - 7dR 0 -9 Address: /700 N15 City: Mi 04011 '! iaaa&S State: FL Zip: 1.3� Tenant/lxssee Name: Phone#: Email "Pj ?AR.r �l,L CD CONTRACTOR:Company Name: Phone#: Address: 2 e3 A✓P .� *V P fo_ city: �%[Aura- Stater Qualifier Name: _Ze Phone#:?e4J State Certification or Registration#: Certificate of Competency#: Contact Phone#: __ ��d`�`f / Email Address: zziiEaklt C e�&(' DESIGNER:Architect/Engineer. Phone#: Value of Work for this Permit:$ Cg Square/Linear Footage of Work: Type of Work: ❑Address DAlteration ONew /k'Repair/Replace (1Demolition Description of Work: Submittal Fee$ ® Permit Fee$ /„ �� CCF$ CO/CC$ Sunning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Stmctural Review$ TOTAL FEE NOW DUE$ 'londing 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 ELECTWCAL 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 the absence of such posted notice, the inspection will not b and a rei a on fee will be charged Signatmire � Signature Owner or Agent Contractor nth The foregoing instrument was acknowledged b/�efore/ this A The foregoing instrument was acknowl ed before this 2- day of L 20�3 ,by Lynn 0. In "' h " day of r ✓ 20�by who is personally known to me or who has produced dI Q q r)R o 1S personall own to me or who has produced w L1'G as identification and who did take an oath. NOTARY LI r• ERMTO A.MDOES NOTARY PUBLIC: Nar y 1 -Stee of FWWA • My Conan.Eom Dee 14,2015 c monads"#EE 153352 ' ,l°'t` Sign: Print: " n t°Se Print: CAS3AN My Commission Expires: - ® l�" My Commissio -. MY COMMISSION#EE219418 EXPIRES 25,2018 APPROVED BY 4f-f'lr— Plans Examiner Zoning Structural Review Clerk (Revised 3/1212012)(R"ised 07/10 107)(Revised 06110=M)(Revised 3/15109) �u r aF � Mai i # rs 8'iYK 11 VA: l f4 all F� E?,F• :r b' ok'er 1 p • 4 r � ks .F. �ibK .lag+S a'� rs+�''k�%;=�� Z@ ... "'@.' � •' ° �._ ��Si� si- [.•�:+' �� ;!_ �?... ..1,..'_a.3. t°.Msl'k �� r�s;�� i��a!�t5.:r�� &b.. STS ;a r . .y M 4 ° jY r,� r � 51 • DATEIMM,pD•VYYY! AC40R©P CERTIFICATE OF LIABILITY INSURANCE 04-17-2012 THIS CERTIFICATEIS 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 ADDITIONALINSURED,the poll y(les)must be endorsed. If SUBROGATIONIS 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 cenificatehotder In Hsu of such endorsement a). AUTOMATIC DATA PROCESSING INS AGCY AC No .t. (877)287-1316 IAffc.Nol: (888)443-611 250717 P: (877)287-1316 F: (888)443-6112 aOORESS: PO BOX 33015 CUS OMER D 8: SAN ANTONIO TX 78265 INSURERISI AFFORDING COVERAGE NAIC e INSURED INSURERA: Twin city Fire Ins Co INSURER B L. S. CURTIS INC- INSURER C; 20341 NE 30TH AVE APT 108 INSURER D: AVENTURA FL 33180 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 1 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. IN R LTA TYPE OR INSURANCE am POLICY NUMBER IMAA/DO/YYYYt ttM+TS QlNERAL LIABILrrlf EACH ` _ 8 j COMMERCIAL GENERAL LIABILITY I PREMISES IF.aecwence! 8 1 CLAIMS-MADE OCCUR ! MED EXP(Any one peroonl - S k PERSONAL&ADV INJURY i 8 'GENERAL AGGREGATE i8 L.W'L AGGRE�T LIMIT A=$PER: PRODUCTS•COMPiOP AGO !8 POLICY :PRO• LOC 8 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 6 _ (Es accident) ANY AUTO BODILY INJURY(Per pe.eon) $ ALL OWNED AUTOS �BODILY INJURY IPer eecalmti'$ I SCHEDULED AUTOS I ' PROPERTY DAMAGE i$ HIRED AUTOS i I (per ecadentl I I NON-OWNED AUTOS I 8 UMBRELLA i i S LAB OCCUR EACH OCCURRENCE 8 ~�EXCESB UAS `-CLAIMS MADE( AGGREGATE 4 DEDUCTIBLE I i $ •-- _ T i RETENTION 8 WOtO COMPENSATION I U• iQTK ANT AND EMPLOYER$'UTABILITY I X i TeRi/ ANY PROMETORIPARTNER+EXECUTI Y!N N 1 A! I :�E.L.EACH ACCIDENT s ,00 0,000 A:OFoRKEIR�M EXCLUDEDT J. 76 WEG TR4954 ! 05/01/2012! E.L.DISEASE•EA EMPLOYEE 8 1,000,000 u yoo.descnbo ender E.L.DISEASE•POLICY LIMIT S 1,000,0 00 oESC 0 toN of oPERAT+aws below DrAcWPTWN OF OPERATION$I LOCAMNS I VEN]CLES IAnseh ACORD 101.Add Bond Rommla Sdm ulo.U moo opine b►equb0a Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Miami Shores Village BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 N.E. 2nd Ave. AurROR+z eseNrarne ..,7 Miami Shores, FL 33138 e 1888-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009109) The ACORD name and logo are registered maths of ACORD 0. "T -OF MXNM -AM TROPS2010ML nOULATION ( ORTS M00 ' 1 3239!9-Q7r�3 G LENT.-fa STEVEN . . . C' 313180 #tr�ort 1 9 i ads Ilk o y u ice � . ' .. aur..: espona i Ci#� f*yacht brok fry u tore t rr lh + P I On weconotny efr€ari ' 0371 :19' If erp�y W Ct f � the ire bu t s 1r� to serve yt r. r �aur� s�-,i asr Ww r7#t 7`her y0tr rtf0(MaVo t#bout artar OvI si s `tira to t r .thdf it p $fit u is t ddperbn+ rr t�ewr�t er errdcle rn b? the ► . 4� oik 1— 136 n E the 3 pa ftmo tf 9 Rie s fr�ferttt 4 egw is Faidy.We � rrtiys r eta r'ge��hat:� "rte y� r Cus era �� . � �� n� .ass Ci y riwiwo is,., yote hew i1ceftel ps Y xi star Sx .i 2014 , 140040 a DEMH H � I ,. .. : .. Wpb` r ' 5a h ' 0 .F �V 0, as a , � �� W g�9 R Ems. 3 �3 .: U. C , Y x ' ate:` ,�r I'• �`� s � � � Ye r •, � -: -.�.., ,;'' +..>. •. � ,...,;: .o=ff. ';s .. � .;:��; a»z ��.��',�::� _`' sir,, s. max` ... '�'. - I 5 i MY MOO ., : i ;0, 04TRICAL' ,. r LOCAL� Ry )60 'MW TOAVMRD I I k T !� U� - AVE 4 szsT�A sloe . 3 '' 'w e 0-6�25/2013 18:00 3059402138 #6569 P.001 /001 -,CC M, DATE(MMIDDNYYY) �✓' CERTIFICATE OF LIABILITY INSURANCE 04-17-2013 THIS CERTIFICATEIS 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 CERTIFICATEOF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUR€R(S),AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER, IMPORTANT: If the certif cate holder is an ADDITIONALINSURED,the policyties)must be endorsed. it SUBROGATIONIS 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 certiftate holder in Neu of such endorsaman(s). PRODUca NAME: AUTOMATIC DATA PROCESSING INS AGCY �CNIEVo r, ;FAX No): 250717 P. 0 - F: 0 - PO BOX 33015 ADDKSS. SAN ANTONIO TX 78265 INSURERS)AFFORDING COVERAGE NAICS INSURER A: TW3n. City Fire In.s CO INSURED INSURER S i I INSURER C CURT I S INC. INSURER 0:20341 NA .30TH AVE APT 108 INSURGN E, AVRNTURA FL 3318 0 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 SE 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 HAVI!BEEN REDUCED BY PAID CLAIMS. `Lire j TYPE OF I NSUHa{NCe Run I Wvv I POLICY NNum" 0IN7I obit--) { (�q /DDlYYYY! I Laarrs GENBIAI tlAtNltrlilr ; I I EACH OCCURRENCE 13 COMMERCIAL GENERAL LIABILITY I I PREMISES Mw occurrence) 18 1 T I� CLAIMS-MADE OCCUR MED EXP(ArnY one perm) I S U Hi I I PERSONAL&ADV INJURY 1 0 GENERAL AGGREGATE I S L� �J PER: i I PRODUCTS-COMtOP AGG S GEE'L AGGREGATE LIMIT Ap t£s POLICY E. JPR0 L—J LOG I `• s AWON OE"tNUO Y ! COMBINED SINGLE LIMIT $ (Es aocgdew) i BODILY INJURY(Per person) i 5 ANY AUTO _ i P!ALL OWNED SCHEDULED I U 0 f 60DILY INJURY(Psr scadm1)l S AUTOS u AUTOS I (PROPERTY DAMAGE I HHIRED AUTOS + I NON-OWNED ) ! r I (Per a0awa x) LJ I S AUT05 UMN031A UAe OGGUR ! ) I FACET OCCURRENCE S I i IXCESS I,nH I GLA(MS•MADEf U I L I I I AGGREGATE 5 DED� RETENTION S N(ORK9t:C,ONY0ENSATION I X I T j TATU`I IOTA AND VtAPLOYERS*uASrUTY ANY PROPRIETOR*ARTNER/ExEcuTIV YIN NIA,i — I E.L.EACH ACCIDENT S ] Q Q Q .0 0 0 A OFFICEWeME�EREXCLUDED7 U 76 WEC TR4954 05/01/2013 05/01/2014 ((Ma xls[ory NIT) I I E"L DISEASE-EA EMPLO s 1,0 0 0,0 0 0 If yyG� dewribu under DESCRIPTION OF OPERATIONS W*W I I E.L.D15EASE-POLICY LIMIT I S 1 j 0 0 Q 0 0 0 ILJ�U � DISCRIP[aoN OF OPERAMO NS I LOCATIONS/VNaittLES(Aflsrit AOO[►D 701,Additiernll I�gnfo[Im Sriiadut9,Nf more cyaes IS raquecd) Those usual to the Insured' s Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Miami Shores Village BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Building Department DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E. 2nd Ave. AWM ENTAtTVN Miami Shores, FL 33138 ��- �GZ-[�� e 1988-2010 ACORD CORPORATION. AN rights reserved ACORD 25 (2010/05) The ACORD name and Ingo are registered marks of ACORD rw ACORN CERTIFICATE OF LIABILITY INSURANCE 04-17-2013 THIS CERTIFICATEIS 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 1NSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATIONIS 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 CO AC NAME: AUTOMATIC DATA PROCESSING INS AGCY PHONE FAX A/C No,Ext): (A/C,No): 250717 P: () - F: () - AL PO BOX 33015 ADDRESS: SAN ANTONIO TX 78265 INSURERS)AFFORDING COVERAGE NAIC# INSURER A: Twin Cl t E e Ins CO INSURED INSURER B INSURER C L. S . CURTIS INC. INSURER D 20341 NE 30TH AVE APT 108 AVENTURA FL 33180 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.00 ILTR TYPE OF INSURANCE 'INS R1 WV POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS-MADE u OCCUR _ _ I MED EXP(Any one person) $ H U PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ EIPOLICY U PECT RO- U LOC $ J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED I SCHEDULED u BODILY INJURY(Per accident) $ L AUTOS AUTOS I� HIRED AUTOS I I NON-OWNED PROPERTY DAMAGE $ LJ AUTOS (Per accident) $ UMBRELLA LIAB U OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE u IJ AGGREGATE $ DED I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABIL17Y X TORY LIMITS ER YIN ANY A OFF]CERIMEMB REXCLLUDEDECUTIVE� NSA 76 WEG TR4954 05/01/2013 05/01/2014 E.L.EACH ACCIDENT $ 1, 000, 000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1, 000, 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1., 000, 0 0 0 uu DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Those usual to the Insured' s Operations . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Miami Shores Village BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE Building Department DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E. 2nd Ave. AUTHORIZED ESENTArnE Miami Shores, FL 33138- 71�z7— I � 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AUTOMATIC DATA PROCESSING INS AGCY PO BOX 33015 SAN ANTONIO TX, 78265 11990 Miami Shores Village Building Department 10050 N.E. 2nd Ave. Miami Shores, FL 33138 a H h N O N i III O Q Q Q O O I� Q Q D Q I� ACORD 25 (2010105)