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EL-13-61517 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 204562 Permit Number: EL -3 -13 -615 Scheduled Inspection Date: January 31, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: ARRONTE, MIGUEL & CARLINA Work Classification Alteration Job Address: 890 NE 92 Street Miami Shores, FL Phone Number Parcel Number 1132060050130 Project: <NONE> Contractor: ALL PHASE ELECTRIC CORP Phone: 305-345 -6480 comments INCREASE SERVICE, INTERIOR REMODEL AND SMOKE DETECTORS nec 110.12 neat and work man like manner. no GFI live exposed panel conductors. INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 202219. CREATED AS REINSPECTION FOR INSP- 202100. O. K. to notify F P L to connect permonent service. 13 dec. 2013 Failed � Add arc fault dreakers. All garage receptacles to be gfi protected. Add inter system bonding bar. Correction Needed ❑ ' Re- Inspection ,r te 'g Fee No Additional Inspections can be scheduled until re- inspection fee is paid. January 30, 2014 For Inspections please call: (305)762 -4949 Page 14 of 22 Miami Shores Village Building Department MAR 2 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 No. PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): Ctir-1 in,_1 77 rroa j-e Phone#: 1 > B9 ; — Address: �1 a A �SA City: State: Zip: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: S 01 () N (S G ;�r � "b+ ` City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: 1 k ° 3 -''6 (- 00 C) (3() Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: City: Qualifier Name: NO �C Flood Zone: WA MENEWAi State Certification or Registration #: Contact Phone#.7 &""g4EW Email Address: of Competency #: DESIGNER: Architect/Engineer: Phone #: Value Type i Submittal Fee Scanning Fee $ f . , "Permit• $ - Cx—x3 JwAddress ZAlteration ONew Permit Fee $ ;Z-ZS f &W CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ ODen 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 rein ion fee will be charged. Signature �<4 Signature Owner or Agent Contractor The foregoing instrument was acknowledged before +me this i — The foregoing instrument was acknowledged before me this day of ft, r —, 20 1 '7, by ei,oy day of l`A(,,- , 20 J�, by R46' Ls V?fy , wh ' person _ _ own to me or who has produced wh 's person wn to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PU C: FERNAN00 R. RODRIGUEZ — ,•`" + .•,oa P ' NANDO R. RODRIGUEZ Sign: • = Notary Public - State of Florida Sign: P °• Aug 9, 2015 ft y om a Notary P Win Print: °'� mm Et1 Print: My Co My C Z ®!3 APPROVED BY _ �9A s70 %tIAA Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) r 08 37 2012 1200b921� '-1 Rd-130031 The Ej- lzC RICAL CONTRA OR be oar IE C3cR`TIFII? rY dSrt w- - i H'�11� °GARDENS` ` : FL .3`.3 0 "7:`.8 ; <; • ; RXCR 'COT' .: (OVi�NOR KEN LAWSON _ _' DISPLAY AS REQUIRED BYLAW SECRETARY m O n��l � on��a 0 ° -4N 540 r 9� %a zgo P °i z N w K (w0 !mil m oitO� -4 le 9� m mmn�j co So V25 a p O f m ��pp O •� r .+ to A g ov N 50�� 0 • A gm -�t4'i 0 N m P :1 rn I aN 0 z 0 z r09 0 m $ m O m N O f r t{ ttt r2� Ir ! r tr r rr t 1114111 r Itfttt fit rr rr tr t 3 °Is a3w.o 33s 00'5b0000 IOOI0009ZZ0 ° ZIOZ /5Z /60 810££ 1=1 SN3GHV9 HV31VIH :1101031nO XV1 AlKMW 3GVa-V tll cumomillimuV 3 -AV9 3AV 16 MN 668II S38d Z3dOl 08Q3d -Vold no SAMMOH lewl a 41803 3IM13313 3SdHd 11v do Nouvol umm v to _ 81 SMl *&Vl All ®M M Bomn eo tram MW AW NOW U3WM 3Nt lAOM al S30 OdVMUCW ION Oa MON ALWIC mu ao�sav°i ONINC • No Aw11nn83N ONILM ANY UV IOM Ol m07o MU JHQ2d AON 830 m 'Ilmom XVl SONMn OT SOJ.3d211NO3 IV3IHI3313 3 vM S/83 )1210M sssulsllp to ea.L °ws J803 3IS13313 3SVHd 11V H3NMO SN3([SVD HV31VIH 8102£ -Avg 3Ab I6 MN 66811 ZST2002133 #31b1S dHO3 3IN13313 3SVHd llb 0 - I5£ L50 'ON IdraM NOLLVa01 / 39M ss3Nlsne IVM3N38 0- 15£L50 ltd ION 00- 1118V ION SISIM 'Id `lwviW a1Vd $ 30V1SOd'S °fl SSmO -Isald A ° CERTIFICATE OF LIABILITY INSURANCE D05/14/2013 PRODUCER 305 - 556 -7399 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SOUTHWESTERN INSURANCE SERVICES, INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4375 PALM AVE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HIALEAH, FL 33012 FAX: 305 - 556 -5469 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: ASCENDANT COMMERCIAL INSURANCE 10233 ALL PHASE ELECTRIC CORP INSURER B: PROGRESSIVE EXPRESS INSURANCE 10193 11899 NW 91 AVE BAY E INSURER c: ASCENDANT COMMERCIAL INSURANCE 10233 HIALEAH GARDENS FL 33018 INSURER E: CnVFROGFS 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR _L13L ADD1 RM TYPE OF INSURANCE POLICY NUMBER GL- 41401 -0 POLICY EFFECTIVE 01/22/13 POLICY EXPIRATION 01/22/14 LIMITS EACH OCCURRENCE $ 1,000,000 A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGE TO RENTED PREMISES Ea oxurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 500 DED GENERAL AGGREGATE $ 2,000,000 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 1,000,000 POLICY PRO LOC B E OMOBILE LIABILITY ANY AUTO 08314488 -1 11/09/12 11/09/13 COMBINED SINGLE LIMB (Ea accident) $ 50 ,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Peraccident) $ HIRED AUTOS NON -OWNED AUTOS X PIP 10,000 PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ E ANY AUTO $ AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ (` WORKERS COMPENSATION WC STATU OTH- ER AND EMPLOYERS' LIABILITY YIN OFFICER/MEMBER BER EXC EXCLUDED? ECUTNE (Mandatory in NH) WC- 606872 -0 02/27/13 02/27/14 EL. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEO $ 500,000 It SPEC PROVISIONS below E.L. DISEASE - POLICY LIMIT I $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS MIAMI SHORES VILLAGE BUILDING DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 3057568972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ACORD 25 (2009101) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD