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RC-14-363Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972` Inspection Number: INSP-218364 Permit Number: EL -2-14-363 Scheduled Inspection Date: August 25, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GARBER, DOUGLAS Work Classification: Alteration Job Address: 53 NE 107 Street Miami Shores, FL Phone Number Parcel Number 1121360070370 Project: <NONE> Contractor: BROWER ELECTRIC LLC Phone: (954)748-6236 tiuiming uepartment comments REPLACE KTICHEN CABINET/REMODELING Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 22, 2014 For Inspections please call: (305)762-4949 Page 27 of 31 . !, Miami Shores Village E Building Department `� t 10050 N.E.2nd Avenue, Miami Shores, Florida 3;3138` Tel: (305) 795.2204 Fax: (305) 756.8972 2 e INSPECTION'S PHONE NUMBER: (305) 762.49j4-0 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 7 Permit No.10 P --2-) Master Permit City: Miami Shores County: Miami Dade Zip:_ Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): _j y,-\, C � Phone#: Address:_ City: State: Zip: Tenant/Ussee Name: Phone#: Email: CONTRACTOR: Company Name: t '� G' ''=�._ �'�` ` --" Phone#:)t/ % Address: `5' , �% ' -'�� City: e, i �ti� �, t ^ State: k Zip: ` Qualifier Name: Phone#: State Certification or Registration #: (- - L~� J `4 �- -" Certificate of Competency #: Contact Phone#:') Email Address: DESIGNER: Architect/Engineer: Value of Work for this Permit: $ `' �` Square/Linear Footage of Work: �5 Type of Work: ❑Address Alteration ❑New ❑Repair//Replace ❑Demolition Description of Work: i Submittal Fee $ Permit Fee $ /✓f�9 ilPff CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 1 n g IV 'r 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 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 a)qroved andq reinspection fee will be charged. Sienature wner U Agent The foregoing instru ent was acknowledged before me this 1 Z day of 1 , 20��, byu -e� who is personally knowri me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Signature Contractor The foregoing instrument was acknowledged before me this day of 2014, by who is personally kn wn to mAKr who has produced as identification and who did take an oath. NOTARY PUBLIC: I Sign: Sign: ✓ nt:NER Pr eEAMON TONER My Commission Ex pr s : �`; Notary Public State of Florida My Commission Expires Mar 5, 2017 My Commission Notary Public State]Fda�%o,=My Commission Expires Commission # EE 880934 Commisstion #� EE :x: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 449 1940 NORTH MONROE STREET (850) 487-1395 WE TALLAHASSEE FL 32399-0783 BROWER, JAMES SCOTT BROWER ELECTRIC LLC 8630 NW 53RD STREET LAUDERHILL FL 33351 Congratulations! With this license you become one of the nearly one million ! STATE of F' Rmn nr :. r is "� e : r Floridians licensed by the Department of Business and Professional Regulation. AEP ..... T! Our professionals and businesses range from architects to yacht brokers, from I -YFRQF� boxers to barbeque restaurants, and they keep Florida's economy strong. i );013004068.; 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.m oridalicense.com. yfl +CERTI'F IED'] There you can find more information about our divisions and the regulations that IROWE2 impact you, subscribe to department newsletters and learn more about the ( I ROWER E 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 license1s �'ERTIFIED;. under th® psovi4ioae. og ch 4.89 F I Stopr;ae3on date:AUG 31 2014' L12051900:3'4:6 0/I% T�.818702' GE 14�A] i CfO '12ACt6k i ,�,, 1; r DETACH HERE ACS 61353_ -5.1- ­..STATE OF FL( DEPARTMENT ( F=1BUSINESB: AND: ELECTRICAL C,ONTRACTO.R a k'CYClTciwii 1'. b JLATION SEQ#L12b51900346 alam ENSE NBR r -F 05>19 2,614.111818:7027 EC1300406,8 rifi .4,.. ' ::K tJj The.r: ELECTRICAL; C6NTRP,CT012¢,y Named below IS CERTIFIED; r UMder tl e.`.grov signs of .Chagt6k = 8§ k Expiration date: AUG 31, 20.14�,'A; r,�,rt,, l � , BROWER, -JAMES $ COTT t -BROWER ELECTRIC LLC:863 , 0 NW 5 3 ST LAUDERHILL FL 33351 "f RICK, SCOTT GOVERNOR KEN LAWSON SECRETARY DISPLAY AS REQUIRED B_Y LAW 115 S. Andrews Ave., Rni. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 I: i Business Name:BROWER ELECTRIC LLC Receipt#'181-3483 ELECTRICAL/ALARMS/CONTRACTOR Business Type:(ELECTRICAL CONTRACTOR), Owner Name: JAMES SCOTT BROWER Business Location: 8630 NW 53 ST Business Opened:02/03/2009 State/County/Cert/Reg:EC13 004068 i LAUDERHILL Exemption Code: ' I` Business Phone: 954-748-6236 Seats Employees Rooms p y Machines Professionals II j I I For Vending Business Only Number of Machines: Vending Type: I, Tax Amount Transfer Fee . ; NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 I, it l i.; THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS I I i I i THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. !!, Mailing Address: t, ii JAMES SCOTT BROWER Receipt #02B-12-00001144 I'I 8630 NW 53 ST LAUDERHILL, FL 33351 Paid 09/03/2013 27.00 { I, i - ---- 2013 e 2014 Feb 11 14 08:55p Brower Electric 954-578-1805 p.3 A C®�'®0M lam% CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDKYYY) 2/11/2014 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 CONS11TUTE 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(ies) 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 lLwl Underwriters Corp. 5220 South University Drive, Suite 101C Davie FL 33328 CONTACT Ciara Gravier NAME: PHONE _ (954)449-13900 FaC Nn.(95C.)449-B901 ADDRESS:ciara(Rcwiunderwriters.com . .INSURER(S) AFFORDING COVERAGE NAIC rR wsURER A Ma fre Ins Co FL 134932 INSURED BROWER ELECTRIC LLC 8630 NW 53RD ST LAUDERMILL FL 33351 INSURER B : INSURER C: INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NtIMRFR-CL1411001975 REVISION NUMBER: 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. INSR LTR TYPE ADDL UBR POMDN/Yy F PODCYEXP- POLICY NUMBER MMID DKYY 191 DfYYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY TO PREMGEISESS (EaRENTED ocaN' E encel S 1-00,000 PREMISES _, A CLAIMS -MADE COCCUR P323812 /8/2014 1/8/2015 MED EXP (Any one personl $ 5,000 ONAL & ADV IPFJURY $ 1,000,000 ERAL AGGREGATE -$ 2 , 000, 000 DUCTS- COMPIOP AGG $ 2,000,000 4Ea GEN'L AGGREGATE LIMIT APPLIES PER; x POLICY PRO- LOC $ AUTOMOBILE LIABILITY BINED SINGLE LIMIT c-IdentANY AUTO ILY INJURY (Per Person) S ALL OWN ED SCHEDULED BODILYINJURY(Pera cldsnt) S AUTOS AUTOS NON-CWNED PROPERTY DAMAGE S FHIRED AUTOS AUTOS Peraccident Is UMBRELLA LIAB HCLAIMS-MADE EACH OCCURRENCE $ EXCESS LIAB AGGREGATE $ CED I RETENTION $ WORKERS COMPENSATION VdC STATU- OTH• ANDEMPLOYERS'' LIABILITY V /N AIfY PROPRIETORIPARTYER/EXECJTIVE E.L. EACH ACCIDENT $ CFFIC=RIGdEMBER EXCL'JDED7 N/A: (Mandalory in NH) E.L. DISEASE -. EA EMPLOYE S IF yes, describe under DESCRIPTION OF OPERATIONS be.ow E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is. required) Electrical Contractor - CERTIFICATE HOLDER GAN L;tLLAIIkJN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The Villages of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Ave Miami, Shores, F1 33138 AUTHORIZED REPRESENTATIVE Ciara Gravier/LUIS ..A AGO RD 25 (2010/05) v IacxJ-tU I U rA%.v�.�,. �..,. ,....y... IN;nes omni o n; Thn Arnon name ntiri I—n— orn ronict--A —rlie of Afirinn Feb 11 14 08:55p Brower Electric 954-578-1805 p.4 ACO ® AVIM 1 VtK 111NUA TE OF LIABILITY INSURANCE 8054 12/1-1/2014 THIS CERTIFICATEIS 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(ies) must be endorsed. If SUBROGATIONIS 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 PAYCHEX INSURANCE AGENCY INC 210703 P: F: (888) 443-6112 PO BOX 33015 SAN AN^ONIO TX 78265 CONTACT NAME: (�NC�No. Ex[): ac.nlo> (888) 443-6112 EMAIL ADDRESS: INSURER($) AFFORDI.AS COVERAGE NAZCA+ INSURERA: ''-C in city Fire InS CC INSURED INSURERB: INSURER C : BROWER ELECTRIC LLC INSURER D: 863C NK 53RD ST INSURER E: FORT LAUDERDALE FL 33351 NnvCe A INSURER ----•-•• vGR 11vlVM IC IVUN1IMCM- O=Inclf I1U1IaA1]CO- THIS IS TO CERTIFY THAT THE POUCIES 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. lABR r17'E0FTA'SU(i1.ACE MDI. Ly. -TR SUB2 WialM.N/DD/YF f'OZICY�YUNBF.R JVrA-YEFf POLICYAWr UNITS Miami Shores Village Bldg. Dept. COMMERCIAL GENERAL LIABILITY CLAIMS-MADE❑OCCUP,. AUTHORIZED REPRESENTATIVE ` 10 050 NE 2ND AVE MIAMI SHCRES, FL 33138 EACH OCCURRENCE 11E TORENTEO PREMISES-Eaocc oce) MED EXP (Any one person) g GEN'L AGGREEGGAA'TTE LIMIT APPLIES PER: POLICY F HPOLICYI I JECT ❑ LOC CTHER:. PERSONAL &ADV INJURY 5 GENBZAL AGGREGATE. PROOUCTS-COMP/OP AGO $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ee accident! $ BOC I LY. NJURY;Per person) BOD LY INJURY (Per acciden-) g PROPERTY DAMAGE (Per accident) UMBRELLA LIAROCCUR EXCESS LIAR HCLAFAS-MADE. - EACH OCCUP.REVCE 5 AGGREGATE C=J RETEN7[QN5 j l A " WDFXEPS COMP VS„111011PER All r:Mr[oy11. IJAB1LIIY ANY PROPRIETORMARTNER(EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandafcry inNH) F—] V ves, describe under DESCRIPTION OF OPERATIONS belcw NIA 76 WEG 7,X7411 06/21/2013 - 06/21/2011 OTFT X. STATUTE ER E.:. EACH ACCIDENT 1 1 i 0 0 0 i o o o E.L. D.SEASE- EA EMPLC-EE 1 00O 9';10 r r E.L. DISEASE - POLICY LIMIT111,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is requlred) - Those usual to the Insured's Operations. Re: Permit V CR 1 11•I l:iA 1 F 1'11J L11F K ^ A I.I-=I I ATI—k1 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (20141101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS_ Miami Shores Village Bldg. Dept. AUTHORIZED REPRESENTATIVE ` 10 050 NE 2ND AVE MIAMI SHCRES, FL 33138 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (20141101) The ACORD name and logo are registered marks of ACORD