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EL-13-2430P C 1 ?2 0 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL I �� Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 211274 Scheduled Inspection Date: May 08, 2014 Inspector: Devaney, Michael Owner: CONDO, SHORES PLAZA EAST Job Address: 726 NE 92 Street L Miami Shores, FL Project: <NONE> Contractor: GENERAL CONSTRUCTION MASTER COMPANY IIC Building Department Comments Permit Number: EL -10 -13 -2430 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060440001 Phone: (305)216 -5617 REPLACE FANS, LIGHTS AND EMERGENCY LIGTHS I Passed Comments INNSPECSPEC TOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 211222. Contractor didn't know the bay number and was at least 25 minutes away at 4 p. m.. Failed Correction ❑ � Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 07, 2014 For Inspections please call: (305)762 -4949 Page 14 of 32 .i TA BUILDING PERMIT X Permit TAe: Electrical JOB ADDRESS: 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 r- i t ' Ocr12S FBC 20 (0 Permit No.L� 'ION Master Permit No. RC-5 —AO-71 IZNA City: Miami Shores County; Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Address: d City, TenanvLessee Name: Email: __,� 1 e CONTRACTOR- Company Address: �q I o 1 City: Wt Q&I 1. State: Zip: %-3 Qualifier Name: Phone #: 2( -P-/ S-6112 State Certification or Registration #: Certificate of Compe cy #: Contact Phone#: 16 /%, Email Address: c�LqD 0-0 141® ®4 _ DESIGNER: Architect/Engineer. Phone# Value of Work for this Permit: $ 5 �lo� 4 d-2) Square/Linear Type of Work: OAddress Description of Work: DAlteration ONew ®Demolition Submittal Fee $ Permit Fee $ �� ' �� CCF $ CO /CC $ . Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ L 3 ° 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 dr 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the p on whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement Fh osted at the j b site for the first inspection which occurs seven (7) days after the building permit is issued. In the a ence posted n , the inspection will not be approved and a reinspection fee will be pharged. SiIforegoing t alb wner or Agent Tns ent was acknowledged b efore me this J 6 da20 /3, by DlOE27' C�known to me r who has produced As identification and who did take an oath. NOTAKV PUBLIC: Sign,. -- Print rfy Commis ion Expires: APPROVED BY =Pubic �. a F$wW@ 01 �i �Ycwm EEf62fte ' «per` x+..,2"120,6 The foregoing instrument was acknowledged before me this Ze day of L, UI .20) �3, by CoQiL 1CL— (v who is personally known to me or who Bras produced as identification and�wh6,1 oath. NOTARY PUBLIC: IS, ®1 ...... Sign: Print:9`sZ ��'?•�� i. My Commission Expires: %,,�'J9A l ` 1, e'� N �� Plans Examiner Zoning Structural Review Clerk (Revised 3 /12)2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) From:Llsbeth Perez FaxID: Page 2 of 2 Date: 1 012WO 13 11:30 AM Page:2 of 2 OP ID: LIPE CERTIFICATE OF LIABILITY INSURANCE F DAT TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE K OCCUR 10 /28DNYYY) 10/28/13 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 pollcy(les) must be endorsed. If SUBROGATION 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(s). PRODUCER Phone: 305 -648 -7070 Avante Insurance Agency, Inc. 7490 West Flag ler Street Fax: 305 -648 -7090 Miami FL 33144 Libia iilvera NcAOMNTEA:cT PHONE FAX A/C No E-MAIL SS: ER cRUSTOMERIDo: GENER -7 INSURERS AFFORDING COVERAGE INSURERA: Mid - Continent Casualty Company NAIC S INSURED General Construction Master Corp. 3340 NW 102 Street INSURER B: Mapfre Insurance Co. of FL 34932 INSURER C: Miami, FL 33147 INSURER D: GEN'L AGGREGATE LIMIT APPLIES PER: JECT F-1 POLICY PRO - LOC PRODUCTS- COMP /OP AGG INSURER E: $ INSURER F AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS - RCY1�71 MY IYVIYIdCR: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWrrHSTANDING 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. ww -A LTR A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE K OCCUR MX tsu" POLICY NUMBER 04-GL- 000861400 POLICY EFF MMIDD 07/17M3 ID MMD/YYYY 07117114 LIMITS EACH OCCURRENCE $ 1,000,000 PREMISES ERoccurrence $ 100,000 MED EXP (Any one person) $ EXCLUDEDI PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: JECT F-1 POLICY PRO - LOC PRODUCTS- COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4150120005663 04/15M 3 04/15/14 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA EXCESS LIAB B OCCUR CLAIMS -MADE NIA EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLLE E RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below $ TWO STATU- OTH- TORY LIMITS ER $ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) General Contractor with Trade Contractor business (Electrical Wiring withing building, Air Conditioning, ,Alarm Installation) CFRTIFICeTR Unl nro MIAMISV Miam i Shores Village Building Dept 10050 N.E. 2nd Avenue Miami Shores, FL 33138 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 REPRESENTATIVE v 1000 -cwV AI.VICU t UKI'UKAIIUN. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD