EL-14-47Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 205957 Permit Number: EL -1 -14-47
Scheduled Inspection Date: January 23, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: CHURCH, ST ROSE OF LIMA CATHOLIC
Job Address: 418 NE 105 Street
Miami Shores, FL
Project: <NONE>
Contractor: SUN POWER ELECTRIC CO
comments
TEMPORARY CHURCH CARNIVAL
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)758 -0539
Parcel Number 1122310150060
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Phone: (305)297 -6678
January 22, 2014 For Inspections please call: (305)762 -4949 Page 18 of 22
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
JOB ADDRESS: 418 NE 105th Street
CEIV
JAN 0 8 2013
By:
FBC 20 (�
Permit No.
Master Permit No. e 4 —9
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcelk
Is the Building Historically Designated: Yes
NO X Flood Zone:
OWNER: Name (Fee Simple Titleholder): Archdiocese of Miami Phone#: ( 305) 727 -6241
Address: 9401 Biscayne Blvd,
City: Miami Shores State: FL zip:_ 33138
Tenant/UsseeName: St _ RnsP of T.; ma rnt-hnl i c ['_hiirc -h Phone#: ( 305) 758 -0.539
Email:
CONTRACTOR: Company Name: Sun Power Electric Co., , Inc Phone#: ( 305) 297 -6678
Address: 1363 NE 182 Street
city: N. Miami Beach State: FL Zip: 33162
Qualifier Name: Silvio Medina Phone#: ( 305) 297 -6678
State Certification or Registration #: EC 1 3 0 0 2 8 9 7 Certificate of Competency #:
Contact Phone #: _ _(3 0 5) 297-6678 Email Address:
DESIGNER: Architect/Engmeer
Value of Work for this Permit:
Type of Work: OAddress
',DAlteration ' ` "` " ONew ORepair/Replace ODemolition
Description of Work: Temporary .Church Carnival Jan. 24 -26, 2014
Submittal Fee $ Permit Fee $ ®OO,,O P CCF
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CO /CC $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $ 1003 - U�
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 proved and a reinspection fee will be charged.
Signa Signature
Owner or Agent q
The foregoing instrument was acknowledged before me this /
day of , 20 , by _ / 1161
is personally known to me o ho has produced
an oath.
NOTARY ` NoMry Pubk . state of Ronda
My Comm. Expires Dec 27,;h17
Commis ion #0 051603
Sign:
Print:
My Commission Expires:
%lonrracwr
The foregoing instrument was acknowledged before me this
day of 20 Ly by
Oho is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBL, W N MARIleTO PASACLm
HE
MY COMMISSION # EB53299
EXPIRES: March 22, 2015
Sign: f' fir% Y n. at A== Rai.
Pgnt:
My Commission Expires:
APPROVED BY Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk
STATE OF FLORIDA
DEPARTM)W OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487 -1395
1940 NORTH MONROE STREET
�
TALLAHASSEE FL 32399 -0783
MEDINA SILVIO J
SUN PB*ZR ELECTRIC CO INC
1363 NE 182ND ST
NORTH MIAMI BEACH Fig 33162
Congratulations! With this license you become one of the nearly one million
Floridians licensed by the Department of Business and Professional Regulation.
Our professionals and businesses range from architects to yacht brokers, from
boxers to barbeque restawrants, and they keep Florida's economy strong.
Every day we work to improve the way we do business in order to serve you bettei
For information about our services, please log onto www.myfloridalicense.com.
There you can find more information about our divisions and the regulations that
Impact you, subscribe to department newsletters and learn more about the
Departments initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly. We
constantly strive to serve you better so that you can serve your customers.
Thank you for doing business in Florida, and congratulations on your new license!
DETACH __H-E.RE
I STATE Of FLORIDA
I$ G'�RTIFSD cin e3one of
aspiration dates `l1Li%4 31 r. ZOO %12D)
JEFF ATWATER
CHIEF FINANCIAL OFFICER
* * 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 lawn.
EFFECTIVE DATE: 10/14/2013 EXPIRATION DATE: 10/1412015
PERSON: MEDINA SILVIO J
FEIN: 943472315
BUSINESS NAME AND ADDRESS:
SUN POWER ELECTRIC CO INC
1363 NE 182 ST
NORTH MIAMI BEACH FL 33162
SCOPES OF BUSINESS OR TRADE:
LICENSED ELECTRICAL ELECTRICAL WIRING CONTRACTOR - PROJECT BURGLAR AND FIRE
CONTRACTOR WITHIN BUIL MANAGER, CO ALARM INSTALL
Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may
not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to to exempt.. apply only within the scope
of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S.. Notices of election to be exempt and certificates of
election to be exempt shall be subject to revocation if, at any time after the fling of the notice or the issuance of the certificate, the person named on the notice or
certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the
person named on the certificate to meet the requirements of this section.
DFS- F2 -DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07 -12 QUESTIONS? (850)413 -1609
Local Business Tax Receipt
Miami -Dade County, State of Florida
-THIS IS NOT A BILL — 00 NOT PAY
LBT
6513403
BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES
SUN POWER ELECTRIC CO INC RENEWAL SEPTEMBER 300 2014
1363 NE 182 ST 6783683
NORTH MIAMI BEACH, FL 33162 Must be displayed at place of business
Pursuant to County Coda
Chapter SA - Art 9 & 10
OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED
SUN POWER ELECTRIC CO INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR
45.00 08/19/2013
Worker(s) 1 EC13002897 0221 -13- 000862
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 gnalMeWoM, to do busineas. Holder must comply with any gonernmemai
or non regulatory laws and requirements which apply to the business.
The RECEIPT N0, above mum be displayed on aD commercial vabiclos — NGami -Dade Code Sec 8a-VL
M For more information, visit www.miamidado.gubxeollector
ae
CERTIFICATE OF LIABILITY INSURANCE �� 0/11/13
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: N the =Mate 1101der IS an ADDITIONAL INSURED, the polIgUes) must be endorsed. if SUBROGATION IG WAIVED, 8UDject t0
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 endomementle).
PRODUCER
Abler Direct Insurance
16123 Biscayne Boulevard
Aventura, FL 33160
INSURED
Sun Power Elerkic Co Inc
1363 NE 182nd St
North Miami Beach, FL 33162 -1333
COVERAGES
Fax 305 754 -7416
(305) 297 -6678
ER71FICATE NUMBER:
(305) 754 -7414
CYPRESS PROPERTY & CASUALTY
REVISION
THIS IS TO CERTIFY THAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Rwi
TYPE OP INSURANCE
ADM
SURR
POLlC1f NUMBER
POLICY ERP
POLICY El(P
LhDTS
A
GENERALLIABWTY
® COtJaAERCIAL GENERAL LIABILITY
❑ EICIANSMADE ® OCCUR
Y
Y
GFL 102737100 81
0912512013
; 09!25/2014
EACH OCCURRENCE
$ 1,000,000.00
Rrm&QWE g RENTED
$ 100,000.00
MED Exp (Arw one
s 5,000.00
PERSONAL &ADVINJURY
$ 1000,W00.00
❑
GE WL AGGREGATE UMrr APPLIES PER
❑ POLICY ❑ PRO- ❑ LOC
GENERALAGGRE GATE
s 2,000,000.00
PRODUCTS -COIu plop AGG
S 2,000,000.OD
$
AUTOMOMLE LIABILITY
❑ ANYMM
ALL ED ❑ p�Tp ln�
❑
❑ HIREDAUTOS ❑ =V8
❑ ❑
EmMi D sENGi E E MIT
BODELYINAW(PerpSOM)
$
BODILYOVa)RY(Perac�erN'
$
E
S
s
❑ UMMIM , A LIAR ❑ OCCUR
❑ EXCESS LIAR ❑ mAwsaADE
EACH OCCURRENCE
$
AGGREGATE
S
❑ DED 0 RETENTION
$
WORKERS COMPENSATION
AND ENPLOYEW LIABp fiT YIN
OAFFlPC� EXCLARTN�ERtDEECUTNE
iMyyagenSgd,atory Lp NH) ❑
DESOI OPBRATIONB belay
N/A
❑ BFA 0TH
EL.EAGHA000ENT
$
EL DISEASE -EA i
S
c:YLO
E.L.. DISEASE - POLICY LIMIT
8
DESCRIPTION OF OPERATIONS l LOCATIONS 1 VEHICLES (Attach AD= 4ol, Addldonai Remarks Schadule, U Rare space is required)
CERTIFICATE HOLDER CANCELLATION
V@ 19M 010 ACORD CORPORATION. All rights !served.
ACORD 25 (2010108) QF The ACORD name and logo are registered mai ke of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ]BEFORE
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
10050 Northeast 2nd Avenue
AUTRORIZED ENTA
Miami Shores, Florida 33138
V@ 19M 010 ACORD CORPORATION. All rights !served.
ACORD 25 (2010108) QF The ACORD name and logo are registered mai ke of ACORD