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EL-13-2034Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 198796 Scheduled Inspection Date: April 29, 2014 Inspector: Devaney, Michael Owner: BISCHOFF, HERMAN Job Address: 1025 NE 91 Terrace Miami Shores, FL Project: <NONE> Contractor: JB ELECTRIC SERVICE LLC tsunoing Department comments ELECTRICAL WORK FOR BATHROOM REMODEL Permit Number: EL -9 -13 -2034 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number INSPECTOR COMMENTS False Inspector Comments Passed O - Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. 1132050010020 Phone: (305)256 -0608 April 28, 2014 For Inspections please call: (305)762 -4949 Page 4 of 25 AC# 51394 (1 STATE CW I'LUKWA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEWL120S2401145 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 BARTLEY, JERRY ALAN J B ELECTRIC SERVICE LLC. MIAMI SW 133 COURT FL 33186 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW 0OW6 Local Business Tax Receipt Miami —Dade County, State of Florida THIS IS MOT A BILL - DO NOT PAY 902065 LBT RUSIMESS NAMEIUMATH M REC lVr NO. EXPIRES 18 ELECTRIC SERVICE LLC RENEWAL SEPTEMBER 30, 2074 10521 SW 118 ST 9020615 Must be displayed at place of business MIAMI FL 33176 Pursuant to County Code Chapter OA - Art. 9 & 10 OWNER S18C. TYPE OF StMWESS PAYMENT RECEPAD J B ELECTRIC SERVICE LLC 196 ELECTRICAL CONTRACTOR BY TAX caiuECT01t Worker(s) 10 ECO002659 875.00 07/03/2013 FPPU10 -13- 000976 This Loral Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit N a cartifieaden of the holder's gnafd'ications, to do business. Holder tmtst comply nth any getwomental or aonprormeeMaf rogelatory laws and requitemaras which apply to the Minas. The RECEIPT NO. above soar he displayed on an commercial vehicles - Miami -Dade Code Sec Re -276. For more information, visit www.miamidede.aov/rsvaReetar LL G Client* 761921 J13ELECTR ACORD DATE tdr�100nrYYl CERTIFICATE OF LIABILITY INSURANCE 9125/2013 THIS CERTIFICATE IS ISSUED A S A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND ORALTER 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. 'IIVIPQRTANT• if the ti&cate holder Is an AtlOhYONAL INSURED, the policy(les) must be endorsed. If SUMOGATION IS WANED, subjectto the tars 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 USI Insurance Services, LLC /SC P.O. Box 141916 Coral Gables, FL 33114 -1916 305669-6000 OISURED J 6 Electric Service LLC PO Box 160358 Miami, FL 33116 305 669 -6000 S3SURE,R(OAFFORDMO COURAGE SURER A : Charter Oak Pine insurariae Comp INSURERS ; Or(dgefield Employers Insurance IN SURER_C: — 1NSURERO: RI SURER E : E►ok NAIC # 25615 10701 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS Q TO CERTIFY THAT THE PCLtCES OF 14SURAp10E LISTED SELOIN HAVE BEEN ISSUED TOTHE INSURED MWEDABOVE FOR THE POLICYPERIOD INDICATED. NOTWITHSTANDING AINY REQUIQEI'..IENT. TEWA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT IWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR LIAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN B SUBJECT TO ALL THE lwv -ls. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LMITS SHOU'YN rA4Y HAVE BEEIN REDUCED BY PAID CLAMS. INSRI ._ . ._.__.. ADOLSIIBR' _._. ._. _ PO��CY EfF `WICY EXP LTR TYPE OF WSURAHCE INSR pyVD POLICY WIABER {lal nvvr > „( DtrYm . LiG9lTS A GEHERAL LIABILITY 16604AO4407AIND13 7109/2013 07^09/2014 EACHOcc.Lo iE -ICE 51,000,000 X COWERCIALGE-4ERALLIPMUTY , 5100,000 CLAMS-LIADE X• OCCUR urm exP t. -jw me mmsgw 55.000 PER8(tAL &ADS/ RVURY 31,000,000 DESCRIPTION OF OPERATIONS 1 LOCATION S I VEHICLES IAttech ACORD 901, AddiIbnal Reniarks Scnadole, Ir more space is repuirei) Miami Shores Viiltage Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 150 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS, Miami, FL 33138 AUTHORIZED REPRESEUTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved ACORD 26 (20101067 1 Ot 1 The ACORD name and logo are registered marks of ACORD #S109T763T/M10444746 KMPEA GEAiERALAaoREGATE 32,000,000 GENLAGGREGATEpUTATAPPEt!SPBR PRODUCTS- COUP.OPAGG 52,000,000 POLICY LOC $ _. AU170121OBILE LIABILITY §TfI?i�JT i ( ANY AUrfl BODILY tty)URY (Per Purace) S O..HD SCHEDULED ALLa BO0ILYI.AWiPsra S HtREDAUros __ NUO{•I09'rTIED ((peracmdTMSrRDAL1AGE UISSRELLALIAR _ OCCUR EACHOCCUIM"CE s EXCESSLIAB CL:I.IS CLAM •GGREGgTE °a DED ! RETDJr1QI4 S B WOMRSCOL9PENSAT10N •ggp48754 T AND EMPLOYERS' LIABILITY M512013 0810512014 x tgwSTLA&s ”. HFYMpPRETCR/PARiP1�RfXECUTNE you OFFK ER2IEUBERP CLUDED? N U 1A E.L. EACH ACCIDEHr 5100,000 (L9andaWry In NH) E.L. DISEASE • ItA EUPLOYEE 5100,000 I s u'4sui1:9 under D CPoPrDN OF OPER9T1 e1mv_._ E.L. OMASE • POLICY ULt R 00 55,000 DESCRIPTION OF OPERATIONS 1 LOCATION S I VEHICLES IAttech ACORD 901, AddiIbnal Reniarks Scnadole, Ir more space is repuirei) Miami Shores Viiltage Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 150 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS, Miami, FL 33138 AUTHORIZED REPRESEUTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved ACORD 26 (20101067 1 Ot 1 The ACORD name and logo are registered marks of ACORD #S109T763T/M10444746 KMPEA 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 FBC 20 � SEP 0 9 2 0 tiv Permit No. Master Permit No. 3 JOB ADDRESS: 1 ® Aj r— g I City: Miami Shores County. Miami Dade Folio/Parcel #: 1 I -'� 2.. O'�- ® O 1 °- C ®'Z 0 Is the Building Historically Designated: Yes NO Zone: OWNER: Name (Fee Simple Titleholder) :�T' Address: IS: �.Z a —!a S " Z[21 z City ' rev, i _i � ©�S .� a,- State: /e , Zip: :Z 3 / 3 Y Tenant/Lessee Name: Phone #: Email CONTRACTOR: Company Name: J- ,? x-- Z rs e 7-p- i c !�; o--x y / t,& /. L e- Phone#: 36 ;� ° Z:rG V a ? Address: 1 a =.3 /' 4- fa LO 13 9 f" l ! S Lg�a / l /Lt MIA&o %4 to _1.7 ®7b City: 414 p I L A State: - 13 186 1—A zip: —3 -3 Qualifier Name: T F— P- P- Y iq R rL E X Phone #: 3 ® 4-Q 8'7 ® P State Certification or Registration #: C'. jo y 0 ref Certificate of Competency #: Contact Phone#: _'S 011, a S- G• - G to 6 Y Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ —�� 00 s ° Square/Liuear Footage of Work: Type of Work: DAddress 10Alteration ONew ORepair/Replace ODemolition Description of Work: ti ice. m ® d& A—Ti te v, of .0 draYde�rrdrsk &aYa�ksY,kiadr &sYdr�aaYde� eat*, kk* de& rY�a�iirVrs4 *,k�kdrF��r9er�r�r�r�r�eia Iadr,, rkaY�Y& �k�Tideatr, ktidadHriF�tskdr &skdr�ir�le�ra�e�Ydrt�Y�rdntefe 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 $ D 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 reins pe i,wiee will be charged. The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 by day of .20 ___, by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTARY Sign: Print: My Commission Expires: NOTARY Sign: Lit Print: My Commis as identification and who did take an oath. APPROVED BY , - A Plans Examiner zoning Structural Review Clerk (Revised 3 /12/2012)(Rrhsed 07 /10/07XRevised 06 /10=09)(Revised 3/15/09) FIRST -CLASS U.S. POSTAGE PAID LVAMI, FL PERM NO. 231 090206-5 THIS IS NOT BILL —DO NOT PAY TRANSFER BUSINESS NAME / LOCATION RECEIPT NO. 0902065 J B ELECTRIC SERVICE LLC STATE# ECO002659 10521 SW 118 ST 33176 UNIN DADE COUNTY OWNER J B ELECTRIC SERVICE LLC SSO. Type of Business WORKER /S 196 ELECTRICAL CONTRACTOR 10 E3 ONLY A LOCAL OW i NUT T ��T� MR TO VIOLATE ANY 40 LAWS O THE DO NOT FORWARD ` rrr OR CITIES. NO I IT axis" TXE 8 AW J B ELECTRIC SERVICE LLC WIND BY LAW. TIMMS JERRY BARTLEY MM O 10521 SW 118 ST L MIAMI FL 33176 Q51,24/2012 110398666 RC0002655, The $LBCTRICAL Ct�1lTTRAC'rOF`" - - _.'_ ,6..fi KEN LAWSON. SECRETARY , Client#: 761921 JBEL.ECTR ACORD -, CERTIFICATE OF LIABILITY INSURANCE DATE "M 7/02/2013 THIS CERTIFICATE 13 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 INSURERS), AUTHORIZED REPRESMA71VE OR PRODUCER, AND THE CER7IFICA7E HOLDER. IMPORTANT: If the cod Bate holder is an ADDITIONAL INSURED, the policypes) must be endorsed B SUBROGATION IS WANM subject to the berms and conditions of the policy, certain policies may require an endorsement A statement on this cerliftdo does not corder niglRa to the certificate holder in lieu of such erdonauen0s). USI Insurance Services, LLC P.O. Box 141916 Coral Gables, FL 33114-1916 11AH19 N r.H. 868 - 757 -4234 I ie"t'r` amt 610-537 -1948 1 INSURER A: Charter Oak Fire Insurance COW 25515 DISURED IN SURER B: Bri kpMd Employers Insurance '10701 J B EIeCIriC Service LLC 12318 SW 133 CL D75URER C INSURER 0 Mlaml, FL 33186 BeSURERE DJ SURER F COVERAGES CERTIFICATE NULIBER- 11MMON NUAAHER: THIS IS TO CER7IFY THAT THE POLICIES OF INSURANCE LISTED FLOW HAVE BEEN ISSUED TOTHE INSURED NAMFDABOVE 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 771E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NI LTR ADULSURR TYR OF INSURANCE NSR POLICY NUMBER LI LETS A GENERAL uasamr X COMMERCIALGENERALUABWTY CLAIMS"MADE is OCCUR 16804A04407AIND12 7/09/2012 071091101 FAcHocawuxE $1,000,000 eNTOm>e $10000 NED EXp one ) $5080 PERSONAL aADV MUM $1,000000 GE7VIBiALAGGREGATE $2,000,000 GEML AGGREGATE LIMIT APPLIES PER: X POLICY �' LOC PRODUCTS - C9MPioPAGG $24000,000 $ AUTOMOBILE LIABLLNY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOS � COMBwEO SINGe E LIMIT ar�dert Bonax INJURY (Perpeen) $ SWILY IMAM (Per acddmt) - A PROPER TY - te._. -_.. - $ $ $ UNBRELLALIAB EXCESS LIM OCCUR CLAIMS-IJADE EACHOCCUFJ43ICE $ AGGREGATE $ DED I I RETENTIONS $ B AND OO RT LIABILITY A7wN ANOEMPLOYERS'LUt80.11Y FfC�ER G9� E GL ECUTNEi - IN N lA Mundd r In NH) Y j Irpe& desalbe under I}ESCIaPT10N OF OPERATIONS b0W 83048754 OSM12 OBIOS1201 X MUM.] W �— ,_ E1.. EACH ACCIDENT. -=__ ELL a -EA EMPWYEE $100,000 Ell. aSEASE- POLICY LIMB $500 OOO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (An" ACORD IM, AdddiDOW Runk! Sdetul% ff amm qa9 M re"Inw) Aland Shores Village Deparbnerd 150 NE 2nd Ave Mlaml, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE W17H THE POLICY PROVISION& AUTHORIZED REPRESENTATIVE 012M2010 ACORD CORPORAMM- All duhrs reserved ACORD 25 (2MO108) 1 Of 1 The ACORD name and logo are registered marks of ACORD 031 503887 KMPEA