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EL-14-2340Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-224049 Scheduled Inspection Date: December 01, 2014 Inspector: Devaney, Michael Owner: DI PIETRO, OLIVER Job Address: 9707 NE 5 Avenue Road Miami Shores, FL 33138-2444 Project: <NONE> Permit Number: EL -10-14-2340 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Low Voltage Phone Number Parcel Number 1132060180030 Contractor: RICHARD A JONES ELECTRICAL INC Phone: (561)747-8233 Building Department Comments LIGHTNING PROTECTION INSTALLED INSPECTOR COMMENTS False Inspector Comments Passed® CREATED AS REINSPECTION FOR INSP-223870. Need the contractor to meet me with a ladder. Failed Correction - �� // / Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. November 26, 2014 For Inspections please call: (305)762-4949 Page 18 of 27 f *. ShoresMiami • et5.X "-�Jgpw",y 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 C INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑BUILDING Q ELECTRIC ❑ ROOFING OCT 23 2614 CDC 20 i Master Permit No.4�9� ❑ REVISION ❑ EXTENSION [3 RENEWAL ❑PLUMBING ❑ MECHANICAL []PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9707 NE 5th Avenue Road City: iami Shores County: Miami Dade Zip: Folio/Parcel#: 1132060180030 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Oliver Di Pietro Phone#: Address: 9707 NE 5th Avenue Rd Cm,. Miami shores State. Florida Zip. 33138 Tenant/Lessee Name: Phone#: Email: 3 CONTRACTOR: Company Name:: RiChard A Jones Electric Phone#:, _ Ll Address: `� /j/1 City: Quail State DESIGNER: Architect/Engineer. Phone#; s Address City: ____State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Lightning Protection installed Specify color of color tru tile: Submittal Fee $2®a oa Permit F $ f �y�. �°� $ CO/CC $ Scanning Fee $ 4--1 A - i) Radon Fee $ DBPR $ cZj�y Notary $ Technology Fee $ 4 Training/Education Fee $ 1 k:3 Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $" (Revi5ed02/24/2014) 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. • •r' • • • • •. Notice to Applicant: As a condition to the Issuance of a building permit with an estimated value exceeding $2500, the applicant must promise In good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subV-p9-tvWtachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the flrst In which c en (7) days after the building permit is issued. in the absence of such posted notice, the Inspection wll be app ed a d a reins ion fee will be charged. or AGENT The foregoing Instrument as actin wledged befor this day of a by �whoersonally known to me or who has produced as identification and who_dkkkllqfi an Signaturev CO CTOR The/forregoing rostrum was acknowledged before me this 1L/ -day of Oi4p �, 20 by who is NqEally known me or who has produced as Identification and who did take an oath. NOTARY PUBLIC NOTARY Py9,JQ Y"4C--",4 Sign: @ Sign: i Print. Print /2o -tauj C r eo I ici e tPRY pV6 H IE GREENE Seal: r°. .`�'. Seal: . _ Notary Public -State of Florida ,,,' ROBIN LYNN aRENER eN; o�c My Comm. Expires Sep 16.2017 +�' °•;,',FOF c °� Commission # FF 054701 °*t '�`: MY COi1AMISSiON # E15=15 (40398-0153 Ftor�eNotaryBenrkecom APPROVED BY � ,� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ANNE M. GANNON 4- a CONSTITUTIONAL TAX COLLECT$.@ Serving Pain Beach County Serving you. P.O. Box 3353. West Palm Beach. FL 33402-3353 www.pbcta)Lcom Tot (581) 355.2264 This document Is valid only when rece"W by the Tax Coflectofs Office. RICHARD A JONES 5LEC INC RICHARD A JONES ELEC INC 204 N OLD DIXIE HWY JUPITER, FL 33458-4984 ullutllnlul,ltl,lulul„ll,lt,lnlnlrt 0ANNE M. GANNON CONSTrNTIONAL TAX COLLECTOR' Serving Palm Beach County Serving you. "LOCATED AT" 204 N OLD DIXIE HWY JUPITER, FL 33458-49" STATE OF FLORIDA PALM BEACH COUNTY 201412015 LOCAL BUSINESS TAX RECEIPT 82.586 ° LBTR Number: 201103452 EXPIRES: SEPTEMBER 30, 2015 This receipt grants tare privilege of engaging in or managing any business profession or occupation within its juris"on and MUST be rxtnspICUM ly disp*W at the place of business and in such e manner as to be open to the view of ffre public. P.O. Box 3353, West Palm Beach, FL 33402-3353 "LOCATED AT" www.pbctax-com Tot. (5613 355-2264 204 N OLD DIXIE HWY JUPITER, FL 33458-4984 TYPE OF BUSINESS OWNER CERWICAMON O RECEIPtMM''E PAID AMT PACT! Butt 23-0108 CW RECMCAL CONTRACTOR JONES RICHARD A ECDD0M 914.1405203.08±11114 sma 801 This document is vaffd only when receipted by the Tat Collector's Office. RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC0o02688 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 JONES, RICHARD A RICHARD A JONES ELECTRIC INC 204 N. OLD DIXIE HWY JUPITER FL 33458 STATE OF FLORIDA PALM BEACH COUNTY 201412015 LOCAL BUSINESS TAX RECEIPT Bs . 586 RICHARD A JONES ELEC INC LBTR Number: 201103453 RICHARD A JONES ELEC INC EXPIRES: SEPTEMBER 30, 2015 204 N OLD DIXIE HWY JUPITER, FL 33458-4984 This receipt grants the privilege of engaging In or 11111111 loll rtltll111Algol All managing any business profession or occupation within Its jurisdiction and MUST be conspicuously displayed at the piece of business and in such a manner as to be open to the view of the public, RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC0o02688 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 JONES, RICHARD A RICHARD A JONES ELECTRIC INC 204 N. OLD DIXIE HWY JUPITER FL 33458 RICHAJO-01 VSCHIAVO r A R�� CERTIFICATE OF LIABILITY INSURANCE °1012112014` 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 HOLIER. IMPORTANT: if the certificata holder Is an ADDITIONAL INSURED, the pollcy(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 Collinsworth, Alter, Lambert, LLC 23 Eganfuskee Street Suite 102 Jupiter, FL 33477 NAME Dianthe Charron PHONE 561 776-9001 IAfCEAtan • ( ) Arc No : (561)427-6730 %4DoREss: dcharron Illc.com INSURERSINSURERM AFFORDING COVERAGE MAIC # INSURER A: FCC[ Commercial Insurance Co 33472 INSURED Richard A. Jones Electric. Inc. 204 North Old Dixie Highway Jupiter, FL 33458 INsuRER S: CastlePoint Florida Ins Co INSURER C : INSURERD: INSURER E: INSURER F; COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. ILTR TYPE OF INSURANCE THE EXPIRATION DATE ACCORDANCE WITH THE POLICY PROVISIONS. WILL BE DELIVERED IN Miami Shores, FL 33138 POLICY NUMBER POLIEFF POU LIMITS A GENERAL LIABILITY 1,CnOMMEMIAL GENERAL uABWTY CLAIMS -MADE FKOCCUR GL00118624 6/1/2014 6/1/2015 EACH OCCURRENCE $ 1100010 PREMISES Ea occurrenoe $ 100, MED EXP (Arty one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00 GM AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS -COMP/OP AGO $ 2,000,00( $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NO -OMED COMBININGLEUMff— (Ea acddo BODILY INJURY (Per person) $ ' BODILY INJURY (Per accident) $ veru GE $ UMISRELLALIAR EXCESS UA13 OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ B wORKER3 COMPENSATION AND EMIPLOYERS' LIABILRY ANY PROPR TORIPARTNERIEXECUTiVE Y" N OFFICERIMEMBER EXCLUDED? F (Mlandatary in NH) If yes, desurtbe under DESCRIPTION OF OPERATIONS below N / A CP761373801 6/1/2014 6/1/2015 X WC STATU OTH- O Y MTBER EL EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 11000,00 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is requiveM RE: Richard A. Jones Electric, Inc. - Electrical Contractor - License 11 is ECM2688 Certificate holder is named as additional insured Including products and completed operations for general liability per CG2033, auto liability when required by written contract General Liability is primary and noncontributory when required by written contract Waiver of subrogation applies to general Ilability when required by written contract Cancellation applies as per policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010105) ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLIES BE CANCELLED BEFORE Miami Shores Village 10050 NW 2nd Avenue THE EXPIRATION DATE ACCORDANCE WITH THE POLICY PROVISIONS. WILL BE DELIVERED IN Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE s ACORD 25 (2010105) ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD