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EL-13-356RC Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 205783 Permit Number: EL -2 -13 -356 Scheduled Inspection Date: April 01, 2014 Inspector: Devaney, Michael Owner: Job Address: 77 NW 101 Street Miami Shores, FL 33150- Project <NONE> Contractor: KLEAN POWER ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010180190 Building Department Comments ELECTRICAL FOR INTERIOR REMODEL 03/06/2013 - PAYMENT DELETED AND SUBMITTAL FEE PAID WITH A CREDIT CARD. ORGINAL PAYMENT WITH CHECK NOT CLEAR BY BANK. OWNER REP CAME IN TO PAY WITH CREDIT CARD. As Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 205051. CREATED AS REINSPECTION FOR INSP- 186228. Put connector on A. H. U. low voltage cable .Smoke detectors to be minimum of 3 feet from A/C grill. Add arc fault breakers. 15 jan 2014 Asked for approved plan and person on job site only screamed that he didn't have to put arc fault breakersin. Need to have qua = • • • eat next • ection. /411 //a 1/ 2-1(3/ March 31, 2014 For Inspections please call: (305)762 -4949 Page 11 of 50 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: 7 Al w City: Miami Shores County: Miami Dade Zip: 3 3 15 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: to s� FBC 20 Permit No. 4F Master Permit No Ff,J .2.: OWNER: Name (Fee Simple Titleholder): FOC 4VI t LLC Address: t 70 1 - 0 ( i (= 14 , , 5 4d,e S v t-e 2 6 2- city: S c. . S 1-es a e«co State: F l o t ,' mt ek Zip: 3 3 6 0 Tenant/Lessee Name: Al 14- Phone #: iv (4 Email: CONTRACTOR: Company Name: IC 1.7‘ +^ �� C Phone #: Address: (� ( (9 I S '� City: S ' )�\ Slate: /� Zip: ) Qualifier Name: fJ 04.3 �' ( Pp �f 6, ' i Phone #: r)-86- c)--c .c0) J) 6& State Certification or Registration #: Qc73w C ? Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Phone #: 30 5 -- 3 Sot - 41 8`tft-/ Value of Work for this Permit: $ 00 0 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace Description of Work: . YM Oil a CI t ine.cr9Y ', f r $ ❑Demolition * * *** * * * * * ** * * * * * * * * * * *** * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * *** * * * * * ** * * * * ** Submittal Fee $ Permit Fee $ /,$^a/ ere" CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ Warre Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 A),HDAVIT: 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 reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this ZO" day of , 20 Al by tOrc:lO cAQMAS MS , who has produced rieSs Gz2 C _ As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 5vS31hA etzt'R) E CAS My Commission Expires: 401 oe s2'at"� Signature Contractor The foregoing instrument was acknowledged before me this Z.C) day of 61013 , by 64_,-;01/14-,. who is personally known to me or who has produced Pk-, .1 D as identification and who did take an oath. ,7601 Plans Examiner • Jimmy ._., sly i Ll-f!a `'` ._- PERAZA Notary Public -State of Florida •vrag,- es Expo dune 21, 2016 'tt.!,, " Commission # 6E210275 Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) otro,°'1;12, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDIYYYY) 8 1/2012 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 policy(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 ce - cats older In lieu of such endorsement s PRODUCER Gil, Garden, Avetrani Insurance Group 10689 N. Kendall Drive Suite 208 Miami FL 33176 INSURED Klean Power Electric Inc 6601 SW 80 St #114 Miami FL 33143 -8154 PHONE _ - 305) 630 -4777 . 305 279 -3022 ai..com ovvrcrns. MI IRA • 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. : R ,- ' -- — - — - -- TYPE OF INSU CE 1 l : ., s ;, 9,� ,;,1, i , LIMITS A GENERAL 0 LIABILITY COMMERCIAL GENERAL IITY' 6602A324488 5/26/2012 5/26/2013 MG_ ate; !i. y $_ 1 000 000 100 000 MED EXP (Any one person) CLAIMS -MADE OCCUR a _� e _ s.•, .. - 000 _. _ GENERAL AGGREGATE — -_ _00_0 $ 2,000,000 . .,_. _ - -- lct• ■ - r P/• A . 2 000 000 AGGRE n •. _ _ TE LIMIT L PER• PRO- —■ AUTOMOBILE • ■ _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS UMBRELLA LIAB EXCESS LAB ■ . SCHEDULED AUTOS • � � OCCUR CLAIMS-MADE � - -- MB 11i3. 'dT s BODILY INJURY (Per person) $ BODILY INJURY (Per agent) $ PROPERTY DAMA e $ $ . 14 -1- Il; AGGREGATE $ - -- — - -- II a _ _ atl v O. '• B _.. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY yyy��1N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERMIEMBER EXCLUDED? (IlAendato�+in NH) If - -- describe under __._4 -. OF •s_TIO •-• L N 0830 -42655 8/1/2012 8/1/2013 - -�- a •. .ti i 1 ®t 7 E.L. EACH ACCIDENT . - 00 r_ A I _ __ _ Sheet•. y _ � 9 s . - . 9 aRU7�: - - ' . 1 f i e A . 1 iipLas .1(zi ,;),.. im,caLy111,1,01 - $ l r , I 00 r _ DESCRIPTION or OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) CERTIFICATE HOLDER CANCELLATION (305)756 -8972 Miami Shores Village 10050 NE 2nd Ave 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 S Rodriguez /LISSET ACORD 25 (2010/05) IN5025 mninn-sr nt ©1988 -2010 ACORD CORPORATION. All rights reserved. This Annafl name, and Inns are, ranla+nrarl marka of ARAQfl STATE OF FLORIDA DEPARTMENT OF MUMS AND PROFESSIONAL REGULATION 0121140CENSING BOARD (850) 487 -1386 "W3339,-0783 Co 1 WM this Hamm you DOOMS one of Ilia nearly one million F Doomed by the it of Regulation. OW professionals to yet brokers, t tip Florida . Evely_day we work to improve the way we do business in order to you Per Int but our services, please log onto WWW. loense.com, There you MOM Infomiettion about � learn s that e Our mission at the Deoartmeat b. License Eby, Regidate Fairly. We &instantly strhre to sera you better so that you can tug your customers. Thank you for doing business in Florida, and ratula is an your now license, DETACH HERE HIS DOCUMENT HAS A COLORED DAC ,GROUND • M'C!'OPFi.N RNC = 1 N MA!'K" PA TE,I "r U .'APErI RATS OP FLO M DEP PROVES qrr E0130020 CERTIPI • ALCM nap Of AC# ?W 616S O ��EGM ATION 12 127010040 k tONTRACITOR 10 aaarzstaa tomukt the psevtitena of 04419 r® liviuties Mat AUG ai. 1014 L120.21 .02831 AC11628770 ! STATE OF FLORIDA RIR TION SEQ# L120821021331 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under tha provisions of Expiration dates AUG 31, a0 ALOES° GUILLERMO ANGEL fOWER ELECTRIC INC 101 OW 160TE AVENUE =Ma RANCEEE FL 33331 NIGOVERNOCt RT DISPLAY AS REQt11RED BY AW SECRETARY