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EL-14-947Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-216266 Permit Number: EL -5-14-947 Scheduled Inspection Date: July 22, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: PEGG, JOHN Work Classification: Alteration Job Address: 333 NE 103 Street Miami Shores, FL 33138-2432 Phone Number Parcel Number 1121360130250 Project: <NONE> Contractor: SHINE ELECTRIC ENGINEER Phone: (305)688-2000 comments CONVERT F.P.L SERVICE FROM OVERHEAD TO UNDERGROUND AND UP GRADE SERVICE TO 200 A INSPECTOR COMMENTS False Inspector Comments Passed Failed�� Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 21, 2014 For Inspections please call: (305)762-4949 Page 32 of 33 50�6 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑BUILDING U ELECTRIC ❑ ROOFING FBC 20 Master Permit No.CI A/ ��-�- Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: _73 -32� '�Zl E `LD___-� • 5` -- Folio/Parcel#: Ib - 21 3L —0) 3 — 0Z 50 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction ,l Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Phone#:(MJ Bt�22' Q S Address:_ 333 ME 103 GTree�" `qqv City: M(GlVY11 ShoreS State: "L Zip: 331 _'�g Tenant/Lessee Name: Phone#: Email: j j CONTRACTOR: Company Name: S�lt1e �I eeVAccJ neat nG Phone#: Address: '��1} (o MW QG S-Tr-e_tT , t City: 0State: zip: Qualifier Name: YCC( aie: e® E• n S Phone#: State Certification or Registration M ecnim i s i g Certificate of Competency M DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: j �� Value of Work for this Permit: $ / ,500. y Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ElNew ElRepair[/Replace El Demolition Description of Work: Qonweek 1FPL Se�v def, 6om Oye_One A 4c UnAerZt row 0,0,8_ qp �M& series m �0 zoo A. Specify color of color thru tile: Submittal Fee $ Permit Fee $ I.f--19 ,0e CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $' /%% A�_ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 OWNER or AGENT The foregoing instrument was acknowledged before me this Ck day of 0-1 , 20 %A . by �6\-)n eqq , who is personally known to me or who has produced as Signature ' CONTRACTOR Thee foregoing instrument was acknowledged before me this 1 day of P1 20 J by T'Zwisw C 5t' 4ds 1E o is ersonally known to me or who has produced identification and who did take an oath. identification and who did take an oath. as NOTARY PUBLIC: NOTARY PUBLIC: ,aPY?'r•., Anisley Fluezo =COMMISSION#EE194256 90 EXPIRES: JUN. 24, 2016 $I WWW.AARONNOTARY.com Print: A Print: l Sea l:;'=o�t"YpGe� A Isley IRA(, Seal: ACOMMISSION # EE 194256 j EXPIRES: JUN. 24, 2016 �4nnu�� WWWA ARONNOTARCcom ffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi APPROVED BY �/�pS/ Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) r A#-616723;:. __ STATE OF FLORIDA DEPARTMENT OF BITSINESS>'AND PROFESSIONAL REGULATION SLTCTRICAAL CONTRACTORS LICENSING BOARD SEt L12061901$93 .• - LTCENS E'NBR 06` 19 2:01211820634'7 EC0001:51.4„ b -SLECTRICAL CONTRACTOR.` Named- _below IS CERTIFIED. Y Under the ,provisions 6E- CYiapt4x, 4fll FS Expiration date: AUG 31, 2014``�; SANTOSFRANCISCO `E DBA SENE -ELECTRICAL-ENGINEER1ItTG V'P t 3876 NW 125° ST OPA-LOCKA FL 33054 RICK :SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW - �® CERTIFICATE ® LIABILITY INSURANCE DATE (MM/DD/YY) 09/17/13 PRODUCER All Motors Insurance 11934 S.W. 8th Street Miami, FL 33184 Phone (305)559-8818 Fax (305)227-0977 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, INSURERS AFFORDING COVERAGE NAIC # INSURED SHINE MAINTNANCE ELECTRICAL CONTRCTR CORP D/B/A SHINE ELECTRICAL ENGINEER 3876 NW 125 STREET- OPALOCKA, FL 33054 INSURER A: SCOTTSDALE INS. CO. INSURER B: NORMANDY INSURANCE COMPANY INSURER C: LLOYDS INS. CO. INSURER D: PROGRESSIVE INSURANCE CO. INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADD'L IN TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE DATE MM/DD POLICY EXPIRATIONLIMBS DATE MMIDD rlNSR A ❑ GENERAL LIABILITY Q COMMERCIAL GENERAL LIABILITYIJDRU-S ❑❑ CLAIMS MADE ® OCCUR ❑ 07/27/13 07/27/14 EACH OCCURRENCE 1,000,000 PREMISES (Ea occurence)TO RENTED 50,000 MED EXP (Any one person) 5,000 PERSONAL&ADV INJURY 1,000,000 GENERAL AGGREGATE 3,000,000 G❑EN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY RI PROJECT ❑ LOC PRODUCTS - COMP/OP AGG 1,000,000 D ❑ AUTOMOBILE LIABILITY ❑ ANY AUTO Q ALL OWNED AUTOS ❑ SCHEDULED AUTOS Q HIRED AUTOS Q NON OWNED AUTOS ❑ COMBINED SINGLE LIMIT (Ea acddent) BODILY INJURY (Per person) BODILY INJURY (Per acddent) PROPERTY DAMAGE (Per accident) ❑ GARAGE LIABILITY ❑ ANY AUTO ❑ AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ EACH OCCURRENCE AGGREGATE B EMPLOYERS* RKERS LIABILITY ON AND ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below NHFL130081 09/23/13 09/23/14 ❑ WCY T s DTM E.L. EACH ACCIDENT 500,000 E.L DISEASE - EA EMPLOYEE 500,000 E.L. DISEASE - POLICY LIMIT 500,000 C OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ELECTRICAL CONTRACTOR INCLUDING FIRE & SECURITY SYSTEM, PHONE LINES, ELECTRICAL ENGINEERING 1'P0TI1:ICSTP wnl nI-R CANCELLATION ACORD 25 (2001/08) QF V HL.VRU VVRI-VRtiI Mry eaoo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MOMOURNM MAIL VILLAGE OF MIAMI SHORES 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 10050 NE 2 AVE OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. MIAMI SHORES, FL 33138 AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) QF V HL.VRU VVRI-VRtiI Mry eaoo Isazszs L6 al uaness Rei �. Mta�ii Cie Cou�lty, State of Florida iFils N6T %i SILL-'t]o`t)T Pi4V` �. 1 x3 - - • BLiSlNESS NAl{/IE�t.�t3Qri'IOI1V � � RECENT NO � x �� sHW 0", �L E G1lVEEi;I�v� �� R 3®, �' 0, 3876 NSI[t=b;1u?iardatpla00sin0tis dPi1 LOCi{Ik'FL 33054 l�ufatiairtta Cibull 40 CFLap ee 8A SEC ' ,YPE OF t3U31NM OW [E;R PAYM� RECEIVED 5HINE MAINTENANCE ELEC CCINTR 198 a8cTRICAL CONTRACTOR BY TAX COi LECTOR i EC900i514 CO(' $45.00 0 /09j20l3 ftrker(s) 1 ECHECK=13-004389 This Local Basini ssTax Receipt only coniums pa ment al the Local Busitiess Tax. The Receipt is not a license, permit, or a certification of the holders qualitimeliy6ri to do hnsiness. Holder mast comply Mth any governmental or nongovemmentel'iegalatory laws and requirements which apply to the basin int! The RECEIPT N0. above most he displayed an all commercial vehicies Miami-Dade Cade Sec For more information, visit tvvlvi miamidade.novhexcoltector :If JOB: JOHN MAY 0 9 2094 333 NE 103 ST BY: MIAMI SHORES,FL.33138 "EXISTING ELECTRICAL RESER OUTSIDE EXISTING METER C.OMBO 200 AMP V AdPAtiRi MII'd1MUN SWINE ELECTRICAL ENGINEERIN 3873 NW 125 ST OPA LOCKA,FL-.33054 `SEL: 305 630-2000 .- E00001 14 -: 0 Master Electrician: EXISTING METER COMSO 200 AMP C 200 A W APA►RY MlHdiMUN