EL-13-2220Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
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Inspection Number: INSP- 200246
Scheduled Inspection Date: February 13, 2014
Inspector: Devaney, Michael
Owner: CONSOLO, ROBERTO AND FREDI
Job Address: 366 NE 93 Street
Miami Shores, FL 33138-
Project: <NONE>
Permit Number: EL -10 -13 -2220
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number
1132060136320
Contractor: WELL ELECTRIC TECHNOLOGY Phone: (305)726 -7098
Building Department Comments
Recessed LIGHTS RECEPTACLES SWITCHES ONE
STEAMER HOOK UP INSTALLATION IN TWO
BATHROOMS
INSPECTOR COMMENTS False
Inspector Comments
Passed EY
Failed
17 �r7 tol.
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 13, 2014 For Inspections please call: (305)762 -4949 Page 3 of 25
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: (3057 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
acT 0.1 2013
Permit No. 6 l 1 —c24 -
Master Permit No. 'P a l ?j " da - 19
Permit Type: Electrical
JOB ADDRESS: _5 (�5c �j 9
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
i
OWNER: Name (Fee Simple Titleholder)
NO Flood Zone:
— _:ffk �
City:' State: Zip: >G
Tenant/Lessee Name: _ Phone #:
Email:
CONTRACTOR: Company Name: Wait E & cj- t rG VEC9A,04o 6y /mac Phone #: �'� —rq 9 _ q! go
Address:
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city: .J+ M State: P Zip:
Qualifier Name: Phone #:
State Certification or Registration #:6c l I 300 l 1 a ` P Certificate of Competency #:
Contact Phone #: 306° � (4 (4 — 9 t J 7 Email Address:
DESIGNER: Architect/Engineer. Phone #:
Value of Work forthis Permit. s. o b Square/Linear footage of Work:
Type of Work: Q X� oss ❑Alteration ❑New Repair/Replace
Description of Work:
Submittal Fee $ Permit Fee $ �e0/� 4CCF $ CO /CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
3.1-1-
❑Demolition
.14 `S'.
TOTAL FEE NOW DUE $ 8 6
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
Owner or Agent
The foregoing instrument was acknowledged before me t his
day of � , 20 %3, by l� 11 e e0la.So %,
who is ersonally�jknown to me or who has produced F 1 6/j
As identification and who did take an oath.
��,� »�uiuurrrr�r
NOTARY PUBLIC:
s
Sign: _ �®
Print: „1 �i:`_
Signature l/ ��
Contractor
The foregoing instrument was acknowledged before me this
dayof s��' ,20a by /011y W
who is personally known to me or who has produced
My Commission Expires: •�% �.S
s,,���rrrrrrre�a A \`?\���`��
��
APPROVED BY � Plans Examiner
Structural Review
(Revised 3 /12/2012 )(Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
as identification and who did take an oath.
NOTARY PUBLIC:
Zoning
Clerk
6208325 STATE OF FLORIDA
DEPARTMENT:OFBUSINESS,'AND PROFES1916NAL REGULATION
ELECTRICAL CONTRACTORS LICENSING: BOARD SEW L12071801161
.
107/18/201213.26000831 JEC13001181
The_: ELECTRICAL CONTRACTOR
Named below IS CERTIFIED'
Under the . provisions of; Chapter �489.:FS...
Expiration date: AUG 31, 2014
WELL. TONY:
WELL ELECTRIC`TLCHNOLOGY' INC
4310 NW 11 STREET .. .'
MIAMI FL 33126
1522
RICK .SCOTT
GOVERNOR
DISPLAY AS REQUIRED BY LAW
Local Business Tax Receipt
Miami —Dade County, State of Florida
THIS IS NOT A BILL — DO NOT PAY
5567087
BUSINESS NAMEILOCATION RECEIPT NO. EXPIRES
WELL ELECTRIC TECHNOLOGY INC RENEWAL SEPTEMBER 30, 2014
4312 NW 11 ST 6807087 Must be displayed at place of business
MIAMI FL 33126 Pursuant to County Code
Chapter 8A — Art. 9 & 1Q
SEC. TYPE OF BUSINESS
OWNER PAYMENT RECEIVED
WELL ELECTRIC TECHNOLOGY INC 196 ELECTRICAL CONTRACTOR By TAX COLLECTOR
Worker(s) i EC13001181 $45.00 08/22/2013
CREDITCARD -13- 006121
This local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license.
permit. or a certification of the holders qualifieanom, to do business. Holder must Comply with any governmental ur
nongovernmental regulatory taws and requirements which apply to the business.
The RECEIPT N0. above must be displayed on all commercial vehicles — Miami —Dade Code Sec Sa 27B.
KEN LAWSON
SECRETARY
JEFF ATWATE:R
CWW FINANCIAL OFFICER
* ar CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 11/02/2011
PERSON: WELL
FEIN: 352252781
BUSINESS NAME AND ADDRESS:
TELL ELECTRIC TECHNOLOGY INC
4312 NW 11TH ST
Mimi FL 33126
SCOPES OF BUSINESS OR TRADE.
1— CERTIFIED ELECTRICAL CONTRACTO
EXPIRATION DATE: 11/01/2013
TONY
IMPORTMT: Parneat to Cbapter "It . MAIO, F.S., an officer of a corporation who $facts exemption from this chapter by filing a certificate of election under this
section may not recover benefits or compensation under this chapter. porsuant to Chapter 440.0502), F.S., Certificates of election to be exempt... apply only within the
scope of the business or trade listed on the antics of election to be exempt. Pursuant to Chapter 440.0503), F.S., Notices of election to be exempt and certificates of
election to be exempt shall be subject to revocation i% at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or
certificate no logger meets the requirements of this section for issuance of a certificate. The department mail revoke a certificate at any time for failure of the person
named go the certificate to meet the requirements of this section. QUESTIONS? 18501 413-16
OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11
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� CERTIFICATE OF LIABILITY INSURANCE 8/8/2013
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAOE AF=FORDED BY THE POLICIES
POLICY NUMBER
EELOW. THIS CERTIFICATE OF INSURANCE DOES NOT OONSTITUT6 A CONTRACT BETWEEN THE ISSUING INSUR6me), AUTHORIZED
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REPRESENTATIVE OR PRODUCER. AND THE OERTIFIOATB HOLDER.
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PRWUQER
IMPACT INSMI ANCR SERVICES LLC
x,8064 SW 33 Court
Miramar, FL 3309
A032618
NAME PAULETTE BROWN
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INURM W AFraAMM COVERAGE NA1CN
INSURER A �, A INSURANCE CO.
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X MMMERC Wl GENERAL LIABILITY
CLAIMS MADE OCCUR
INS B
0185FL00045681
4332 NW 11 STREET
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THIS IS TO CERTIFY THAT THE POURS OP IW9URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMFp ABOVE R THE POLICY PERIOD
INDICATED. NOTWITHSTANDINO ANY REOUIREMENT, TFRM OR 00140TTON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T141S
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THF. POLICIES DESCRIBED HEREIN 13 SUBMCt TO ALL THE TERMS,
&XCLUSIONB AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED UY PAID CLAIMS
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Ci?RTIRICATR LIAI AQD _ _ -- -
MIAMI SHORES VILLAGE
10050 NE 2nd AVE.
MIAMI SHORES, FL. 33138
SHOULD ANY OF THE ABOVE DESCRIBED POUCIF-3 HE CANCELLED RFFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLJCY PROVISIONS.
1OW2010
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reserved.