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EL-14-619
?1 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 FB DIVED MAR $ s 2014 BY: BY: Permit No. Master Permit No.t"/ % L/— Permit Type: Electrical JOB ADDRESS: (df 4..SE )0a- 'r l' City: Miami Shores County: Miami Dade Zip:33 S 3 g Folio/Parcel #: ) 320(0 —Dl3- iGgO Is the Building Historically Designated: Yes NO )X Flood Zone: OWNER: Name (Fee Simple Titleholder): C ( 120-41/)c)I°15— Den ' ■5 Phone #: Address: (o IJ E ioD- City: U-Q,tc 4- -' P►.o•e5 Stater. Zip: 33 3 Tenant/Lessee Name: r�(1 A Phone#: Email: / CONTRACTOR: Company Name: /c Ac 4 / iMA's/P•r"5 ,,,,,--c ' Phone#: 7 fr '• 7 F2g‘ Address: _iYo e; ..5./4-, / / 5, / _ / City: i 4 /0/4 / /1 � State: f---/ Zip: 3 3 / C/ I/ Qualifier Name: (1•S /d /t // I yzr•z Phone #: 3e25-376 G .5—,3 State Certificati • ' egistration ° / G / 0.5 i Certificate of Competency #: 7 �` GOD 00 Contact Phon . ' d Email Address: 0 55/ r R o /7/ ,w/ C'ii-/0f� ,04t / , CGS Phone#: DESIGNER: Ar Value of Work for this Permit: $ 41- ®O Type of Work: Address OAlteration Description of Work: to l 0 (C., k-1 -rte Qv" av-ev -ec Square/Linear footage of Work: ❑ New Repair/Replace ❑Demolition kc°\-Y1cc \ Se(vic -P k 11 I/0V vof ******** * * ** **** * * * * * *** * * * * * * * *** * * *** Fees* * * * * * * * ** *** * * ** * * ** * ** ***** ** ** * * * * * * * * ** Submittal Fee $ 5C - w Permit Fee $ idaPi'®® CCF $ CO /CC $ Scanning Fee $ s Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ '1, \ 6 - n Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) / 4 Mortgage Lender's Address /'F/ City State 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 iri 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is .subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the .first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature 0 ! er or Agent The foregoOg ins rument was acknowledged before me this). day of \O- C 201, by &Si( aird t910 , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: 1.17-- Print: J,5L9 L My Commission Expires: APPROVED BY M tIZ # FF019058 2 ?$ EXPIRES: MAY19,2017 +4,tAsi' WWW.AARONNOTARY.com Signature z.Z-j.-42---0-‘6 Contractor The foregoing instrument was acknowledged before me this <2 day of UO$,a LN\ , 20 I , by O - who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Sign: Print: ° - COMMISSION #FF0190 My Comm ',r - 79RES: MAY19,2017 •47;41;0— WWW.AARONNOTARY.com i Zoning Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 RODRIGUEZ, OSVALDO ELECTRICAL MASTERS INC MIAMI SW 14TH ST FL 33144 Congratulations! With this license you become one of the nearly one mMion Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myflorfdallcense.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! D, 1-, H HERE THIS L;oc MaNT HAS A COLORED BACKGROUND • F1ICROPRfNTINC L I':EMARK (850) 487 -1395 STATE OF FLORIDA AC# 6 3 3 SEA DEPARTMENT OF BUSINESS AND PROFESBI REGULATION ER0013057:, RAG ELE RODRIGUE ELECTRIC (INDXVm LICENSING' TO CONTRACT 12700931' R Irk ALL LOCAL 5 PRIOR TN; T AREA) HAS REGISTERED Expiration date, AUG under the provisions of ca.48! 31, 2014 L12090402106 AC# 6335647 STATE OF FLORIDA DEPART BU C S MGULATION A R lac MU BOARD SEt# L1209040210€ 12700 °3:17 The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chap Expiration date: AUG 31, 201463`, (INDIVIDUAL :MUST .MEET ALL REQUIREMENTS PRIOR .ZO- CONTRA RODRIGUEZ, -_OS LOO, ELECTRICAL.-MASTERS "INC 8445 NE 2 AVE MIAMI FL 33138 RICK SCOTT GOVERNOR Av Ao nrna ui r Dv i AtAI KEN LAWSON SECRETARY Constructiort� s QB ualifj„ng Board BUSINESS CERTIFICATE OF COMPETENCY 97E000003 ELECTRICAL MASTERS INC D.BA.: tODRIGUEZ OSVALDO certified under the provisions of Chapter 10 of Mrani -Dade County Municipal Contractor's Tax Receipt Miami —Dade County, State of Florida --MISTS NOTA BILL -DO NOT PAY Cc NQ: 97E000003 BUSINESS NAME/LOCATION `LECT KCAL MASTERS INC 8400 $V 14 ST M! MI, P 33144 OWNER RECEIPT NO. NEW BUSINESS 7436805 TYPE OF BUSINESS ELECTRICAL CONTRACTOR MC EXPIRES SEPTEMBER 3012014 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 For more information, visit www.miamidade_nov @ axcollector Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY =5307: BUSINESS NAME/LOCATION ELECTRICAL I ICL MASTERS INC 8400 SW 14 ST MIAMI. cL 33144 OWNER ELECITdCk.7.*LAFTERS :NC Worker(s) 11 RECEIPT NO. RENEWAL 3857902 SEC. TYPE OF BUSINESS PAYMENT RECEIVED BY TAX COLLECTOR 2C0.00 C9./05/2013 3 C222-13-X1244 LBT EXPIRES SEPTEMBER 30, 2014 Must be displayed at place of business Pursuant iQ County Code Chapter BA— Art 9 &10 PAYMENT RECEIVED FELE Ri AL CON-TRACTOR BY TAX COLLECTOR 0S/05/2013 3 97E0000O3 0222-13 - 001244 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 holder's 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 Code Sec lia -216. For more information. visit www.miamidade govRaxcoliector OP ID: TC A. ---RO CERTIFICATE OF LIABILITY INSURANCE °�1 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: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 certificate holder in lieu of such endorsement(s). PRODUCER More Insurance Brokers 2700 SW 137 AVE Miami, FL 33176Es6: Teresa R. Carmona, Agent CONTACT PHONE o. EMI; 1 FAX No): (MMIr POLICY Y1 UMITS CUSP OMERIDa,ELECT.1 INSURER(S) AFFORDING COVERAGE NAIC 0 INSURED Electrical Masters Inc. 8400 SW 14TH Street Miami, FL 33144 INSURER A: Florida Citrus, Business (FUB) mum B : Travelers Property Cas.Co. 10/09/2013 INSURER C: Progressive Express ins. co EACH OCCURRENCE INSURER D : 1,000,000 INSURER E : RENTED DAMAGE TO Ee ce) PREMISES ( ortae� INSURER F : 100,000 COVERAGES TIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTHSTANDING 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 #L TYPE OF INSURANCE I� VD POLICY NUMBER (MM DWYYYYYI' (MMIr POLICY Y1 UMITS B GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR 660- 7A846384 BLANKET ADD'L INSURED 10/09/2013 10/0912014 EACH OCCURRENCE $ 1,000,000 X RENTED DAMAGE TO Ee ce) PREMISES ( ortae� $ 100,000 CLAIMS -MADE MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 X GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE OMIT APPLIES PER: I LOC PRODUCTS - COMP/OP AGG $ 2,000,000 7 POLICY D- ECT $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 02363602-0 08112/2013 08/12/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per ate) $ X PROPERTY DAMAGE (PER ACCIDENT) $ PIP $ 10,000 $ UMBRELLA MB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y (N ri (Mandatory N EXCLUDED? If yes DESCRIPTION OF OPERATIONS bebw N 1 A 10640035 04/01/2013 0410112014 X 1 OR TAUNTS I ER EL EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIB $ 1,�, DESCRIPTION OF OPERATIONS! LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace le required) Electrical Contractor City Of Miami Shores Fax :308. 756 -8872 10050 NE 2 Ave Miami, FL 33138 CITYMII SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. I' ` AUTHORIZED REPRESENTATIVE , tgot.giatit, goo wroz,tt, ACORD 26 (2009/09) m 1988 -2009 ACORD CORPORATION. AN rights resery ed. The ACORD name and logo are registered marks of ACORD P1TYPY Fri; frbr IMMO GeraelAngle ate A Babe= Calculated catch Basin CaeeetetaadrSeabee mart aammomme Center Una —Chan Link Fence oear Comae Deers Diameter Manage hareaterce Genet Easement Enamelware N.E 103rd STREET AVM co c CH Mae. GP Cone 0 0 trie Gnat Ene F0 >n thei ur LP. a MA0 w m N.E. 102nd 0.15 a-- °11E lair 15J0 1000 li{ ! One Story Residence No 69 4 • 23' PARKWAY 2V ASPHALT PAVE NT W.E. 102nd STREET 1 9acoadnnets hereon are ofapparerarheas. Fermowr *bybbrrdmeans. teeowrostarWermnatdemadned nat Ward Ureargmund anthem ie tngs,Rshown amassed en assumed metaBana Ina ofRecord. lands shown hereon were not abstracted far easements and/or men ofrem& demeanor, p ellent Tres certification Is ady far land as descmed. Kb net a certlflaelon O ream easements, or Reedomtamencumbrances. ABSTRACT NOT REVIEWED. There/nay be additional rearletlons notabeam an this survey eat may be found In the mac names a/ Ms sentry. ASSTRACMOTIMMEWECL BOUNOAftY SURVEY has been prepared for Vie ea wa use or the entities namedherews The CertlEacte does not mane Mara unnamed party. Tres survey ems based on the monuments fauna on the Reid. LEGAL DESCRIATlON: Lots 20 & 21, Block 1Z Plat thereof, as recorded In Plat M1AMH ADE Court, Florida. AMENDED, according to the of the Public Records of PREPARED FOE Clark Reynolds & . Leyra, 69 N.E. 102 Street Muni Shores, FL 33138 PL SICWI P1. i� PAS PAG PP. POI Pc pr R Rea ILLS. ENG Wa R9N WW Mac Sec r IMP UM. W.F. WME ant Fo�ied IIXIranApe Reber Rene Rants Pow°a81 aeakellan Iron Pipe Mensal Eureless lake Mantenence Easement aaAteamme ardreenseteEasement r aernmed Pia & Oise Number Natosmk Offset Overhead Gay Lam Plet PaROah Pa9eerCum me vR�emeenereCanbaPoae Aram _ • U Prelessione1 le dBaxrya PareaBegeweng Pawed Cernm ere Rent of Renew Cr aeae Maar Reamer aaaanee Pasta Tanana Rahn Residence Re lard&swept Railroad Ewan neynr6, Mapper Seam To Utlay Bermes tansy Wood Fence Wmaerer WIG bane:ranee Emma SLRIVEYOR'S SEAT antes Wheats to *name and the algha1 raked sat of a Rmkla Named surveyor and mapper; this mapirematIs Aar tec mamma a atf BOUNDARY SURVEY MOJARENA & ASSOCIATES, INC. Land Surveyors & Mappers Cerdficate ofAlon No.6698 P.O. Box 560126 MIamL FL 33256-0126 (305) 278 -2494 REVISED: 02 -01 -14 FLOOD ZONE: X BASE N/A NELSON Registered Surveyor fi Stateof Roars TWIT rii`i re 11 -02 -11 1' a 20 N.M. 11 -0222 ELECT -1 OP ID: KH A`WRV CERTIFICATE OF LIABILITY INSURANCE �'�(" '"' 04/01/2014 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 POUCIES 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 policydesj 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 !Sure Insurance Brokers 8700 W. Fiagler St., Suite 270 Miami, FL 33174 Teresa R. Carron, Agent CONTACT Teresa R. Carona, Agent PHONN , mil, 305 - 223 -2533 1 ice, No): 305-220 4765 ADDRESS: tcarmona@isurebrokers.com INSURERS) AFFORDING COVERAGE NAIL 0 INSURER A:Florida Citrus, Business (FUB) mown, COMMERCIAL GENERAL LIABILITY INSURED Electrical Masters Inc. 8400 SW 14TH Street Miami, FL 33144 INSURERS :Travelers Property Casualty Co 860- 7A846384 BLANKET ADDITIONAL INSURE INSURER c 10/09/2014 INSURER D : $ 1,000,000 INSURER E : $ 100,000 1 RERF: $ 5,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 INKR LTR TYPE OF INSURANCE ;umSUBIT ASR wvo POUCY NUMBER POLICYEFF (MM(DDIYYYYI POLICY EXP I MMIDD/YYYTI UMITS B GENERAL X mown, COMMERCIAL GENERAL LIABILITY 860- 7A846384 BLANKET ADDITIONAL INSURE 10/09/2013 10/09/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES tEe ocaarerxe) $ 100,000 MED EXP (My one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER —1 POLICY f JEC fl LOC $ AUTOMOBILE — _ UABILITY ANY AUTO AUTOS OWNED HIRED AUTOS _ _ SCHED LED AUTOS COMBINED SINGLE LIMIT (Ea accidett) Js $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY P IDEENNT) $ $ UMBRELLA UAB EXCESS UAB I OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED I I RETENTION $ A WORKERS COMPENSATION SILI AND EMPLOYERS' UA TY ANY PROPRIETORIPARTNERIEXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? LJ (Mandatory In NH) tf DESCRIPTION OF OPERATIONS below N / A 10840035 04/01/2014 04/01/2015 X WC STATU- TORY LIMITS OTH- ER E.L EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It mere she is required) Electrical Contractor City of Miami Shores Fax:305- 756-0972 10050 NE 2 Ave Miami, FL 33138 CITYMII 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 �9411014, 1 eteet, ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 212976 Permit Number: EL -3 -14 -619 Scheduled Inspection Date: May 23, 2014 Inspector: Devaney, Michael Owner: DENNIS LEYVA, CLARK REYNOLDS Job Address: 69 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ELECTRICAL MASTERS INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060131680 Phone: 305 - 265 -7996 Building Department Comments RELOCATING ELECTRICAL SERVICE FROM THE OVER HEAD TO UNDERGROUND Infractlo 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 - -. L.0;72 May 22, 2014 For Inspections please call: (305)762 -4949 Page 18 of 21