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EL-13-2078 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-201734 Permit Number: EL-9-13-2078 Scheduled Inspection Date: October 22, 2013 Permit Type: Electrical, Residential Inspector: Devaney, Michael Inspection Type: Rough Owner: O'NEILL, DIANE Work Classification: Alteration Job Address:1181 NE 103 Street Miami Shores, FL Phone Number Parcel Number 1122320310060 Project: <NONE> Contractor: LANGER ELECTRIC COMPANY Phone: (786)251-8585 Building Department Comments REPLACE LOG IN METER CAN Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed c Failed _,7Z ' 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 38 of 42 09/11/2013 14:19 9549848613 LYNNE LANGER PAGE 01/02 Miarrfi Shores Village k ..Bu Min Department �P. IMN-E.2nd Awme,Miami Shores,Florida 33138 Tel:(305)7952204 Tax:(505)756.8972 INSPECTION IS PHONE NUNME'R.(305)762.4949 -- FBC 20 BUILDING Permit No.e L13 —RCM� PERMIT APPLICATION faster Permit No. Perrnit°fype:Electrical ' JOB ADDRESS: ----- City: l�dian�n��kus��s �+' (`minty: Miami Is the Bii 3 Mxtork4y Designated:.Yes _ —NO NO .. ................ ... "_---.- Flood Zorn: OWNER:Name{gee simple I itleliolc1er}: Address• �..........._. s - City: h•'1`a4y'4 1S vq)v -- stye:- �-- ----- lip: TenantrLessw NAMO.. Phone#: l-:nail: CONTRACTOR:Company Name: �J �7��— Phonr.# Address: City: �. Qualifier Name: Phone#:�`77 State Certification or l gie#ratu�n Cetiificate of Campekwy#l: Contact Phone#: � Email,Address: me DESIGNER;ArchitecdFogineei: Phone#: Value of Work for tbis Rermlt:$ ��� S`tluxmff near Rootage of Worm:. Type of Work: ❑Address DAlterradon ❑New P19 •'kiepiaae Memolition Description Of Work: .............. CCR$ CUlCC� scorning Fee$ Rao=Fw$ DBPR$ Band$ •• � • •„ Notary$ TrainkWwAlwation Fee$... ..... . . Twimlogy Rep$ Double Fee$ 5tnx4w l Revitw$ TOTAL FEE NOW DUCE$ 09/11/2013 14:19 9549848613 LYNNE LANGER PAGE 02/02 Bonding C onipany's Name(if applicable) Bonding Company's Address city State' " ' zip Mortgage Lender's Name,Cif applicable) Mortgage Lender's Address City staito zip Applicudon is hereby made to obtain a pwrriil.to do the work and installautions as indicated. I certify that rlo work or instal 4on has commer&ed prior to the issuance of a•peruait aid that all 'pork will be pa:formed to meet ft standards of all laws xegulating• construotion in this jurisdiction. I midustand that a separate permit trust be secured for ELECTRICAL FORK,P'LUMBIN'G,SIGNS, WII,L.S,POOLS,FURNACES,ROJI ERS,H1=IATERS,TANKS wd Alit CONDITIONERS,ETC._... OWNIRR'S AID IDA,'VIT: I certify that all the&refining information is accurate aid that all work will be done in compliance wkb 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 NOTIC9.OF COMMENCEMENT:y N,vtkce to AppIk4ist: As a condition to igre rssuaface of sa baeddit permit wick an 4stanated valor �zng$2500,Ike applicant neat prmnise in good faith that a copy of the notices of oom a =mmt and coneErudion•diets law brockwe wall be delim-ad to Ow person whose property b subject to amt•.A19o,,a cen4W copy of the rewrded norbe•of o0 .. t neat be Posted at the job site for tlw firss irtspertion which occurs se (1) days after the,building perrrait is &sue . d}a the Serra such posted notice, ow wpection will not roved and a rehwpectian fee widdbe oh4rged, Signature Signature ° Owner ox Age • . Cfl actor The foregoing instrument was aeknowled 0d lire me this The forego mg Instrument was acknowledged before tm rhi.s_12� day of -W-h-20I-L by D im yit. C)'w-AL, day of 20 I2,by wha is personally known to we or who/task produced E L. W K who is personally known to me or vft lies p9ndueed 8 ' CC n As identaiioation and wba did take an oath. as identification and who did take an oath. NOTARY FVBLIC: NOTARY 11MIC: Sign: Print• 1✓ Print; C LX4 L L �o �--- *F'' POSw Notary Public State of Florida 1Vly Conn My CommitWon Pkppires: a • � Hr1E anY T Kelly RLg� N.,,,,4 o Y Commission DD928506 YATAU,JR.of�a& • Expires 09!28!2013 141Y N#EE 116573 ## u clTridera�rttaers xaaau. ­2a 13 APYROY» d Z° Flatus Fsxamirter zoning Structural Review Clerk (itevised 3t12"20f21(Re9Tised OZl10l07)(Ravised 0611012009)(Rgv'ia,d 3/25109) i LANGE-2 OP ID:LC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 03/08/13 THIS7-CERTIFICATE.IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPOW 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(ies)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 - - 954-776-2222 CONTACT NAME` Brown&Brown of Florida,Inc. 1201 W Cypress Creek Rd#130 954-776-4446 A/cCNo Ext: A No): P.O.Box 5727 E-MAIL ILLSS: Ft Lauderdale,FL 33310-5727 Andrew Noye,CIC,CRIS INSURERS AFFORDING COVERAGE NAIC# INSURER A:Hanover American Insurance Co+ 36064 INSURED Langer Electric Company dba INSURER B:*Hanover Insurance Co.+ 22292 Langer Electric Services Co INSURERC. FCC I I n surance Com an + 10178 6500 NW 21st Ave,Suite#1 Fort Lauderdale,FL 33309 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. IN SR ADDL SUB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD MMIDD LIMITS j GENERAL LIABILITY � EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY ZZJ765636503 03/10/13 03/10/14 PREMISES Ea occurrence $ 100,00 CLAIMS-MADE FxI OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 GEI,L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY FX1 PRa Loc lEmp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acddern $ 1,000,00 B X ANY AUTO AHJ947590201 03110/13 03/10/14 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Peracddent $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE UHJ765636003 03/10113 03/10/14 AGGREGATE $ 5,000,000 DED I X i RETENTION$ 0 $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY YIN X d T C ANY PROPRIETOR/PARTNER/EXECUTIVE 69637 01101/13 01/01/14 EL EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? ❑ NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEEI$ 500,000 Ii yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 A Equipment Floater ZZJ765636503 03/10/13 03/10/14 Leased 8: Rented Eq 100,00 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,tT more space Is required) I CERTIFICATE HOLDER CANCELLATION MIAMI-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Building$Zonin THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g g ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores,FL 33128 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT OF' Bt7SINE39 ANA PROESS.IQNAL REGITION M ELEO 'RIrCAI, GOI�'1'RCTORS LICENSING �QRD 19L4 0:NORTH MO�TROE` STREET , (8 "a 4'8 7-119 5 m TT m V., e . LA1fiER RI,EC 3t C{1MPANY ' 65xb 0 ��iAl, 2wSfi AEI�[TE S�L7. TE I, S±',01213' LAL7DEIALE' '�,,:33.3 09 -- i -.trw Congrattlationsl: With this 1rGense you lecotne one of e,n ark ;o ' r � � ' + M'a h �� ' " \ , . s utk'S tilt•.;, q,: . ."+ fi, FJor�dians licensed by the bepartmen#of Br�siness acid= rbfsssional R ulatlgn, �, Ap ,,.. Our f0fession0ls,•and br srr�e, s s range:#rb}y,arChltects to Y'"`^�:ytJ oK; •' > -\ �,r ,•}.,; gyakYl,J. �2r erf 'from.. S.- .p � ..�,x r., Wj, boxers to�barbeque restaarants,wand the Kee Flohda`secijnopi sro'" ° t `'� y `$F ' ° Y p rig Every day we work to improve the way we do business in order to setye you Bette oridalicens�cqY � �. 3 For informafion about our services,please log onto www m m E CRICTt�i > There you can:find more:information abodt our division$;and the regul,stions Pt�` .* !,u'' to .•. .�N E.,�x :. t,.i.-.,: impact you,subsenbe fo department newsletters and•-learn mote about the GER R Department s initiatives Our mi§son at the De artment-1. J.icense•EfflcientJ ,.Re ulate l=ard We ... ��rims constantly strive 6 serpvo;'you b tter so:that you can here ont;dustamers.. .:•'(:' `' . ThanK'you for doing business in=Floritla and.eongratulattons on your.bew licenser gip{ W17-11C AT i t tz ra as a ;� t 'D�T�CH HARE ...,...;t- .. .. .: f !-<.Y.^' �. t,t`mt'-� .$ E,g i d.x.:.:s Pz'e:}.>:;:*"„ss„`sf.•;�-. �8� �;,:�. 9 t ro3-; ,r , lie ® s e ® s • .(..+,owl t �I 6 3° 5` "�.`�t t, •t. 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