The URL can be used to link to this page

EL-13-1342Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 193576 Scheduled Inspection Date: July 17, 2013 Inspector: Devaney, Michael Owner: PAANS, SACHA Job Address: 1700 NE 105 Street 103 Miami Shores, FL Project: <NONE> Contractor: FOSTER & SON ELECTRICAL CONTRACTORS, INC. toommenrs TWO SMOKE DETECTORS Permit Number: EL -6 -13 -1342 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)527 -7050 Parcel Number 1122300500030 INSPECTOR COMMENTS False Inspector Comments Passed EJ_ Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Phone: (305)644 -5869 July 16, 2013 For Inspections please call: (305)762 -4949 Page 15 of 38 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: JUN 1320113 ��a00000000004ao ®oo� ®oo W Permit No. j , 1 � 4 2 Master Permit No. Ma-1 �� City: Miami Shores County: Miami Dade Zip: Foho/Parcel #: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Titlehold Address: LC) ® NO Flood Zone: City: State: N`--t,— Zip: c5 Tenant/Lessee Name: Phone #: Email: X27- -404S C� CONTRACTOR: Company Name-7-r,0--994L 4 'E c-AL- Phoned 305 ° -31'3 4° Address: 2 4- of �i -3 -tyT City: �Al State: :f:_Q< A Zip: Z7- Qualifier Name: ®lam L PhonefiC. 4' State Certification or Registration #: ° 00 L 5U -(o Certificate of Competency #: c-C cob's 5C, Contact Phone#'?, _5 4 � - -6 t�b q- Email Address: e%A 50 YI (E- ® sY-% DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ -Z '2�7z) ' Square/Linear Footage of Work: Type of Work: DAddress DAlteration Y1,Kew ORepair/Replace ODemolition Description of Work: Submittal Fee $ Permit Fee $ f Cpl 04,1 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip 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 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. Signature Signature t ®'1 t' Owner or Agent The foregoing instrument was acknowledged before me this 1 day of JO 'k , 2013 , by who i er n kno a or who has produced f. As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY aotw;;; o LMM ALVAREZ % MY COMMISSION # EE 15M * * EXPIRES: January 17, 2016 - 1 A-4aA Thin Rudad Nd0 $661= The foregoing instrument was acknowledged before me this day of SJ aC , 20 i3, by who is ® na ly known to or who has produced entification and who did take an oath. 3 Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) NOTARY PUBLIC: Sign: Print: %- �' L My Commission Ex *y LAMALVARR �c '% MY COMMISSION # EE 150323 *_ * EXPIRES: January 17,2016 Zoning Clerk 2013 -06 -10 17:23 Ana Beatriz 3054184706 >> 1 800 685 7530 P 1/1 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) °•"" 1 06/10/13 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 policypes) must be endorsed. ff SUBROGATI ON 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 . PRODUCER Just Insurance Brokers 1200 NW 78 Ave Suite 105 FL 33126 CONTACT Ana Camafreita PHONE (305) 418 -4701- 214 (305) 418 -4706 Justinsurancebrokers.com pD lLS anac@justinsurancebrokers.com PRODUCER CUSTOMER 1119* Phone (305) 418 -4701 Fax (305) 418 -4706 INSURER(S) AFFORDING COVERAGE NAIC F INSURED Foster & Son Electrical Contractor, Inc. INSURERA: Scottdale Insurance Company 03292 INSURERS: A 2498 NW 3rd Street INSURERC: INSURER D : Associated Industries Insurance Co, Inc. 23140 Miami, FL 33125 INSURER E : $ 1,000,000 (305) 345 -3134 INSURERF: MED EXP (Any one person) rrnveeAnM* I 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 - TYPE OF INSURANCE POLICY NUMBER (MMID gNVA PM LIMITS GENERAL LIABILITY _ A © COMMERgAL GENERAL LIABILITY ❑ ❑ CLAIMS-MADE © OCCUR ❑ Y CPS1652482 09/072012 09/072013 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 ❑ GEN'L AGGREGATE LIMIT APPLIES PER: ® POLICY ❑ PRO- ❑ LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS- COMP /OP AGG $ 1,000,000 AUTOMOBILELIABILITY F—] ANY AUTO COMB NED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ❑ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Par accident) $ El HIRED AUTOS ❑ NON- OWNEDAUTOS ❑ PROPERTY DAMAGE (Per accident) $ $ $ D ❑ UMBRELLA LIAB ❑ OCCUR EXCESS LIAB CLAws -MADE NIA AWC10223337 04/302013 04/30201ACCIDENT EACH OCCURRENCE $ AGGREGATE $ ❑ DEDUCTIBLE RETENTION WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECIJTIVE YI OFFICER/MEMBEREXCLUDED? (Mandetory lnNH) If yyes describe under DESCRIPTION OF OPERATIONS below $ WC STATIJ OTH $ E.L. EACH ACCIDENT 0 $ 1,00,000 E.L. DISEASE -EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 Ii i T_ DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2nd. Avenue Miami Shores, Florida 33138 305.756.8972 ACORD 25 (2009/09) OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTAnVE v hosts -zu11JU ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD