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ELC-12-2053Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 � 2 ! 0 Inspection Number: INSP-180912 Permit Number: ELC-10-12-2053 Scheduled Inspection Date: January 09, 2013 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Fire Alarm Owner: , Work Classification: Addition/Alteration Job Address: 9475 NE 2 Avenue Miami Shores, FL 33138 - Project: <NONE> Phone Number Parcel Number 1132060133760 Contractor: ECOLECTRIC COMPANY Phone: (305)482-1788 comments ADD ATM TO EXISTING ISLAND Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. INSPECTOR COMMENTS False Inspector Comments 'J7& January 08, 2013 For Inspections please call: (305)762-4949 Page 14 of 40 Miami Shores Village Building Department 90050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 752.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical FBC 20 Ike Permit No.L Master Permit No. ' � JOB ADDRESS: q q q "t City: Miami Shores � C County: Miami Dade Folio/Parcel#: 11- � W(zP ( 20 (4c-) Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Title/�c-o1holder): 'f� (O� Addretr• 11)1 1) • - e Y 6-M City: Tenant Email: 191 — a CONTRACTOR: Company Name: C Ge L F-�7ri 1 G CG/'9 �/�tiY Phone#: 3 05-- y eZ - 17 Address: ` 4,!�G S w l G City: /411AM M I State: Fn: 3 3 1 016 Qualifier Name: e c F _'v Al /Ao,S Phone#:. 30s=33 • -0,5- 3" `l State Certification or Registration #: E (f, 13 ®® 193 5 Certificate of Competency #: ■ i is , . , r a i I r r yrs. lr I® , .. > '00 A,- "t.'/ A..- -r#L i ,!f _ l> Contact Phone#: DESIGNER: Architect/Engineer: Value of Work for this Permit:$ // Q t �F% Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ONew ❑Repair/Replace ❑Demolition 12' ttl Al Description of Work: GAJ ass Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $• 0 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 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. 6 Signature � '- Owner or Agent The foregoing instrument was acknowledged before me this*d day of 20 , by who is personal "own to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: U�� % Print: My Commission Expires: Signature Contractor The foregoing instrument was acknowled I efore a this V c-- day o , 20 4Zby C who is perso ly known tome or who produced as identification and who did take an oath. NOTARY Print: Nicole Glass M Commry - ISSION#EE210416 c My Commission EE032687 y - Expires 10/0512014 %yid . 0',c EXPIRES: JUN. 24, 2016 floc Expi . OFR�o www.kARONNOPARY.can APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/122012XRevised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) 0 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (306) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. C. !!!L COPY OF LIABILITY INSURANCE l'CERTIFICATE HOLDER TO BE M- MI SHORES VILLAGE BL®G MP -T-) D. - COPY OF WORKERS COMPENSATION jE.ITHER CERTIFICATE OR EXCEMPTIONI IF CONTRACTOR IFAS A MIAMI DADS COUNTY CERTIFICATE OF COMPETENCY: A. - COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEFn D. COPY OF WORKER COMP INSURANCE 01THER CERTIFICATE OR EXEMPTION YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33136 ■�■��r■■■■,.■�is■s.�r■r■■■■■■�s COMPLETE G©NITttACTOR'SINFOIRMATION��r■■■■■aaaaar�■e■■a�a■a�� BUSINESS NAME: ZE CQ BUSINESS ADDRESS: WSW STATE T _G' ZIP CODE 1 BUSINESS PHONE: QDL, 1� $F FAX NUMBER Q �3 CELL PHONE �� g_0y / QUALIFIER'S NAME: G144;-T QUALIFIER'S LIC NUMBER: �G C3vo f T- E -MAIL ADDRESS OF APPLICABLE): CLI ELFT J N f� I VVS G ec�mgmic a cq.S CM1W on 3R9W BY M.dV I RV =0 MUWV .RA 99th. ib ,A8'PesF:.,di X•". Y _ _ _ ECOLcom-M SSMON A CERTIFIC I�TE� ATE OF LIABILITY INSURANCE ,G,212012 THISCERi1FICAIrl IS ISSUED AS A Wtr' M OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE COMMFICATE HOLDS!#. TW8 CERTIFICATE DOES NOT AFflRMATWELY OR NEQATNELY AMEND, EXTEND OR ALTER THE COVEWIQE AFFORDED $YTttEpOL"M Bim. TM CERTIFICATE OF INSURANCE DOES NOT CONSTTlUTE A CONTRACT SEE} THE ISstMoo IKSURt3R(S), AUT'HpMZL-D RLEPRESENTATWE OR PRODUCER, AND THE CERTIFICATE HOLSTER. IMPORTANT: if fire oeftlllaab hider In an ADDfR01" INSURED, lira AogeY(be) miji be ondweed. It SUBROGATION 15 WANG, outs t to the tar w and cendMons of the PaNcy, certain PON81" M" m*dm an ortdor8emsnL A obdomma on this m6floats dogs not cordes' rwft to the M00caft holler In bou of such ondataeme►tt(a). ereomtocle - -^^r� Alter. Fowler & Ffe * LLC w its Sq�na Blvdkwr (nS) @22 7$�p FL 55@16 12450 SW 1171h Cony Mkml, FL 53185 THS IS �cwMIL I NUIR MM TO CEitIIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HA1/E BEIM ISSUED TO Tw INWRED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOWSt"STANINNG ANY REQUIREMENT. TERRA OR CONDITION OF ANY X117 Rp►CT QR OTHER DOCUMENT IMTH RESPECT i0 VM11CH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN, THE INSURANCI AFFORDED BY THE POUMES DE80RIBIa'D HEREIN IS SU&JECTTO AIL„ THE TWW3, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. L.ifM98 6WVM MAY HAVE BEEN REDUCED BY PAID CLAIMS, '�Y�loPce LIMILFFY POLICYLam A X cowmmmL wNstAL uAmuly a o tet Add'I #nsdt w CP02W562 311x1012 311IM3 Lum aaCt ra(tWoe i 1 aooasrer�es s MED EXP (kiy wwpgrwo �vON* .,.ADV WJ MYGENOMAGOWAATE EI9AATEUWrAPPI.MSKR: X �� IOC�,E i 2 PRODUMZ(- 3MPlQPA( S 2 kmyADL IJMMMro �� OtarJEaWDI6YOV AMOSX kALIAFD 1 LfAB E�OC�CIR�R� uDwas �1t28'13811118 sodeve BODRY�.�{RYIPer'peeeenlNe MYft8tdd" $ i EACH dCCURREAiCE S A8ti1tEGA7l. � --- A ANY PkCPFiEtO�N'A� YIN C1rtIC r 1 I'� ��I* �LU1�D7 � N/AJ 3MAM2 8111201E €LEACMAf�W4Kr �$ �N tle9aBse4Mm €L DISEASE. EA S :1AN 0F NaT#OpefoW EL DISEASE . POucY umrr i i GFO Atl4AsiwcAnoNsiv�ec� (Ad,.bAooRa*+e%A*MWna mwmahomvmow mukum putrAjit IONG ME 2nd Avg NI buil Shmm FL 85188 ACORD 25 (2010/05) SHOULD ANY OF THE ARM DESCRUM F'OI.M.8 IM CANCELLED BEFORE THE EXPIRATf M DATE MMOF, NOTIO8 WILL. 13E OMJVMW At ACCC)tQANCE YUII'H 7W L MMy PRQV $, AtnnQamd pavammAwa 4467 ®110 ACORD TIO ACORD name and logo are ragh t and marks of ACORD !!1l1Rri.Zt� 1p Y 4 Ii7E!{II�LJ.i1�3Cfl.QRii'1�"/2!^t'iI�L l�a':l HL+IL Q. . AC# 6.1.152,82-6 STATE OF, FLORIDA. • . DEPARTMENT OF • '$USINES•5.•,ANb: PROFESSIO AL FtI4ULATION ' ► : • ELECTRr'CAL CONTwci5RS LICENSING BOARD ., 3E4# LZ2060501244 106/05/2012:111.818851i EC1300.53• �.:;{;: �_��;._:' -<= =''• The-SLzCTRTCAL' CO' ; . :a_ ,z��, ..•..� : � :h ry.; '' •Named below.:IS' CEit1'SBxA.. .''c •, :;' }•,M ..• , }'. .. -y�" Vader the • provision$ off' Che ted ,:....':�, -:- �, ; gat.::: r- .... �r _.. ;'. . M y ` :n �:_ :.oil-:wuU1-.3.{..,'.=:iru.. ILscp2 ii.�4�.0u date: • AUG 3 �. 2 �4 '`';,r2r .•;' • A�;, •:.::�''• i. .-'a•� Am ITf MINS, CLIFF ROBERT : '::; ' •; c ,:{�{{�� < ;�'4"' ECOLECTRIC COMPANY' 9635 9W"114 •COVRT' MIAMI FT, 31176 "�i •:.; • ` � • ,, . RICK • SCOTT GpvERNOR —•–•--__–•-- -__.._ ___.__.�, DISPLAY AS REQUIRED BY LAWy T" 33IZR,EI+i LAWSON SECRETARY -oar (3 v s d� ("-5 �S� - 3 to -,531-2-