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EL-13-2875Inspection Worksheet 12 Miami Shores Village J 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 -2737 Inspection Number: INSP- 205131 Permit Number: EL -12 -13 -2875 Scheduled Inspection Date: February 11, 2014 Inspector: Devaney, Michael Owner: ROSS, IAN Job Address: 640 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: AUTOMATION AMERICA CORP Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)979 -3879 Parcel Number 1132060171820 Phone: (786)417 -9161 Building Department Comments DEMOLITION IN KITCHEN AND MASTER BATHROOM 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 Commen ///-6).0/4/ February 10, 2014 For Inspections please call: (305)762 -4949 Page 6 of 37 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 ¶jaMc) BUILDING PERMIT APPLICATI.ON Permit Type: Electrical 64o 1VW 181A JOB ADDRESS: FBC 20 Permit No/ Master Permit Nojemezr 12— -ta"' 31 sf City: Miami Shores County: Miami Dade Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple TitleV Ider): _% � � _ Address: gj Z/ VE i'8 /h At State: G zip: 3313$ Phone#: St5 ??9 33,9? City: J(Ft24 .411810A Tenant/Lessee Name: Email: Ce504 71 Phone#: Zip: 33/33 CONTRACTOR: Company Name: Address: (c 15 2. S City: MieUelt Qualifier Name: L c $, . L, mot; State Certificationnor Registration #: Contact Phone#: m 4 A °7 9i tol DESIGNER: ,Architect/Engineer: A- u+°® vru t oett A vn erce 5. Phone#: 786 -1'17 9161 1 ZS CT state: l Zip: 351 8 5 s Phone#: 8 — 417 gi 6 `1 Certificate of Competency #: ®aoeo634 Email Address: Q to lei �/l rt 5 0i1 490S0 Phone#: Value of Work for this Permit: $ 50 0 m c-© Square/Linear Footage of Work: 14 DO °° Type of Work: Address ❑Alteration New ❑Repair/Replace ADemolition Description of Work: 0 e o f [hall off, %tekc a mwi ma. t'e r * * * * * ** ** * * * ** *** * * *** ** *** * *** ******** Fees * * ** * *** **** * * ** ** ******* **** * *** * *** *** ** Submittal Fee SIC iV , Permit Fee $ /894' ,m' CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE$ 1 t1 • M CO /CC $ Bond $ 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 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, The fo day of Owner or Agent egoing instrument was acknowledged befo 21-_, by I1 .Kit who is personally kno NOT Sign Print: Signature- me this Ca The foregoing ins , day of who is personally My Commission Expires: *+k********** APPROVED BY **** ** ***** on r • or ent was acknowledged before me this -4 NOTA oath. Sign: Print: My Commission Ex J2)/7 ***************** M* * * * **************** * *********** eta * *******ak*** ************ *M**** 24./2; G- Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06!10 /2009)(Revised 3/15/09) Zoning Clerk AC STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 LUIS, LUIS AUTOMATION AMERICA, CORP. 6152 129 CT MIIA FL 33183 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,myfioridalicense.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 STATE OF FLORIDA AG . ,. 2a a a 5 a a DEPARTMENT OF BUSINESS AND PROFESSIONAL.. REGULATION ER13014554 08/20/12 128034777 REG ELECTRICAL CONTRACTOR LUIS, LUIS AUTOMATION..AERICA, CORP. (INDIVIDUAL` MUST' MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING 'IN ANY AREA) HAS REGISTERED under the provisions of Ch.489 sapiratioa date: AUG 31, 2014 1,1200:2002405 T -II:� p )C I:IMEPJT I I As; A :oLc) r F (: KC o'Y7 jI) I ttC�k?p 9VTrA7�aH, : �hEnr't�R (, STATE OF FLORIDA -DEPARTMENT RTCQ AND SRG T ION L CTCAL CONTRACTORS SEQ# L12082002405 LICENSE NBR 08/20/2412;..128034777 ER13014554 The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 _FS.. Expiration date: AUG 31, 2014 .: (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) LUIS, LUIS AUTOMATION AMERICA, CORP. 6152 SW 129 CT MIAMI FL 33183 RICK SCOTT: GOVEMOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY NOTE: THE VALIDITY OF THIS COPY IS ONLY FOR 15 DAYS AFTER DATE NEXT : AUGUST 07, 2013. 12/26/2013 23:34 7865734486 • INSURANCE NOW AGENCY PAGE 01/01 AgC43kRir CERTIFICATE OF LIABILITY INSURANCE ; „°" 20°' 3" AWL NSA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POUCIES AUTHORIZED IMPORTANT: If the certificate holder Is an ADDITIONAL. INSURED, the pollcy(Ias) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policy may require an endorsement. A statement on this certificate does not Confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 786 -:73 -4485 786- 573 -4186 insurance NOW Agency 12915 SW 132 Street suite 4-B Miami, FL 33186 SIP Mayleen Blandon PHONE aim Fwa:786- 573 -4485 I .Mar. 786- 573-4486 ovit CUSTOMER ID Ilk trieWrEade AFFORDING COVERAGE NAILS INSURED Automation American Corp. 6152 SW 129 Ct. Miami, FL 33183 ∎1.01• w•was _ ∎_._._. M...... -_- IIesuRERA: Wilshire Insurance CO. 12/22/2013 SURER B : EACH OCCURRENCE INSURERS_: - _ ✓ INSURMI DI INSURM E : MED EXP (Arty one mason) -..: -- _..- .._.__... ..r. .o.v,. nu.00r.,a: 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. t • YPEOF INSURANCE ,, AWL NSA SUER WVD POLICY NUMBER "- 41:ICT y- I „i:i� �, t• }., Ur9TS ;i; �� A GENERAL COMMERCIAL GENERAL LIABILITY CL0034769 12/22/2013 12/22/2014 EACH OCCURRENCE S 1,000,000 $ 10QO00 5 5.000 $ 1.000.000 _ ✓ PREMISES o Beg) J CLAIMS -ABIDE ✓ OCCUR MED EXP (Arty one mason) PERSONAL$ AM/ INJURY GENERAL AGGREGATE $ 2 000.000 $. �.Q0.000 AGGREGATE PER PRODLIOfS- (�IAFIOPAGO V 1 rNT n Y J L AUTOMOBe E LIABILITY ANY AUTO ALL OWNED AUTOS SCI IROULEOAUTO2 HIRED AUTOS NON-OwNED AUTOS COMBINED SINGLE LIMIT (E8= Meng s - — — BODILY I? RY (Per pan) a — INJURY (Perms) a .•..._ PROPERTY (Per DAMAGE s $ UMSRELLA LIAR H . R EXCESS UM CLAIMB MADE EACH $ AGGREGATE $ — DEDUCTIBLE RETENTION $ a $ WORKERS AND ANY OFFICERIMEMBER (�Jns, DESCRIPTION CONPENSATION EMPLOYERS' LWBJUT YIN N / A I TORYLILAITS ��ER� PROPRIETORIPARTNERIE mouTIVE EXCLUDED? ■ A►.• eACM ACCtoENT $ E.I. DISEASE -EA EMPLOYEE $ Ito y In weer OF OPERATIONS Wow EL DISEASE - POLICY UNIT $ DESCRIPTION OF OPERATIONS! LOCATIONS J VENICLAE (At Ch ACORB 401. AdgM01iI &gnmrbg SOW” E mac Wan is - ----- - - - - - -- ) / Miami Shores - 10060 NE 2nd AVE Miami, FL 33138 FAX:3O5 -706 -8972 ACORD 25 (2009109) AP4CEU ATION SHOULD ANY OF THE ABOVE DESCRIBED TIM EXPIRATION DATE i - OF, ACCORDANCE WITH TH AUTHORS= \t‘, • 1985 -2 ' .. A The ACORD name and logo are registered marks of CORD 9. TES BE CANCELLED BEFORE WILL BE DELIVERED IN a een,' don RPORATION. All rights reserved. Elt 'f'74 4 gqlt