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EL-14-1716Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INSP-217387 Permit Number: EL -8-14-1716 Inspection Date: August 25, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: CRANE, AMY Work Classification: Addition/Alteration Job Address: 9015 NE 4 Avenue Road Miami Shores, FL Phone Number Parcel Number 1132060460080 Project: <NONE> Contractor: MESA BROTHERS INC Phone: (305)345-1974 Buildina Deaartment Comments REPLACE GFI Infractio Passed Comments INSPECTOR COMMENTS False Passed 10 Inspector Comments �'-_z' Cr Failed El Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. For Inspections please call: (305)762-4949 August 22, 2014 Page 1 of 1 Miami Shores Village Building Department AUG o tog 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Y: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ELECTRIC ❑ ROOFING FBC 20 LG- BUILDING ® Master Permit No. 7 fV Sub Permit No. k 4' «i ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Addition �N Alteration ❑ New [� Repair/Replace ❑ Demolition Description of Work: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type:77oad: Construction Type: g� Flood Zone: BFE: _ OWNER: Name (Fee Simple Titleholder) Address: 9 ® / �;; ^-0�7 -- City: `' Tenant/Lessee Name: Email: '�—e NO FFE: State: Z42 Zip: / one#: CONTRACTOR: Company Name: A0 0 9q- � 3- Phone#: Address: City: State: _��®` ��_ Zip: Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: �6-- Zip: Value of Work for this Permit: $ ®® ® 0 " fV Square/Linear Footage of Work: Type of Work: ❑ Addition �N Alteration ❑ New [� Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ 15�) ° CD Permit Fee $ ✓✓'�®` ®o CCF Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ _ 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 Zi 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 patrm— !� Signature NER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this I d fay of i 20 by day of 20 JIJ by C. aWf-, who personally known to whois4rei 0 me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: &ked_ Sign: Print: Print: JW00 #ff084756 Seal: ''�' �ARAAEBTEP Seal: �'"MY COMPASSION FF 073975DIPIREB; JAN 21,2018 EXPIRES: March 29, 2018 OBW h Ugh tet 6th Ineu�i:e � ,X BanW nbu nary Putt Under APPROVED BYit t> 10-4"X Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ACUREI uertiricate of Lianiiily insurance I 8/6/2014 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 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 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 Progressive Employer Insurance Agency, Inc. 6407 Parkland Drive Sarasota, FL 34243 Contact ame PHONE A1C. No. Ext): 888-925-2990 A/C. No.): ADDRESS certs@progressiveemployer.com INSURER(S) AFFORDING COVERAGE NAIC # Miami, FL 33138 Insurer A: Guarantee Insurance Company 11398 POLICY EXPITR IMMIDDPQrM INSURED Insurer A: Safety National (A) Progressive Employer Management Company, Inc. 6407 Parkland Drive Sarasota, FL 34243 Insurer A: Arch Re U.S. (A+) Insurer A: Alterra Bermuda (A) Insurer E: Insurer F: EACH OCCURRENCE I:UVr-SAMA C;EH I IFICAI F NUMBER' 000004706:4 RFVICITIN KI IMRFR- 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 TYPE OF INSURANCE ADOLSUBPOLICY INA V'AMJ Miami, FL 33138 EFF POLICY EXPITR IMMIDDPQrM OMITS GENERAL LIABILITY --- EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑OCCUR DAMAGE TO RENTED $ PREMISE Ea occurrence MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ POLICY 0 PRO- MLOC—I AECT $ AUTOMOBILE LIABILITY COMBINED SINLGE LIMIT (Fa �Idenfi BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIREDAUTOSH NON -OWNED AUTOS PROPER1 DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED I 1RETEN-nON$ $ A WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY YM WCP50000D301GIC 09129/2013 09/29/2014 XWC STATU- OTH- $ EL EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (MANDATORY IN NH) N/A F-LDISEASE - EA ACCIDENT $1,000,000 It yes, describe under F -L DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Coverage is extended to leased employees, but not subcontractors of Mesa Brothers Inc Location coverage effective date: 09/29/2013 Contractor # EC 13001870 CERTIFICATE HOLDER CANCELLATION Fax: (305) 753-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Miami Shores Villa a EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WfTH g THE POLICY PROVISIONS. 10050 NE 2nd Avenue AuthorizedRepresenta8ve Miami, FL 33138 d v T aos-cuT u At eurru uunrunA I wn. An rlgms reservea. NOTE: ALL SHEET MUST BE REVIEWED MIAMI-DADE COUNTY DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES Herbert S. SafFir Permitting and Inspection Center 11805 SW 26th Street (Coral Way) • Miami, Florida 33175-2474 • (786) 315-2000 APPLICATION FOR MUNICIPAL PERMIT APPLICANTS THAT REQUIRE PLAN REVIEW FROM MIAMI-DADE FIRE RESCUE AND/OR ENVIRONMENTAL SERVICES PROVIDE MUNICIPAL PROCESS NUMBER HERE P Job Address 2C)5— fie¢z ?? Contractor No. C r— C' i s-9 7 7 LL ! J — —0G —" o Last four (4) digits of Qualifier No. a oOZ u Folio e,-() �� v M on Ctractor Name n cAA-i ✓"� 1� . Lot v Block I- zo Qualifier Name o a 2 Subdivision PB P9 0 LL o z Address IS N Z{ -F �► 1/ 1S_ —90 City State _Zip Metes and bounds [ ] New Construction on [ ] DemolishJ �$'► �oa� Vacant Land [ ] Shell Only Current use of property CJlti1 LL W Alteration Interior [ ] Addition Attached Description of Work w ] Alteration Exterior [ ] Addition Detac 0[ ] Relocation of Structure [ ] Re -Roof ' 0. 2 [ ] Enclosure [ ] Repair [ ] Foundation Only Sq. Ft. 15� Units Floors [ ] Tent ----,.Value Work P [ ] Repair Due to Fire of ] MBLD` C;/ w [ ] Chg. Contracto Owner " W Category [ ] Re -Issue Address [ ] MELE y [ ] Re -Stamp Cityp [ ] MLPG [ ] RevisionW Phoneme • Last four (4) digits of Owner's Social Security No. a [ ] MMEC [><FIRE ¢ [ ] Not Applicable for Fire 0 a w Name 'q P Owner Address ( o /V 1(j o S Address R z IL C z 0 CL City 10L Vn i �� State`�'ip 1 `3 v City State —&p Z _zip av¢W K Phone 205 - 7 33 Q Phone I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible at the rate of $19 fort first hour and $65 per ea ditional hour in the review fees. Minimum charge one-hour a dition to aw y w 114 Request: Date: NW LLW 2^d Request: d Date: E 31d Request: Date: I am requesting Optional Plan Review (OPR) to be scheduled as soon as possible at the rate of $75 for each discipline. a a Additional review fees may apply. O 0 3 114 Request: Date: o2"d Request: Date: ¢ W 31d Request: Date: 123_01-192 6113 BUILDING PERMIT CATEGORIES CATEGORY DESCRIPTION PERMIT TYPE BUILDING 01 GENERAL BUILDING -COMMERCIAL MBLD 02 SUB -GENERAL BUILDING -RESIDENTIAL MBLD 08 CANVAS AWNING MBLD 10 COMMUNICATION TOWER MBLD 15 DEMOLITION MBLD 29 METAL AWNING & STORM SHUTTER MBLD 48 SCREEN ENCLOSURES MBLD 55 SWIMMING POOL MBLD 56 TENNIS COURTS (SURFACE PAVING) MBLD 86 TRAILER TIE DOWN MBLD 88 WALK-IN COOLER MBLD 91 MARINAS MBLD 92 LOW SLOPE APPLICATIONS (GRAVEL, SMOOTH FIRE MODIFIED, SINGLE PLY) MBLD 95 SHINGLES (ASPHALT, FIBERGLASS) MBLD 96 SHINGLES (METAL ROOFS/WOOD SHINGLES & SHAKE) MBLD 97 STAGE 2 VAPOR RECOVERY SYSTEM MBLD 99 SOIL IMPROVEMENT MBLD 0100 BULK STORAGE PROPANE TANK MBLD 0101 REMOVABLE STORM PANELS MBLD 0107 TILE ROOF MBLD 0110 WATER MAIN MBLD 0111 SITE PLAN MBLD 0112 INDOOR EVENT/EXHIBIT MBLD ELECTRICAL 04 FIRE ALARM SPECIALTY MELE 16 SPECIALTY WIRING MELE 38 GENERATORS MELE LPGX 01 LIQUEFIED PETROLEUM GAS MLPG 02 MISCELLANEOUS MLPG 04 LIQUEFIED PETROL. GAS/STATE MLPG MECHANICAL 09 ABOVE/BELOW GROUND TANKS/PUMPS & POLLUTANT STORAGE SYSTEM MMEC 38 COMMERCIAL HOODS MMEC 43 FIRE CHEMICAL MMEC 46 SPRAY BOOTHS MMEC 48 SMOKE CONTROL MMEC 52 RESIDENTIAL ELEVATOR MMEC FIRE 32 FIRE SPRINKLER FIRE i