EL-13-1457Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 208963 Permit Number: EL -6 -13 -1457
Scheduled Inspection Date: March 17, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: BLANCO, CHRISTIAN
Job Address: 1360 NE 103 Street
Miami Shores, FL 33138-
Project: <NONE>
Inspection Type: Final
Work Classification: Alteration
Phone Number (754)214 -2875
Parcel Number 1132050300070
Contractor: FLORIDA CABLE NETWORK INC Phone: (305)274 -3662
comments
LOW VOLTAGE WIRING SPEAKERS AND DATA.
INSPECTOR COMMENTS False
Inspector Comments
Passed
Ee CREATED AS REINSPECTION FOR INSP - 197154. LOW VOLTAGE
Only ready for rough ins ection.
Failed
Correction l
Needed / ❑ ` 7A/0. -4�
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 14, 2014 For Inspections please call: (305)762 -4949 Page 18 of 24
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JUN 2 7 2913
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS: , 3
Permit No. 'r1f _/ `%5-77--
o `1
Master PermN'
Zroe- 154— Vf-z 845
City. Miami Shores County: Miami Dade Zip:
Foho/Parcel #:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholder): N r /S�fa
Address: i �� °'V t% , 5 r
NO ✓ Flood Zone:
&4 1104ofe,
City: M i a'yK '( S K-0 f s State: rfl( aw
Tenant/I.essee Name: Phone#:
Email: /1
CONTRACTOR: Company Name: L0 64At0 CoL-LkQ Q .2
Address: 33 t I ST 5aztz l® 14^
City: I am State: F c- Zip: 3 3
Qualifier Name: Sad At Ki e2, Phone#:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: 0 Email Address: 0_0 i lv - C n C. , VW
DESIGNER Architect/Engineer.. Phone#:
Value of Work for this Permit: $ Qdd Square/Linear Footage of Work:
Type of Work: DAddress Alteration ONew ORepair/Replace
Description of Work:
R
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
ODemolition
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of c encement posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issu th' ab a of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. A P
Signature
Own or Agent
Contractor
The fore oing instrument was acknowledged before me thi% � The foregoing instr�ent was acknowledged before me tlu�
day, . t� , 20I by 1vA016% &jti W iNik$g) y of - , 20M S, byv ALJ1— M �r�o�z
who is personally known to me or who has produced who is personally known to me or who has produced t L�
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires:
as identification and who did take an oath.
NOTARY
My Commission Expires:
rErlans Examiner
I :_- =
Structural Review - - - - - - Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
1
BUILDING
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 VIM 2 ®204
Tel: (305) 795.2204 Fax: (305) 756.8972 -
INSPECTION'S PHONE NUMBER: (3057 762.4949 LY;
FBC 20 1
Permit No. -F—L13 19
PERMIT APPLICATION
Permit Type: Electrical
JOB ADDRESS: 13 4? O ME
I-
Master Permit No.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple
la 3 57
NO Flood Zone:
City:- L CL Wl_ S i,4 MS State: IF(— Zip:
Tenant
Email:
CONTRACTOR: Company Name: l . ti R•l dt IV �(. 1 6� Phone #: 3D15—_Z7? `3 Z
Address: (e" S SO 1 0 s c. t
City: M O W,\ C .J /State
Qualifier Name: J A I V 1 i'L ��/l L7 Phone #: _q/7 _'910
State Certification or Registration #: a C) �f Certificate of Competency #:
Contact Phone #: Email Address: S Q J L CN L - ngt
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration
Description of Work:
❑New ❑Repair/Replace ❑Demolition
Submittal Fee $ 22 Permit Fee $ C--C)
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $_
Technology Fee $
TOTAL FEE NOW DUE $ [0-3, CSC
Bonding Company's Name (if applicable) _
s;
BondiWCpmpiiWs�k4oe,; y'
City' State
Ntortgage Lendbe§ Nitmefif applicable)
Mortgage Lender's Address
City
State
zip
zip.
A
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 mus be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In die absence such posted notice, the
inspection will not be approved and a reinspection fee will be charged. II
Signature C C'
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 _, by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
day of .20 _, by ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
2l� /y
APPROVED BY L°/3 Plans Examiner Zoning
Structural Review
(Revised 3 /12/2012)(Revised 07/10/07 )(Revised 06 /10/2009XRevised 3/15/09)
Clerk
r
ACORD® CERTIFICATE CIF LIABILITY INSURANCE
2/19/201
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
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PRODUCER
MULTI LINES RISK UNDERWRITERS INC
10250 SW 56th St #C202
.Miami, FL 33165
NAME:
PHO (305) 598 -1411 FAX No); (305) 598 -7851
ADDRESS:mlines @bellsouth.net
IN8URER(61 AFFaROwe covERAea
NlUC9
INSURER A : The Travelers Insuance Co.
INSURED Florida Cable Network Inc.
6765 SW 105 Ct
Miami, FL 33173
INSURER B:
11 -9- 1311
INSURER C:
EACH OCCURRENCE
INSURER D:
DAMAGE 10 KEN 'r.
PREMISES Es occurrence
INSURER E
MED EXP (Arty one person)
INSURER F
PERSONAL &ADVINJURY
r.OVFRA(;FS r.FRTIFIr`ATF MIIMRFR- 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
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EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INGIR
LTR_
TYPE OF INSURANCE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
yryp
POLICY NUMBER
10050 NE 2ND AVENUE
MMID
LIMITS
A
GENERAL LIABILITY
$ COMMERCIAL GENERAL LIABILITY
X CLAIMS -MADE [—] OCCUR
AUTHORIZED REPRESENTATIVE
IB253410
11 -9- 1311
-9 -14
EACH OCCURRENCE
s 1,000,000
DAMAGE 10 KEN 'r.
PREMISES Es occurrence
$ 100,000
MED EXP (Arty one person)
$ 10,000
PERSONAL &ADVINJURY
$ 1,000 000
GENERAL AGGREGATE
s 1,000,000
GERL AGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOC
PRODUCTS - COMPIOP AGG
$ 1,000,000
s
AUTOMOBILE LIABILITY
ANYAUT0
ALL TO OS WNED AUT08UIFD
HIRED AUTOS AUTOS ED
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BODILY INJURY (Per person)
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BODILY INJURY (Per accident)
$
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$
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UMBRELLA UAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNEPMECU11VE
OFFICBWMEMSM EXCLUDED? ❑
(Mandatory in NMI
if me. describe under
DESCRIPTION OF OPERATIONS below
NIA
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E.L. EACH ACCIDENT
s
E.L. DISEASE - EA EMPLOYEE
s
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more spew Is required)
,\P'TfT1r1^ATL" IJ,\I renlr+cc I ATIMI
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MIAMI SHORES VILLAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
BUILDING DEPARTMEWNT
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10050 NE 2ND AVENUE
ACCORDANCE WITH THE POLICY PRO SIONS.
MIAMI SHORES, FL 33138
AUTHORIZED REPRESENTATIVE
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ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD
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