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EL-14-1476Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-220540 Scheduled Inspection Date: September 30, 2014 Inspector: Devaney, Michael Owner: GRABLE, JANE Job Address: 1700 NE 105 Street 117 Miami Shores, FL Project: <NONE> Contractor: LINCOLN ELECTRICAL CONTRACTOR INC ),Y- ILI �' 5 Permit Number: EL -7-14-1476 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1122300500170 Phone: (305)694-1616 tswiaing uepartment comments REMODEL OF KTICHEN AND ADD SMOKE DETECTORS Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed El #4�4792_4. Y'0' "-'X Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. September 29, 2014 For Inspections please call: (305)762.4949 Page 31 of 31 PArR ME- f BU NAL F EbjiATION JG`BQARD' ISSUED: 06/04/2014 DISPLAY AS REQUIRED BY LAW 0 R SEQ # L1406040001880 LIN / y - �V Ts tea. SEQ # L1406040001880 LIN / y - �V Ts 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 P. -V v JU0 0 2M4 FBC 20 Master Permit No. C, lq — 1�-rl Sub Permit No. 'F -L I�,-A ( 4-7�, ❑BUILDING iRILECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS [:]CHANGE CONTRACTOR CANCELLATION SHOP DRAWINGS JOBADDRESS:' l X00 NE City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): J Am L I Address: /Q 0 / ��'/�lo U- City �A( AID ( �() r� State: Email: '1" V ou . L - hone#: P: `3 3 1 ?y CONTRACTOR: Company Name: 6Z-�/GfJt,M t Lt:v%Lzt4t, cvAA`1"c.r-o�S �,. Phone#: 3 j$®�q q" U/6 Address: ® ��1C Lot to �4 City: f_ Zip: 3 �i a Qualifier Name: r3A&AfrX alT.,-A$.0®zi Phone#: State Certification or Registration #: X00) !�Z- - I Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit:14 .;� .5 en, Square/Linear Footage of Work: _ Zip: Type of Work: ❑ Addition �Z Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: PZC,0'*00 1, ®r- #jTrCj4CA1 4`6 400yl-o fr Specific color of color thru We.- Submittal ile: Submittal Fee $ Permit Fee $ %✓�116110 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ I I ;J' - 150 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 Orevbsence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. n Signature �-� Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before a this ©c) day of V L 201t-( by YAC= gt:,�2- day of J� 20 � by r who is personally known tome or who has produced A-ID01vf'n' who is personally known tome or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: s.cOiQ,'�y 12n lu Print: - OTgRY P cn °mmissi My Commission Expires: EE 173459 //";/,//OF �co•........ /";/,// �rFF L0 i110��`` APPROVED BY�i�i L[ ��)' Plans Examiner WVEC Lie -MC -as identification and who did take an oath. Structural Review NOTARY Sign:. Print: My CommissionRotary Public. State of Florida Commission# EE 159541 [AN My comm. expires Jan. 12, 20, (Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Zoning Clerk LINCO-2 OP ID: YL ,A�CO,RL7 CERTIFICATE OF LIABILITY INSURANCE D 07/09TE /2014 Y) 07�o9�zala 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: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 Insurance Market Place LLC 2801 SW College Rd Suite 3 Ocala, FL 34474 BARTOW INSURED Lincoln Electrical Contractors Inc PO Box 611004 North Miami, FL 33261 A BARTOW 352-237-2700 Tlac. NoL352-237-5884 _!NSYRER(S) AFF-OADING COVERAGE INSURER A: Federated National Insurance' INSURER B: Florida Citrus Business & Ind dNSURER C INSURE -R D INSURER E INSURER F _. _ _ • _ NAtC a DVERAGES _ CERTIFICATE NUMBER: _— ��- REVISION NUMBER: IRIS IS 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 1NDICAIED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT `O WHICH 'THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE. AFFORDED BY rHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDI HONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS PoLiClf EFF TYPE OF INSURANCE_. -.. ..1fiISL..I .G!..,,,...„_ .__....._PCEifGY Na/F if E:1Y,....... ....__.mm .�Mt,9tDDiY'Y.'iY MPtliiD/YYYY LIMITS .I� �i X COMMERCIAL GENERAL LIABILITY EACtf GDCCURK ,Ni„t_ � — 1_100010 ctAlr4,s rVAoe XOCCUR GL -0000017634-o1 07/1012014 07110120115 100,0 X Lil P __.. � _ ......„.. ........... AU'°i'3ga01311F I..tAR11 f -T -Y ANY AUTO ALL OWNED AUTOS l•,ti NON-(W$Nt L3 HIRED AUTOS AJ10;; UMBRELLA LIAS .�•ir{� EXCESS LIAR ` ;,IF,15 r•,aa,;;; WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIEIORMARTNER;EXECOTIVE 01?-1CFRWr.MBER EXCWDEO, N i A tMandafory in NH) it yes 1JeSC1,tC undo, "1 S RJJITION OF GPErtA it 5,00 P!, RSONAd_ E A0V INJURY 1 11000,00 (3FN(`R;',! Ix.,°az-4rrT-. 2,000,00 It a,lE.li°lw i or41=a I .,.., 2,000.00 tksr <scelrstantt KTnt�llt'r Iras[rl�Y,r;�, ,,;3rt ,. R004. F .WAJt""Ptvr 3,,t<Ykrrtq S.. _.. d>la611t:.K2e"Y L➢titvt4:f S 1 ,i,1,dl.r:.jde A', 10536041 04/01/2014 i 04/01/2015 i E t EAC:tI �t c lI9F::rd T F I U'ISEAS@ E[ir t>TYCI:E v L. L OiSLA;SL „_Wx I.1bV[ DESCRIPTION OF OPERATIONS i LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) 3agher Nimroozi is excluded from workers compensation. :.:cense #EC -13001591 1.000,00: CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCEWITH THE POLICY PROVISIONS. Building Department __ 10050 NE 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 BARTOW ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD