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EL-14-486Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 209097 Scheduled Inspection Date: March 19, 2014 Inspector: Devaney, Michael Owner: SCHAEFER, NORAH & PAUL Job Address: 47 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MIZPAH ELECTRICAL INC _u Permit Number: EL- 3- 14-486 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060130390 Phone: 305 -620 -2701 tsuiming Department comments KITCHEN CABINET REMODEL UPGRADE GFI'S Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comment Passed 21 Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 18, 2014 For Inspections please call: (305)762 -4949 Page 37 of 51 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:1(305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical FBC 20 MAR 1.3 2014 Permit No. c% /�( — y� Master Permit No.R, ( (A — Cj j S JOB ADDRESS: -q-7 n E �� City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: \Vb3� O Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): Phone #: ®� -rZ Address: N 1�7 51 sr City: fy) )` (- M; State: Zip: % 3 Tenant/Ussee Name: Email: t-bra-A CONTRACTOR: Company Name: _ Ift P4 Phone #: 519 / Address: ;? a1 3 U) N 1,J City: 166 vnI 4SOLtC6 State: -F / Zip: 33c�S Qualifier Name: 05 rr,7 D l OS Phone #:YvS ---1,4� State Certification or Registration #: J,_ Certificate of Competency #: V�4 Contact Phone #: _�0 yl� �Gf Email Address: 017- ®d 67M h 07 r G 0,% a La ,h4 th DESIGNER: Architect/Engineer: �r� c� �- _ Phone #: �fSCo -�)6 " oo2i ^ P Value of Work for this Permit: $ ® Square/Linear Footage of Work: %Clip Se, Type of Work: ❑Address Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work -%A -- g/Y'i� G1�,c� � . _ �' ec:;c'SSr�Q Ccsr -►S �es �, 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 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 afier the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Z"=_a=a_4A1 Owner or Agent The foregoing instrument was acknowledged before me this 4R_ day ofR4g, 20% , by /I%GI4 Sclig1° -Pcf , who is personally known to me or who has produced a /Z 13 /J 3S %�6 As identification and who did take an oath. NOTARY PUBLIC: Sign: My Joanna M Feliciano My Commission FF 082763 Expires 01/1212018 Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 by who is personally known to me or who has producedD" Q/ `r QQ as identification and who did take an oath. APPROVED BY Plans Examiner Structural Review (Revised 3 /12/2012XRevised 07 /10 /07)(Revised 06 /10/2009 )(Revised 3/15/09) NOTARY PUBLIC: Sign: �+ i C o• y Co a XI hxw Public State of Florida r. Joanna M Feliciano My Commission FF 082753 ?prop Expires 01/12/2018 Zoning Clerk Congratulation'sl With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. s Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. 2 Every day we work to improve the way we do business in order to serve you bettey For Information about our services, please log onto www.myfloridalicense.com. C MtJt� M, There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the ... . . ... Department's 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! iraxjoa-a X% WC -f t1 r L V Lee County Tax Collector Detach and display bottom portion and keep upper portion for your records Veecou„y LEE COUNTY LOCAL BUSINESS TAX RECEIPT wqbqa 2013-2014 Tax Co Wor ACCOUNT NUMBER: 0611820 ACCOUNT EXPIRES SEPTEMBER 30, 2014 s4f. o9 of F� am Location 506 RICHMOND AVE LEHIGH ACRES FL 33972 MIZPAH ELECTRIC INC DIAS ALSTON W 506 RICHMOND AVE LEHIGH ACRES FL 33972 May engage In the business of CERTIFIED ELECTRICAL CONTRACTOR THIS LOCAL BUSINESS TAX RECEIPT IS NON REGULATORY THIS IS NOT A BILL - DO NOT PAY PAID 335480 -3-1 09/12/1312:14 :35 LYR1 $50.00 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW 9 =r-cGrT1VF na/18/2012 EXPIRATION DATE: 013/18 /2014 IMPORTANT F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who O elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. ..Pursuant to Chapter 440.05(12), F.S., Certificates of election to be w� ^^ 19 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY WORKERS' COMPENSATION LAW EXEMPT FROM FLORIDA CERTIFICATE OF ELECTION TO BE 0 EFFECTIVE 06/18/2012 EXPIRATION DATE: 06/18/2014 PERSON: ALSTON W DIAS FEIN: 650485336 BUSINESS NAME AND ADDRESS: NIIZPAH ELECTRIC INC 512 POINSETTA AVE LEHIGH ACRES, FL 33972 SCOPE OF BUSINESS OR TRADE 1- ELECTRICAL CONTRACTOR IMPORTANT FPursuant to Chapter 440.051141, F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election I- under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05021, F.S., Certificates of election to be H exempt.. apply only within the scope of the business or trade listed on E the notice of election to be exempt E Pursuant to Chapter 440.051131, 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 filing of the notice or the issuance of the certificate, the person named on the notice or bertificate 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 QUESTIONS? (850) 413 -1609 CUT HERE Carry bottom portion on the job, keep upper portion for your records, DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 Ma r. 13. 2014 11:21AM No. 3421 QP:_,1.IDOm CERTIFICATE OF LIABILITY INSURANCE 1 .'03/13/14 PRODUCER Annette Willis Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 18401 N.W. 27 Ave ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Miami, FL 33056 Phone (305) 626 -2403 INSURED MIZPAH ELECRIC INC 512 POINSETTIA AVE LEHIGH ACRES„ FL 33972- fax (305) 825-5472 INSURERS AFFORDING COVERAGE _ INsURER A: Granada Insurance Company INSUR @R B: INSURER C: _ INSURER D• NAIC # COVERAGES I INSURER F: I THE POLICIES OF INSURANCE LISTED 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, INS R I L TYPS OF INSURANCE POLICY NUMBER GENERAL LIABILITY ❑V COMMERCIAL GENERAL LIABILITY 0185fl00015912 ❑ 1311 CLAIMS MADE (V-1 OCCUR A ❑ GFN'L AGGREGATE LIMITAPPLILS PER 2 POLICY 0 PROJECT Cl LOO AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALLOWNEDAUTOS ❑ ❑ SCHEOULEDAUTOS ❑ HIREDAUTOS ❑ NON OWNED AUTO$$ n - -- GARAGE LIABILITY ❑ ❑ ANY AUTO EXCESSIUMBRELLA LIABILITY ❑ Cl OCCUR Cl CLAIMS MADE ❑ DEDUCTIBLE L7 RETENTION s ANY PROPRIETOR I PARTNER / EXECUTIVE OFFICER I MEMBER EXCLUDED? Ir yea, describe under OTHER DESCRIPTION OF OPERATIONS I LOCATIONS ELECTRICAL CONTRACTOR CERTIFICATE HOLDER I1Te MMfi olATg: MMIt)D LIMITS _ 10/18/13 10/18/14 EACH OCCURRENCE 1 DAMAGE T RENTED PREMISES Ea occurence) MED EXP (Anyone person) PERSONAL &ADV INJURY _ 1 2 GENERALAGGREGATE PRODUCTS-COMP /OPAGG -2 COMBINED SINGLE LIMIT (Ea accident) _ BODILY INJURY (Per person) _ BODILY INJURY (Par amttlenn PROPERTY DAMAGE (Per awXenq AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE I AGGREGATE I I Q we sT �_ ❑ oR E.L. EACH ACCIDENT E.L. DISEASE • EA EMPLOYEI E.L. DISEASE -POLICY LIMIT I EXCLUSIONS ADDED BY ENDORSEMENT I MIAMI SHORES VILLAGE 10050 NE 2 AVE MIAMI SHORES VILLAGE, FL 33138 QF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 INSU)qER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 0 ACORD CORPORATION 1988 Licensing Portal - License Search Page 1 of 1 11:34:19 AM 311312014 Data Contained In Search Results Is Current As Of 03/13/2014 11:34 AM. Search Results Please see our glossary of terms for an explanation of the license status shown in these search results. For additional Information, including any complaints or discipline, click on the name. * denotes Main Address - This address is the Primary Address on file. Mailing Address - This is the address where the mall associated with a particular license will be sent (if different from the Main or License Location addresses). License Location Address - This is the address where the place of business is physically located. 1240 North Monroe Street Tall- h-ssee FL 32a99 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA /EEO employer. Copyright 2007 -2010 State of Florida, Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public- records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. 'Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emaiis provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Chanter 455 page to determine if you are affected by this change. https : / /www.myfloridalicense.com/wlll. asp? mode =2 &search= LicNbr &SID= &brd = &typ= 3/13/2014 Name License License Type Name Number/ Status /Expires Type Rank Certified Electrical DIAS, ALSTON Prima EC0002175 Primary Current, Active Contractor - Cert Electrical 08/31/2014 License Location Address *: 512 POINSETTIA AVENUE LEHIGH ACRES, FL 33972 Main Address *: 512 POINSETTIA AVENUE LEHIGH ACRES, FL 33972 Certified Electrical MIZPAH ELECTRIC INC DBA EC0002175 Current, Active Contractor Cert Electrical 08/31/2014 License Location Address *: 512 POINSETTIA AVENUE I EHIGH ACRES, FL 33972 Main Address *: 512 POINSETTIA AVENUE LEHIGH ACRES, FL 33972 * denotes Main Address - This address is the Primary Address on file. Mailing Address - This is the address where the mall associated with a particular license will be sent (if different from the Main or License Location addresses). License Location Address - This is the address where the place of business is physically located. 1240 North Monroe Street Tall- h-ssee FL 32a99 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA /EEO employer. Copyright 2007 -2010 State of Florida, Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public- records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. 'Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emaiis provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Chanter 455 page to determine if you are affected by this change. https : / /www.myfloridalicense.com/wlll. asp? mode =2 &search= LicNbr &SID= &brd = &typ= 3/13/2014