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EL-13-2535Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 208769 Permit Number: EL -11 -13 -2535 Scheduled Inspection Date: April 02, 2014 Inspector: Devaney, Michael Owner: HARRIS, BRETT Job Address: 1173 NE 103 Street Miami Shores, FL 33138 -2651 Project <NONE> Contractor: J.A.G. ELECTRICAL ENTERPRISES INC Permit Type: Electrical - Residential Inspection Type: ugh Work Classification: Addition /Alt ration Phone Number Parcel Number (305)764 -9401 1122320310070 Phone: (954)971 -0999 Building Department Comments RELOCATE 6 ELECTRICAL OUTLETS INSTALL 2 120V IN KITCHEN UP GRADE 2 PANELS TO CURRENT CODE 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- 208651. Add smoke detectors and GFI protected receptacle for personel. Correct open wiring. April 01, 2014 For Inspections please call: (305)762 -4949 Page 15 of 42 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 Nov 0 8 2013 Y: FBC 20 Permit No. E l I 3- 5-35 Master Permit No.R C. 13- 07533 Permit Type: Electrical JOB ADDRESS: 1 \ - fv c- I 6 ezi S T City: Miami Shores County: Miami Dade Zip: 3 3 i 3� Folio/Parcel #: Is the Building Historically Designated: Yes NO )( Flood Zone: OWNER: Name (Fee Simple Titleholder): le-T1--- -t' 6� Phone#: 3') 5 I � 'Q / Address: I k1-3 N e 1 s stf. City: i(4.i4 % S "tee' —S State: Zip: 73./ Tenant/Lessee Name: Phone#: Email: SKr4 fe a i 2 ce:> Go" kA l • c. CONTRACTOR: Company Name: -T A G \ CAL. b Phone#: C C ‘V-10 0 « Address: ° K- r• € --- J 0 *l C+ . City: N i-- A v. State: 'F4.. Zip: Qualifier Name: -' 9 " A 5 C & c is Phone#: State Certification or Registration #: �- �' ' ' Certificate of Competency #: Contact Phone#: A .S G% n 2D° Email Address: .s 0 aas A s 'S ( Cs 42 '.i :. t=., _LS .A1-'4 • tv ) . DESIGNER: Architect/Engineer: P Av' iG. CAM l AEG G. Phone #: 3'' S 12. ° 3° Value of Work for this Permit: $ S ®® C) Square/Linear Footage of Work: Type of Work: ❑Address Alteration ONew ORepair/Replace ODemolition Description of Work: C €' k C� c./- i"L 6 E> le Gad ` s/\ ( c..o ; le vs( l -1 S F da LL. (a) Ito v e se k tTdne.. -% 6, v P�JAPE 2 (',,el 1C.» v) C�cie"Ir Code- ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ ��i ' � CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Jag, % ' 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. 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 FT FCTRICAL 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will. _ : e a' roved and f einspection fee will be charged. Signature Owner or A ent 0uln ment was acknowledged before me this dai.of, ,by3; �AZt , w %En to me or who has produced l 0 AO J s identification and who did take an oath. 'jJ$Lre: / / /!lllllIt Sign: Print: My Commission iresNOTARY PUBLIC - STATE OF FLORIDA CAN # DD974308 MY 1XIMMISSION EXPIRES MARCH 24, 2014 * ** * * ** * * * * * * * * ** * * * *** APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this D1 day of 42.416-- •41 , 20 /1, by GJ C77JY0s'? who is personally known to me or who has produced i () C as identification and who did take an oath. NOTARY PUBLIC: Sigi:Val / I 7272-tz-' Print: / % `tJ/44'4 niar# My Commission Expires: /')14r .040 /y �x�, ��xa�xm�va�a���ra��x» a��a��a�a�s�x�r�► ��r�xwnse�s�+><+ x�ra�r�a> ��a�a�e�a�► ��* ��xeed��r����x�x� *�>�a�>k�a�+r�w���x�a�w Z G,���� Plans Examiner Zoning Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 GORDON, JONAS A J.A.G. ELECTRICAL ENTERPRISES INC 7251 47TH PLACE LAUDERHILL FL 33319 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 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.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 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! DETACH HERE (850) 487 -1395 STATE OF FLORIDA AC# 6 3 2 26 31 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ER0014175 • 08/30/12 128063619 REG ELECTRICAL CONTRACTOR GORDON, JONAS A J.A.G. ELECTRICAL ENTERPRISES IN (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under the provisions of ch.489 Expiration date: AUG 31, 2014 L12083003905 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 DBA: Business Name: J A G ELECTRICAL ENT INC Receipt #:ELECTRICAL /ALARMS /CONTRACT Business Type: (MASTER ELECTRICIAN CONTRA OR Owner Name: JONAS GORDON /QUAL Business Opened:02/27/1997 Business Location: 6047 KIMBERLY BLVD STE G State /County /Cert/Reg:93 -CME- 1436- X /ER0014 NORTH LAUDERDALE Exemption Code: Business Phone: 954- 971 -0999 Rooms Seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: JONAS GORDON /QUAL 6047 KIMBERLY BLVD STE G NORTH LAUDERALE, FL 33068 This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and /or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 2013 - 2014 Receipt #03B -12- 00013365 Paid 09/25/2013 27.00 003287 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6429997 BUSINESS NAME/LOCATION JAG ELECTRICAL ENTERPRISES INC DOING BUS IN DADE CO MIAMI FL 33000 OWNER JAG ELECTRICAL ENTERPRISES INC Worker(s) 4 RECEIPT NO. RENEWAL 6698352 EXPIRES SEPTEMBER 30, 2014 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 SEC. TYPE OF BUSINESS 196 ELECTRICAL CONTRACTOR 08E000801 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 09/16/2013 CREDITCARD- 13- 008857 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 NO. above must be displayed on all commercial vehicles — Miami —Dade Code Sec 80-276. For more information. visit mv w.miamidade aov/t oil ctor 10/25/2013 11:67 9545839802 JW INSURANCE PAGE 01 15L,StRAE, CERTIFICATE OF LIABILITY INSURANCE 10/25/13 THIS-CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER .1Vil Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 100 North State Road 7, # 106 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Margate, FL 33063 ALTO covoisoAFFoRpm BY THE POLIC.....EJS (AV,. Phone (954) 583-7213 Fax (954) 583-2045 — INSURED J.A.G. Electrical Enterprises, Inc. 6047 Kimberly Avenue Suite G North Lauderdale, Fl 33068 COVERAGES INSURERS AFFORDING COVERAGE .... iNstsigus...Danal Indemnity ......... -. INSUREJLIEL _ _ ______ IRsUREILI2I... — —___ . • •.—. — INSURER ___ • . — • . INSURER F: THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 06FITHEPOUCY PERIOD INDICATED, NO*M1STANbiNG —• • 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 CONDMONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID MAIMS. L.T.R INF T. POLICY Numarn listkiltigovp°FFETLyni7E. NAIC *MR Arm. iypE oF INSURANCE A IR] COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY GL105132 00 CLAIMS MADE OCCUR GERI AGGREGATE LIMIT APPLIES PER 121 POLICY 0 PROJECT 0 LOC ••••••■•■■ • .....•••••■•••• AUTOMOBILE LIABILITY ID ANY AUTO El ALL OWNED AUTOS El SCHEDULED AUTOS O HIRED AUTOS O NON OWNED AUTOS GARAGE LIABILITY O ID ANY AUTO EXCESS/UMBRELLA LIABILITY 0 OCCUR 0 CLAIMS MADE El DEDUCTIBLE O RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR! PARTNER I EXECUTIVE OFFICER I MEMBER EXCLUDED? If yes, describe under SPECIAL pROVISIONS below OTHER 09/17/13 MOT ExFiRATioN EBTLIEE/P.. LEAITS EACH OCCURRENCE 13XMAOETETRINTEr 08117h4 p_neaSES_Ema %Lem). MED EXP (Any one person) AMORAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGO Fire Damage Usability COMBINED SINGLE LIMIT BODILY INJURY (1!9r. BODILY INJURY (Per accident) PROPERTY DAMAGE ecolden9 AUTO ONLY • EA ACCIDENT OTHER THAN _MACC AUTO ONLY: EACH OCCURRENCE AGGREGATE 1,000,000 . 5,000 1,000,000 . 2,000,000 1,000,000 50,000 AGO •■••■■• ■...•■■••■•••••••• o TiS Q/H• E.L. EACH ACCIDENT EL DISEASE - EA EMPLOYEE Si.. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS ILOCATTON—S7VEHICLES (EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *** ELECTRICAL WORK WITHIN BUILDINGS, OUTSIDE CABLE INSTALL *** • cERTiTakiiTciliiii. Miami Shores Village 10050 NE 2nd ave Miami Shores Fl 33136 ACORD 25 (2001/08) OF CANCELLATION -... rSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL N DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO Tmciiirr, BUT F URE TO PO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND ll 'us, vtiTH ;, Pi rra:-.1 ITS AGENTS REPRESENTATIVES. _ ......._ AUTHORIZED i "..f..- '..iw- • , ' r f @ACORD CORPORATION 1968 JAGELEC -02 GOMI CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 10/25/2013 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 .EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If 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 Automatic Data Processing Insurance Agency, Inc 1 ADP Boulevard Roseland, NJ 07068 CONTACT NAME: PHONE E-MAIL Ertl: ADDRESS: (/C, No): INSURER(S) AFFORDING COVERAGE NAIC S INSURED J A G Electrical Enterprises, INC. 6047 Kimberly Blvd. Ste G Pompano Beach, FL 33068 INSURER A :Hartford Underwriters Insurance Company INSURER B 30104 INSURER C : INSURER 0 : INSURER E : COVERAGES CERTIFICATE NUMBER: INSURER F : • 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 TYPE OF INSURANCE ADDL. INSR SUBR WVD POUCY NUMBER POLICY EFF (MMIDD/YYYY) POUCY EXP (MM/DD/YYYY) UNITS EACH OCCURRENCE $ GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTtO PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (My one person) $ GEN'LAGGREGATE PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ POLICY LIMIT APPLIESPER: JE LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE — — — LIABILITY ANY AUTO OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON .OWNED AUTOS COMBINED SINGLE UNIT (Ea accident) $ BODLY INJURY (Per person) $ BODLY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LUIBIUTY ANY PROPRIETOR/PARTNERIDIECUTI�E Y / N OFFICER/MEMBER EXCLUDED? ¥ (Mandatory In NH) If yes, descdbe DESGRP110N OF OPERATIONS below N/A 76WEGDR9318 6/20/2013 6/20/2014 X I TORY C STATU- I T ER EL EACH ACCIDENT $ 100,000 EL DISEASE - EA EMPLOYEE $ 100,000 E.LDISEASE- POLIOYLIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedu e, if more space is required) CANCELLATION Miami Shores Village 10050 N East 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 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010 /05) The ACORD name and logo are registered marks of ACORD