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EL-12-2230 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 -- 1(0 4 Inspection Number: INSP-188537 Permit Number: EL-11-12-2230 Scheduled Inspection Date:April 04,2013 Permit Type: Electrical- Residential Inspector: Devaney,Michael Inspection Type: :eh Owner: CAUCHI, PAUL&MAGDALENA Work Classification: A n Job Address: 131 NE 96 Street Miami Shores, FL Phone Number Parcel Number 1132060132590 Project: <NONE> Contractor: FIALLO ELECTRIC CORP Phone: (786)399-0832 Building Department Comments garage conversion to bedroom 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. April 03,2013 For Inspections please call: (305)762-4949 Page 25 of 26 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 NOV 2 6 2012 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 201 p BUILDING Permit No. FLI PERMIT APPLICATION Master Permit No. ( � Permit Type: Electrical JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes O Flood Zone: OWNER:Name(Fee Simple Titleholder C v [✓ l 1 Phone#: *5 (O�® Address: PIN IV City: Aw I State: Zip: 1 3 A- Tenant/Lesseaae��N��ame: Phone#: Email: 1AA-151 `,ffq—or a^ CONTRACTOR:Company Name: f� C) H, , FL co k_ a Phone#: '7961 .3 99 71552 Address: 7 V 2 t S c,j i Z 1—ielE City: /V 1 ;4A4 of State: =L. zip: 3 31 Qualifier Name: I.O i S 9 g/,U f2 Phone#: 796, 3 2% 09 3 a State Certification or Registration#: C=. C D©O 3& &3 Certificate of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: Phone#: V �foi Type of Work: DAddress DAlter lion ONew ��++�� air/Replace ODemolition escri t on o L 00 Ue b Submittal Fee$ 0.0 Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ jak / 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 A lication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has PP Y P fY 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. G6WARNING 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 be approved and a reinspection fee will be charged. I P Signature - Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of f ® ,20 IL by H4^EPP4(AA -. C avc�l/, day of 1-0 ,20 Z,by who is personally known to me or who has produced �'t/7 who is personally known to me or who has produced 1' c.a) As identification and who did take an oath. as identii�ficaat�tiionn and who did take an oath. NOTARY PUBLIC: NOTARY PU yW: __VZ4-.,iii • tiY i vtJun a APgr •••� Sign: ��i,, Sign: 4y �" Print: : 4 Print. L • C My Commission Expires: Commis I �;.•' . 9l4y ��is�QFFLOR1Da .``. S I u8\. APPROVED BY 2�� Plans Examiner Zoning Structural Review Clerk vis 12/21 V(R 07/10/07)(Revised 06/1 0/2009)(Revised 3/15/09) 12/06/2012 16:51 FAX fm001 Dtc. 6. 2012 4.28PM FLORIDA BANKERS INSURANCE No- 0682 P. 1/1 65W CERTIFICATE OF LIABILITY INSURANCE i2=2 r' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIR MTIVELY OR NEGATIVELY AWWD,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT SETWEEI THE MUM INSIIRER14},AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. mOumr.Kam cerWm%hakw is onADDt71 M L UMWAMBm Pow)must be mbm@t Bt iATI=mIt&1 vv%Belo gWWMWWconc0000f#opofty,co%npolftenWrequinanandWsoMenL AstuemotanUbCwtm abadewOdcm6erfWafa to cwMWate holderht Neu ofsuch FROMMER MARIA M ALONSO Florida Baolm Inane M 2684493- No: (3M)262-OM 7278 SW 8 Stmt •=n Miami,FL 33144 Phone (31026"66493 Fox (305)262-0879 NMNlRRAFFQF=GC0V8V= ?=* MOURM t A: FEDERATED NATION&1NStiRANCE COMPAN Fido M.J.E3eoft Corp. S: PROGRESSIVE EXPRESS INS.COMPANY 7025 SIN 17 Tern ROURM C: MIAMI,FL 33155 OwAtm a- (788)3887152 COVERAGES CERTIFICATE NUINBEW REVISION NUINBER: TEAS ISTO CE RTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE M MED MMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDMANYRECUIREMENT,TERMORCONDMONOFANYCONNMACTOROTHERDOCUNENTWfM RESPECT TOWNCH rHIS CEIMFICATS MAYBE ISSUlW OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAID CLAIMS. OENERAL UAMMY EACH OCCURRENCE S 300.000.00 Q COMMERCJAL GENERAL LlMUTY PRE sES Eeoacurr s 100.000.00 ❑ Cl CLAIMS-MADE p «CCUR OL-05040049?3.02 MED ExP(NN ON WOM) $ 5.000.W A ❑ 04M 2M2 04Ma=13 PERSONALBAaYIRUW S 304.000.00 ❑ GENERAL AGGREGATES 300.000.00 GENL AGGREGATE LIWTAPPUESPr:R PRO D_ICTB-COWPJOPAM S 300.000.00 JZ POLCY ❑2& ❑LOC 6 eonasrNED SINGLE uWr AUfOMOaR.EtdABHdfY (EeecaideMj � ❑ ANY AM DODLY INUUW tPer perm) $ 101000.00 t3 ❑ ALL OWNED AUTOS 01898091-0 10/12012 t0/12fZ0 F3 SODLY I W UW(Per odds" $ 20,000.00 © AUTOS PROPERTY DAMAGE ❑ rol�D Jwros {per aecwnr) S 10,x.00 s ❑ W*oavNED,wros $ ❑ UNBRlB.tA UAS ❑OCCUR EACH OCCUR $ ❑ E=M LM ❑CLAIMS•MAM AGG EGAM s ❑ DEaucrlaLE s RErENnoN s Warjam ccmre moN W&STUT oTH AND Orr YERa'UABLITU ANY PR�ETOWPARTNEREXECUM YIN NJA E.L.EACHACCIDEN'f S }yam J�DCCLC E.I..otsEAse-EA a Ir TIONS betwv ELMSEASE -POLICY LMT S L-- -— , -H DEqCWMQN oF oPQWnO is J LOCA'nONB rVBtNCLEB 1Attaoh At:or�16a,AddRlorad Reaarra 8ahedWe,nrmn sr ream ed3 CERTIFICATE HOLDER CANCELLATION SHOIRD ANY OF THE ABM DMWjWW POLK=BE CANCELLED WWORE nW00"M TSINOATOTHt3REF.HOTIORWILLB@DELIVERED M MIAMI SHORES VILLAGE ACCORDANCE Wn7f THE POLICY I'l 149- 10050 NE 2 AVE MIAMI SNORES,FL 33138 0 losomM ACORD CORPORATION. AN rights rested. ACORD 25(21HIM)QF The ACORD nwo old lago 8TS FBWW d ma t3 dACORD 12/06/2012 16:51 FAX IM002 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (650) 487-1395 TALLAWSREMONRO STREET 32399-0783 SALAS LUIS ANDRES FIALL6 M J ELECTRIC CORP 1715 SW 88 AVE MIAMI VL 33165-7847 Congratulations With this license you become one of the nearly one million Floridians Ocensed by the Department of Business and Professional Regulallon, Our professionals and businsasss range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. i - - Every day we work to Improve the way we do business in order to serve you betted For information about our services,pl ease log onto www.m oridallcensecom. There you can find more information about our divisions the regulations that t Impact you,subscribe to department newslstters and loam more about the Department's initiatives. Our mission at the Department Is:Udense Efficiently,Regulate Fairly.We instantly strive to some you better so that you can serve your customers. Thank you for doing business In Florida,and cxxngratulailons on your new ftensel l DETACH HERE :# 6164656- p.: ��STATE.oF FLORIDA gg$z g�{ DBPARTML C 9T, AI►S RACMRSRLICEN3I 8t3aRD TION SEQ#TA12061600261 611612012 2012 110398971 ECO003163'',.<Y� ':_ ELECTRICAL CONTRACT81 . a_. uned below 'IS CERTIFIED bier the provisions of Chapto r-,.'489::. 8?• cpiration dates AVG 31, 207.4��.. PZ MJ' MCTR ALL6 IC' CORP` 7025 SW 17 TERRACE MIAMI FL 33155 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REOUIRED BY!AW 12/06/2012 16:51 FAX IM 004 03-05-2012 JEFF ATWATER STATE OF FLORIDA CHIGPISMAtNC1ALOPMER DEPARTMENT Of FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO 8E EXEMPT FROM FLORIDA WORKERS' COWENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 03105/2012 EXPIRATION DATE: 03/0812014 PERSON SALAS LUIS A FEIN: 204232837 BUSINESS NAME AND ADDRESS; FIALLO M 4 ELECTRIC CORP 7028 SW 17 TERRACE MIAMI FL 33155 SCOPES OF BUSINESS OR TRADE: 1- CERTIPIND ELECTRICAL CONTRACTO IMMAaT., Paraaaat to Chaplor 440 . 061144 F.S., ao cutter of a corporation Who aleck exemption from this chopler by filing a aaptilem of ateetlon odor Me "some may nut recover bandits or compensating Under {hie chapter. pursuant to Chapter 440.061121, F.S., Car"llestes of election to be exempL.. apply only within the son" of the basr11esa or We listed os tiro Unlace of election to be exempt. Pormant to Chapter 440.06113% F.S. 110ticas of aleeUou to he exempt ad eerditaatas of 01001,011 to he exempt shell he subject to revocation it 0 env time after the thing of the nodes or Me Inseam of the eerulleft the person named an Ike notice of aertttkete no longer sags as ragairemento of tats aoatian for Isens oe of a cardflcato. The department absil revoke a certificate at sov time for failure of We parson named as the ca"1114e1e to meet the ragalrements of this Section.QUEST1gjdS? {fj60i 413-1Q WC-262 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA I IMPORTANT DEPARTMEtNT OF FtidANCIAL 89MCOS DIVISION OF WORICERS'COMPENSATION F Pursuant to Mow 44%05{14}, FA, an officer of a corporation who CONSTRUCTION INIWSTRY 0 elects exemption from this chapter by filing a certificate of election G1111WIFICATE OF ELECTION To EE M MPT FROM FLORIDA L under this section nW not recover benefits or cornpensetion under this WORKERS'COMPENSATION LAW D cWter. EFFECTIVE;- 03/04/2012 EXPIRATION DATE: 03/08/2044 Purauatlt to Chapter 44'446021, F.S.. Certificates of election to be PERSON: LUTE A SALAS H exempt„, apply only within the geope of the business or trade listed on FEIN 204232837 E the notice of election to be exempt BUSINESS NAME AND ADDRESS E Pursuant to Chapter 4411081131. F.S. Not!=$ of election to'be exempt RrattO m r atscrw troy and certificates of election to be exempt shelf be subject to revocation 70:15 8W 17 TERRACE If, at luny time after the filing of the notice or the issuance of the MAW.Ft 33155 cartifieats, the person named on the notice or certificate no longer meet the requirements of this section for Issuance of a cottlfioste. The department shall rmka a certifies" at ashy time for failure of the SCOPE OF SUSMSS OR TRADe parson named an the certificate to meat the requirements of We I- C0trtutso a fiCTRlone.CONTRA= section. QUESTIONS? (660) 413.1609 CUT HERE �► Carry bottom portion On tl4 10% keep upper portion for Your T000rds. 12/06/2012 16:52 FAX IM 005 :LNFa1Ni+ Ai3twOOtli�tTlt? , 20i2:• AL" E"T RSOL�i 2018 MRST•CL.AS8 ` &0@ Ff,OLDFlA:. tkS.P08TACIR PALO t+f:AtJi LNA'8R'4 OAK 281 �;i 894811 pg1RB{�Al�l� l C RaE "[P$L�Li• ART.8&10 FBk9AD :ThLLS is Nar A BILL.T DO Mar PAY 411AL a$usinags�raIi.00ATioN RECBIPf 606320-0 "F FIALLO M J ELECTRIC CORD SS1E0 EC0003163 7025 SW 17 TERR 33153 UNIN DARE COUNTY awmm FIALLO M J ELECTRIC CORP WORKERI/S 800.Type of Business A F�CTRICAL CONTRACTOR m( jrft norem'' 00 NOT PORWARD f To p�81 AW=6M ev ui rx� FIALLO M J ELECTRIC CORP TOM 7025RSW 17ATERRFRES M=ZM o ±�TM MIAMI FL 33155 m BABOON) i=ill,=Ali„k�N=��1=,}=3►=�=i1}11�=11==►6=1===l=I,�=I,��,��i 000075.00 SEE OTMR SM 12/06/2012 16:51 FAX 9003 ORIDA OF BUSINESS AND PROFESSIONAL REGULATION CONTRACTORS LICENSING BOARD (850) 487-1395 MONROE STREET 32399-07$3 MRES SCTRIC CORP FL 33165-7847 ;rsrAs 09.:F*0R1Qa=. .......AC ` : rou become one of the nearly one million ;gD 'R�,T !�T;pFBTB INS =: ant of Business and Professional RegulatEon. '< b`':PRS�"Ra --a* �..,R�t3VL�TIG�=;{, r. , .:- r •angs from architects to yacht brokers,from >� s :... d they keep Florida's economy strong. `NCO0h�. t3 : �..,.. `lr 71 `� 3 �/: �.�y 0 3989 vay we do business in order to serve you better.l please log onto www.myfloridaiicense.com. t�'�G�7ERTFrED:'ii ►EC` RICAL° GQNTI;ACT01 n about our divisions and the regulations that it newsletters and learn more about the ,:<:- 9 ?.AIO:, iJ:: Rr`=CflRR. � { .icense Efficiently, Regulate Fairly. We so that you can serve our customers. zs -c Tx z b , ®�d der e=o3F.Pv )rida, and congratulations on your new licensel rses�, aaco3-At '31 z23?14 �12fl6L�6Q0�'$ DETACH HERE =41210MI 11111111 VIN= ld :ST AT-E OF FLQ 1DA;r... . s `S PR�F`t�3S oNdvi�A O C NTRARS =.L-ION ': S�Q#Ll2 0 61.6D 0 2 81- �s 1«. :vr t,°�• .:y'.: :;_i�: �3��+�"• tea. ``y+-.�°. :-`.f ?`.'�:.;^,. _