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EL-14-683Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 210794 Scheduled Inspection Date: April 14, 2014 Inspector: Devaney, Michael Owner: MALAMED, ADAM Job Address: 9215 N RAYSHORE Drive Miami Shores, FL 33138- Project: <NONE> Contractor: FOSTER & SON ELECTRICAL CONTRACTORS INC tsunaing uepartment comments Permit Number: EL -4 -14 -683 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number (917)685 -2273 Parcel Number 1132050270590 Phone: (305)345 -3134 REPLACING AN EXISTING ELECTRICAL PANEL 200 AMP I Infractlo Passed Comments EXISTING ONE WAS NOT IN ITS BEST CONDITION INSPECTOR COMMENTS False REPLACING 5 GFPS IN THE KITCHEN Inspector Comments Passed E!r_ Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 14, 2014 For Inspections please call: (305)762 -4949 Page 19 of 19 Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756-8972, For Inspections please call: (305)762 -4949 Permit Number: EL -4 -14 -683 Invoice Number: EL -4 -14 -51158 Applicant: ADAM MALAMED Company Name: Date Payment Type Check Number Amount Change 04/04/2014 Credit Card $50.00 $0.00 04/08/2014 Credit Card $116.70 $0.00 Total Payment: $166.70 Tuesday, April 8, 2014 Page 1 of 1 .Miami Shores Village Building Department 90050 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 Permit Zip4 ZM4 Master Permit Noz //— D �� JOB ADDRESS: R U S Uay— *h Br io Q..t y City: Miami Shores County: Miami Dade Zip: 211 ON9-, Folio/Parcel #: Is the Building Historically Designated: Yes NO V Flood Zone: OWNER: Name (Fee Simple Titleholder): X-'� R m n A LAM lb Phone #: 91-1-(-09h ' 73 Address: Ct21S WQ&Th 1�1�\(Sno e — V. City: '(n larn �Z)h nf2c, State: �l1 Zip: 3 3 Tenant/Lessee Name: Phone #: 1 • ` ZZZ Email: usm a lo�me rl� �� hpp Lc� m CONTRACTOR: Company[�N,, e: S�d J�� ' �KK,4 ( Jl lcC'6K Phone #: 3DF9V-9) 3`% * -Ry- or Address: Z"F / . w, sj-T � City: ^;-A m1 State: A46- 4 Zip: Zju Qualifier Name: 0-41 L 060a Phone #: q ®S' (Nj, -9i 39 State Certification or Registration #: 19eo%o l-6 el Ve rt ifi ate of Competency #: Contact Phone #: 1 ' ��J� 7 Email Address: . DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ J "O ` Square/Linear Footage of Work: Type of Work: ❑Address /, , ) ❑Alteratio ONew Uepaxr/Replace Description of Work: &LP `mod 0 ,tc1n G'��fo �: ath, %l , wp l lww. ;_�:I .v . -. ❑Demolition Submittal Fee $ Permit Fee $ J'S �' gad CCF Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding ggnjpa4y,'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 sub'ect to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspect o which occurs seven (7) days after the building permit is issuedIroal In the absence of such posted notice, the inspection will not a proved and a reinspection fee will be charged. Signature Signature Owner or Agent V The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this e f day of Q-+ L , 20 Iq , by AoA nt MA L-A ME-0 day of 4M ( l-.. 20 IL!q, by who is personally known to me or who has produced who is personall own to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: as identification and who did take an oath. NOTARY PUB NOTARYPUBLIC -STATE OF FLORIDA Wu %,Uvenm • t: ptu,4 y Commission Commission # EE055273 Expires: JAN. 30, 2015 BONDED TM U ATLANTIC B0NDING CQ, jNQ 4e4r4e4rxYsk3: �Ys44: �Y�YnYde�YsYkkaksYk YaY:k Ydr4eae4rsh Ykd: �Y4e9ede�k9e�1eFr9rdr4nY4e & &�Y4r�oYs4drde &aY Yk4e�Y4e4: akat�& 9es Y�& anY�Y3e4c3e�fe9eaYaY�Y�Y�Y�Yde :Y4r�Y tsY�Y Y &a43e Yi&de�rk�YaYde4. tdetY Iy APPROVED BY ��/�%'%� 2G Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012 )(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) n *a'L', idonsl With thiL- license you become one of the nearly one million = !cridiarK licensed by the Department of Business and Professional Regulation. )ur profe>sionals and businesses range from architects to yacht brokers, from `o barbeque restaurants, and they keep Florida's economy strong. -" '_'• wie worlt to improve the way we do business in order to serve you betteq ncc r .ei:iori about our services, please log onto www.myfloridalicense.com. are o + can find more information about our divisions and the regulations that subscribe to department newsletters and learn more about the r: "it's initiatives at the Department is: License Efficiently, Regulate Fairly. We drive io serve you better so that you can serve your customers. ' ar•`• for doin.p business in Florida, and congratulations on your new license! I DETACH � �'- ,t,�Rk,i tiT r r �'�k;'; -�' " ' � ��" t {TljSrDOCiJ,1111EWh1T' A9 A,C,O,LQRED"B/1G,KGFIQUND � MICROPRIN•FIN( h� STATE OF FLORIDA AC# 6 28 ?B 4 9 DEPARTMENT OF BUSINESS AND PROFES SITONAL - -REGULATION ER0015146 ff32 118193885 REG ELEG t i F' �+ FA STER, : TOR FOSTER &' -..5 �: 3` CAL CONTRACT (INDIVTDY.' ET ALL LOCAL LICENSING RE(lJ ENTS PRIOR TO CONTRACTING ANY AREA) HAS REGISTERED under the provisions of ch.489 Expiration date: AUG 31, 2014 L12082102675 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LTC"F1�1C�! Aqn� SEQ• #L12082102675 108121/2a.1,9 I] 18193885 IER:0015146, The ELECTRICAL CONTRACTOR Naxned below HAS REGISTERED Under the provisions of Chaptekpk Expiration date e AUG 31, 2014. ,:;.;:;;�;:�.` �g.�'.•. (INDIVIDUAL MUST MEET ALL LOC REQUIRE1vM TTS PRIOR TO CO-NTRACT�N ) ~; FOSTER® JORGE L FOSTER & SON ELECTRICAL CONTRA RN' : F•" i 24 -9:3 NW 3RD ST 'IILA -:� F'L 3:125 1`2CE SCOTT GOVERNOR. FEN LAWSON SECRETARY CC# 01 -CME- 1979 -R Ref. 13301801 Expires 8131/2014 Ctrl# 14 -17623 Cbnstnaction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 99E000259 & SON ELECTRICAL CONTRACTORS INC D.B.A.: FObTER JORGE L is certified under the provis ons of Chapter 10 of Miami -Dade County hUN(OrIt Ltfng. n a • � DADE MIAMI• IA For more information, visitwww.mia +�jidade.gov/tax -olle to Local Business Tax Receipt Miami —Dade County, State of Florida THIS IS NOT A BILL — 00 NOT PAY L�BT 414997; BUSINESS NAME /LOCATION RECEIPT NO. FOSTER & SON ELECTRICAL EXPIRE$ RENEWAL CONTRACTORS INC 4333787 SEPTEMBER 30, 2014 2498 NW 3 ST Must be displayed at place of business MIAMI, FL 33125 Pursuant to County Code Chapter 8A — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESO FOSTER &SON ELEC CONTRACTORS INC 196 ELECTRICAL COf\iTRACTOR PAYMENT RECEIVED BY TAX COLLECTOR Worker(s) 1 99E000259 45.00 08/02/2013 0226 -13- 000684 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 qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0, above must be displayed on all commercial vehicles — Miami —Dade Coda Sec 88-278. M:a V�DgD For more information, visit www.miamidada aov /ta, xollsrctta_r instruction Trades Qualifying Board ESS CERTIFICATE OF COMPETENCY & SON ELECTRICAL COI rRACTORS INC FOSTER JORGE L Is Certified under the provisions of Chapter 10 of Miami -Dade County SIB) 2014 -04 -04 10:10 Ana Beatriz 3054184706 >> 1 800 685 7530 P 1/1 A�oR° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDrrrM TYPE OF INSURANCE 02/062014 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 certlficate holder in lieu of such endorsement(s). PRODUCER Just Insurance Brokers 1200 NW 78th Ave, Suite 105 MME; Nelson Romero REQUIRED PHONE. (305) 418 -4701 FAX No l: (305) 418 -4706 EMAIL ADDRESS: ohadjezQibfl.net INSURER(S) AFFORDING COVERAGE NAIC Miami FL 32126 INSURERA : Colony Ins. Co> GL4030489 INSURED Foster & Son Electrical Contractor, Inc. 2498 NW 3rd Street INSURERS: EACH OCCURRENCE INSURERC : PREMISES Ea occurrence) INSURERD : Associates and Industries Insurance Co., Inc. MED EXP (Any one person) Miami, FL 32126 INSURERE: PERSONAL & ADV INJURY INSURERF: - -- RGV101V1V NUIVIOCR: 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 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADbE LTR TYPE OF INSURANCE INSR POLICY NUMBER POOLIIC EFF POLICY EXP LIMITS GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR Y Y GL4030489 09/072013 09/072014 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence) $ 1 00,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS NON -OWNED AUTOS COMBINED SNGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ D UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE NIA Y AWC10223337 04!302013 04202014 EACH OCCURRENCE $ AGGREGATE $ DIED I I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y1 ANFIPROPRIETEREXARTNER / CUTIVE ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below VNC STATU- V OTH- TrIP $ E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -FA EMPLOYE $ 1,000,000 E.L. DISEASE- POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace Is required) Electrical Contractor. CERTIFICATE HOLDER SHOULD ANY OF 7HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) O 1988 -2010 ACORD CORPORATION_ All rinhfa rnr_nr A The ACORD name and logo are registered marks of ACORD