EL-14-914Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-214711
Scheduled Inspection Date: July 08, 2014
Inspector: Devaney, Michael
Owner: MOORE, REBECCA
Job Address: 9118 NE 5 Avenue
Miami Shores, FL
Project: <NONE>
Permit Number: EL -5-14-914
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132060140010
Contractor: VOLT ELECTRIC CORP Phone: (305)200-7967
comments
NEW KITCHEN RECEPTACLES AND CEILING LIGHTS IN
KITCHEN INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-214611. Dryer needs 4 wire cord
1E and receptacle.
All dedicated circuits need receptacles rated at the over currant setting.
Add smoke / carbon monoxide detectors.
Failed ❑ Cover open junction box in cabinet.
Correction ❑
Needed Y
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
July 07, 2014 For Inspections please call: (305)7624949 Page 22 of 43
Miami Shores Village
Building Department SCOTVT
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAY 0 6 20%
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BC 20oo�a
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
❑BUILDING
XELECTRIC
❑ ROOFING
❑ REVISION
❑ EXTENSION
❑RENEWAL
❑PLUMBING
❑ MECHANICAL
❑PUBLICWORKS
[:]CHANGE
CONTRACTOR
❑ CANCELLATION
❑ SHOP
DRAWINGS
JOB ADDRESS:I , E 5 h'\
City: Miami Shores County: Miami Dade Zip: I
Folio/Parcel#:1(' 16 L. ��i� 1 y ` L> 0 10 Is the Building Historically Designated: Yes NO V'Occupancy Type: V'ad: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): R'e �(( :i� R Cyo'- I I6� tivle4� 1 �� C� � � Phone#: 'f—USO C' C 2� 2—
Address: III <� u,/c S -A -t') Ayc
City: (1/111 o- t"A'A i h o :" e S State: F i— Zip:
Tenant/Lessee Name: Phone#:
Email: Kt_ C,'r iy1y)c-a�j r$ L'b' CC'Al
CONTRACTOR: Company Name: 8, G ���f [��C 60r=lp Phone#: 30.E 90 0 D'T G
Address: %61 LQ
City: 47Na (ie4x io_ State: F L Zip: 530 12—
Qualifier Name: '0 Con I ortz 2 /� Phone#: 605L90'0 r7f * 17
Certification rtification or Registration #: &A f -✓(Certificate of Competency #: / 3 ® 5,3 9
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit:
City:
State: Zip:
Footage of Work:
Type of Work: Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: %yQW to -r! A-) c - eco +et c-1-4 9 44 °')
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $ DBPR $ Bond
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $ 1 i94 •q
Bonding Company's Name (if applicable)
Bonding Company'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 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 theAbsence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Owner or Agent
Contractor
The foregoing instrument was acknowledged before me this The foregoing instrumlt was acknowledged before me
this day of 20 by of 20 by'
who is personally known to me or who has produced `who is personally known to me or who has
! _ As identification and who did take an oath. � identification and who did take an oath.
NOTARY PUBLIC:
Sign
My Com i�i�r? om M WFe�Fn�53
`p poi' Exphes 0 111 212 01 8
NOTARY PUBLIC:
Sign
%VWNJ9WW 082753
Expires 01/12/2018
APPROVED BYE Plans Examiner Zoning
Structural Review
(Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
Clerk
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner - Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project
prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner, must obtain workers' compensation coverage. Corporate
officers or members of a limited liability company (LLC) in the construction industry may
elect to be exempt if
1. The officer owns at least 10 percent of the stock of the corporation, or in the case
of an LLC, a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
3. The corporation is registered and listed as active with the Florida Department of
State, Division of Corporations.
No more than three corporate officers per corporation or limited liability company members
are allowed to be exempt. Construction exemptions are valid for a period of two years or until
a voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village
does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore,ov u maybe
personally liable for the worker compensation injuries of M Berson allowed to work under this permit. Please check with your
insurance carrier since most property insurance policies DO NOT cover this type of liability.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Owner P r Contractor
Print Name: &Z 69 C t �° �� Print Name: (i') `3
Signature: � ��(.C%�i�!� Signature:
State of Florida )
County of Miami -Dade )
Sworn to and subscribed before me this
day of 1--ta
By
state of Florida
Joanna M Feliciano
(S$AL) y Commission FF 082753
to
State of Florida ) \ I
County of Miami -Dade) v
Sworn to and subscribed before me this 16
day of Md _ , 202�O.
ULVAK I IVILN 1 UI- bUb[Mbb ANN VKUV=i*1UNAL. Kr.0 .L.AI 1UN
ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
RODRIGUEZ, ODONIS
VOLT ELECTRIC CORP
831 W 53RD TERR
HIALEAH FL 33012
Congratulationsl 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 tog onto
www.myftoridalicense.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!
The Department of State is leading the commemoration of Florida's 500th anniversary in 2013
For more information, please go to www.VivaFlorida.org.
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DETACH HERE
ISSUED: 11/27/2013 SEQ # L1311270000604
DISPLAY AS REQUIRED BY LAW
CERTIFICATE OF LIABILITY
ESTE +�arxYYvf
01812414
THIS CERTIFICATE IS ISSUE AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATZ H THIS
CERTIFICATE DOES NOT AFFI TIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BEEN THE ISSUING INSURER(S� AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT. if the c hdWw ' is an ADDITIONAL FNSUREO, tale Policy{i } must be en . ` If SU ATION IS �9, .sul�e� to
the terms and conditiom of ft pollcy, 'cart Mn policies; may requins an andorsemeft A statment rm this C ls:dates not canfer d9l'" to the
"ri heats hokler In Kou of such ;endorae e'
PROtiUMR
fipWs Insurance Croup
3454 W 84th St Sulte 202-J
Hialeah Gardens FL. 33478
cmTAuT Kate Cabrera
3t 5260-68114 n
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AFFrSRt CtY1rRRAt3E NAC
RMRER A: ASCENDANT UNDERWRITERS, L_ C
INSURM
Volt Electric Corp
831 W 53 RD TEkR
Hialeah FL 33472
INSURERS,
IN RER C
INSUIRMI D:
tNsttRER>�
INSURER F
%ow Y 6..,\/'iVLV. vier s ss svr� i .rte a®.w[sowre v..
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BaOW HAVE BEEN ISSUER TO THE INSURED NAMED ABOVE FOR T33E POLICY PERIOD
INDICATED. N01WTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEKT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED UR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT To ALL THE TERMS,
EXCLUStONSAND:CONDMONS OF SUCH €?OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSUVANas
GENERAL LI IrY
POLICY NIJANSER
1,000,000
EA*i OCCURRENCE $
P 461SES` $ 100'wo
COMMERCIALGENERALLIAWL"
C AIMS- >= ❑ OCCUR
Mw IDCP I&M oris Pew} 5,444
PERSONAL, & ADV INJURY $ 1.444,000
A
GL -43469.,0
111=013
141261241
GENERAt;:6lCsfaRESATE $ "7,440x000.
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GERL AGMEGATE LINT APPLES PER:
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DESCRIPTION OF t PM711ONS I iMIMM 1 VEMCUM (A#Kh ACORD 101, AdManW RMWeAS 8chedVIO R a-- space is r )
EleWoal Con actor
WAMI SHORES VILLAGE BLDG [SEPT
t0064 NE 2ND AVE
MIAMI sHoRE a, FL 33158
The ACORD name and Ingo are reg[sterea mance or F*uvmu
PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE
F-----------
STATE
—---------STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DMSION OF WORKERS' COMPENSATION
CONSTRUCTioN INDUSTRY EXEIAPTION
CERMWATE a: @LECTION TO BE OnUff FRad FLOMM
VIOM03W COMPBMTM IAW
EFFECIWEDAM 1==3 BMW= DAM
PEIWON ROMM EZ ODONIS J
H Plustlant to Cimpter 440.05(13). F.S.. NaNces of ernl t0 be
FM 40376 W I E exallpt and ceruftetes of election W be eulaTW shag be
BUSINESS NAIL AND ADDRESS: R subject to revocaftion If, at any Me after the flum of the notice
VOLT ELECTRIC CORP I E or the Ismance of the cerfiftate, Ohm penial nwned on fie
notice or ceirliflarts no
section for issuance of awe. The depaftwd 9ha0 moke
831 W 631W TERRACE I a cei at wry thus for ft&m of the person nmrmd a1 the
HIALEAH FL 33012 I cue to meet the Terpftments of Oils SBC11
SCOPES OF BUSINESS OR TRA
LICENSED ELECTRICAL
ONTRACTOR
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413-1609
GIUt3
Construction Trades Qualifying Board
BUSINESS CERTIFICATE OF COMPETENCY
13E000539
VOLT ELECTRIC CORP
DB_A :
ROD I�DONIS
certified under the provisions of Chapter 10 of Miami-Dade County
'Local Business Tax Receipt
Miami-Dade County, State of Florida
-THIS IS NOT ABILL -DO NOT PAY
LBT
7163464
BUSINESS NAME/LOCATION RECEIPT NO.
VOLT ELECTR C CORP
EXPIRE S
S
NEW BUSINESS
831 W 53 TER
SEPTEMBER 2094
7441625
H KLEAH, FL 33012
Must be displayed at place of business
Pursuant to County Code
Chapter 8A -Art. 9 & 10
OWNER SEC. TYPE OF BUSINESS
VOLT ELECTRIC CORP 196 ELECTRICAL PAYMENT RECEIVED
C/OODONIS RODRIGUEZ PRES CONTRACTOR 45 45 TTAX COLLECTOR
.OD 12/022013
Worker(s) 1 13EM39 0226-14-001118
This local Business Tax Receipt only esairam pnymoM of the local Business Tax. The Receipt is sot a license,
Permit, or a cerdication of the bldeYa 114011fications,to ds hasiness. Holder most coney with any gwernmeatal
or nongovernmental regulatory laws and requiremoots which apply to the htmioaws
The RECEIPT No. above now be displayed on sig commercial aekiclos-Miami-Dade Code See ga-276,
MtAM For move informadoo,visit wyxertr idadssovltaxes oetor