EL-14-1985Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-225616 Permit Number: EL -9-14-1985
Scheduled Inspection Date: December 22, 2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: KIMBERLY KRAUSE, JACK EFROMSON Work Classification: Alteration
Job Address: 290 NE 100 Street
Miami Shores, FL
Phone Number
Parcel Number 1132060134440
Project: <NONE>
Contractor: CPS ELECTRIC, INC. Phone: 305-607-8221
Iiunaing uepartment comments
3 SMOKE DETECTORS AND GFI IN BATHROOM IPassed Comments
INNSPECSPEC TOR COMMENTS False
Inspector Comments
Passed 121
:rte
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
December 19, 2014 For Inspections please call: (305)762-4949 Page 30 of 38
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
FZEC I W
SEP 11 2014
FBC 20`O
BUILDING Master Permit NoAC- $-1 q-, I
PERMIT APPLICATION Sub Permit No. FUN 10 Y5
❑BUILDING �LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [-]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
Specify color qj color thru tile:
G
Submittal Fee! Permit Fee $ 1r&4 ea104-7 CCF $ ®_ CO/CC $
Scanning Fee $ few Radon Fee $ � � c) DBPR $ Of Notary $
Technology Fee $ Training/Education Fee $ _ Double Feesr$
Structural Reviews $ Bond $ �V)66
TOTAL FEE NOW DUE $ 1
(Revised02/24/2014)
CONTRACTOR DRAWINGS
Q
JOB ADDRESS: Zlg 0 06
/00 S?
i /
City: Miami Shores
County
Q
Miami Dade Zia• �3��73
Folio/Parcel#:
Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction
Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): (�
�C k'
iE 17n O s'( -S OVA Phone#:
Address: -5cn,
Qyim..
City:
State:
Zip:
Tenant/Lessee Name:
Phone#:
Email:
CONTRACTOR: Company Name: C
('
P S G&
-LTA- � , Phone#:?Os (^] / 3 'vyS ?0
Address:_ /('0�0 I -%UL) 2e'*e-A
C
City: ''!1I
State:
/6c— Zip: 1
Qualifier Name:
Phone#:
State Certification or Registration #: t'C—'
G 1 0 Q Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
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:
y.
Specify color qj color thru tile:
G
Submittal Fee! Permit Fee $ 1r&4 ea104-7 CCF $ ®_ CO/CC $
Scanning Fee $ few Radon Fee $ � � c) DBPR $ Of Notary $
Technology Fee $ Training/Education Fee $ _ Double Feesr$
Structural Reviews $ Bond $ �V)66
TOTAL FEE NOW DUE $ 1
(Revised02/24/2014)
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 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.
Q f)-
Signature Y Signature
O NER or AGE TRACTOR
The foregoing instrument was acknowledged before me this
day of 0 GI/b 201 v . by
who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign
Print: Cossi # FF 006305
, Tom; Z n a ems tape
Seal:
The foregoing instrument was acknowledged before me this
day of D 6 .20 by
v -f -J &S-n� who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
RICK SCOTT, GOVERNOR KEN LAWSON. SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSKWAL REGULATION
ELECTRICAL CONTRACTORS LICEIwNSWO BOARD ,
EC 1335401
The ELECTRICAL CONTRACTOR V. '
Named below IS CERTIFIED
Under thens of Cha 489 FS,
a -
Expiration date AUG 31.20
ROMERO, ANGEL
is
CPS ELECTRIC INC
1600 NW 28TH AVE
MIAMI FL 33125
ISSMO. OP10=14 DISPLAY AS REOUIREO BY LAW S 00 L140710(*01314
W
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0
CL J
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND
PROFEM90A L REGULATION
FC13005401 UFA),,07/10,2014
CERTIFIED ELECTR- CONTRACTOR
ROMERO, ANGEL
CPS ELECTRIC INC
TIf £EiiilflE(5 undot 11Wr a*4Nri&1*"S Of Ch 4*11 *4
1*f% AUG 11 201t
t .f
Local Business Tax Receipt ■
Miami -Ludo County, State of Florida
s1*s1-5W)! A 0%, � - 00 NO TPAY
�T29�9�
*U$400*0 %A#M&0CAY Oft >01
PIRES
C P 5 ELECTRIC INC MS ER 34, 2014
16401" 28 AST
Xvc ; yF 7 t+i 4trt 'q v;
1s Of "us"* SS ►AYMtNi oks"Nso
P EiG RCi i t�Cr 8Y TAX CO[LiCTOII
45.00 09/; 1120 t 3
fsa 10 ICi3t541 t�fe,St i3il6T'
TINT Lanai Taa Rae rdy[;.ff? s #064" cwt of The Lrtrl sawasm Trr T!r RraOW IN to r brrvas.
tabor 016* i drr a +yrr triaasv tr it arrwMNw1M IW irrt 0Mi 4#8A woo" p"mao
141r1 mlets" trexr art 1rj0*v*** Wbkb rP* to 60 bow**",
TI<r NiCLM'T fit? r►rvr rrM�it Yr tar►trrrt rr t# tr�nMettarlra4ths <Mirwe-TArts Erfr iaa lr-,iiM v�;
fee Wto, swrMar,va ""011M 6.lalM000("t
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Oct 13 2014 12:01PM HP LASERJET FAX
0-:3
••���� �.+� nvI P%rru%=R I IVMLT UR NEDATIVELY AMEND,
BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITWE
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER
IEXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
. A CONTRACT BETIMEN THE ISSUING INSURER(S), AUTHORIZED
IMPORTANT- 11 the Certificate holder Is an ADDITIONAL INSURED, the
the terns and corIdNions of qts poocy, certain policies may require an e
eerfMcate Mer in ueu of such endotsene sj.
Icy{les) must be endomed. If SUBROGATION IS WANED, asubject to
1 ent. A statement on this cerfiflcatB does not confer r%Ms to the
a
PRODUCERCOKTACT
MENDEZ INSURANCE/FIN SVCS
508E 49th 3t
Hialeah, FL 33013
?
j
I
NAIAE:
A`j8 : (305) 769-4936 Na•(305) 769-1844
ADDRESs:mendezlily9hotmail . color.
easLMMt M AffVROM coVER 4E twucr
INSURER A: ASCI!'NDANT Cf�.RCTJM VND . —
INSURED C. 8. S. ELECTRIC, INC.
1600 NW 28 AVE
MIAMI, FL 33125
LIC#EC13005401
�
INSURER 9:
INSURER C:
_
INSURER D:
INWRER E:
INSURER I; : —
COVERAGES CERTIFICATE NUMBER
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDr
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AF
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY f
Mw
N HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
ION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
FORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
AVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
POLICY NU
R
0
MM1DD
LlL41TS
A
X CORINMIAL GRUICAL LANNUTr
CLAIMS -MADE D OCCUR
X 500 DED
GL -34425-
i
1
09/23/14
09/23/15
EACH OCCURRENCE $ 2,000,000
PRE61II9E8 occ�urenra $ 200,000
MED Exp (Any arm persan) $ 5 000
PERSONAL&ADV INJURY $ 2,000,000
GENE AGGREGATE LffiHT APPLIES PER:
RPOLICY F-1JE& ❑ LOG
OTHER:
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMPIOP AGG $ 2,000,00
s —
AUTOMOBILE LWMLITY
UTO
AN VIINED SCHEDULED
ALL OWN
O
AUTOS AUTOS
HIRED AUTOS NON -OWNED
AUTOS
?
I
1
Ee mWent $
BODILY QNJURY (PV pwwn) $
LILY INJURY (Par accident) $ —
Per E $
UMBRELLA LIPS
EXCESS LIAB
OCCUR
CLA90-MADE
I
EACH OCCURRENCE $ —
EACH OCCUGATE
$ —
DED RETENTION$
WORKERS COMPENSATION
$ —
—
A
AND EMPLOYERS' L1ABErrY
�IPCEWMUSEArxXGUM?? E YC�NIA
11p dew be�urder
DESGtRIPT]Or1t)FOPERATIONS baaw
y
WC -62117-
j
j
06/02/3406/02/15
STATUTE ER
_
EL EACH ACCIDENT $ 1,000,000
EL DISEASE - EA EMPLOYE $ 1,000,000
£.L.DISEASE - POLICY LUT S 1 000 000
'
DESCRIPTION OF OPERATION/ LOCATIONS / VEHICLES (ACORD 101- A41"Onal ROMA I
ELECTRICAL WORK
Schedule, may be a8aehed ff more epeceierepu3red)
P=DTICI#�ATL un, nre
VILLAGE OF MIAMI SHORES i SHOULDARMY OF ABOVE DESCRIBED IPOLA
10052 NE 2 AVE I THE EXPLRATI TE THEREOF, NOTICE
MIAMI SHORES , $'L 333 3 $ ACCORDANCE T E POLICY PROVISIONS.
I
305-756-8972 I AUTHORIZED E ATNE
®1 2014 ACORD CORPORAI
ACORD25(2014/01) The ACORD name and I00o are registered marks of ORD
BE CANCELLED BEFORE
1 BE DELIVERED IN
AU rights reserved.
• ELECTRICAL ,CONTRACTOR � 6leC7 c
RESIDENCIAL,COMERC[ALJ NDUSTRIAL.
Customer name; q"-C-te, t mmsc*7 Date' / l'
Work Address; i2e?o l) e /0
OFFICE;786/355/8273 CEW305MWV56 ^ 7'-/
Licensed and insnivd Thunk You
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Bathroom
Closet
911
Bedroom
SEP
with FBC10ZZI
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Scope of work
1. Remove existing tub
2. Remove existing tile on walls and floor
3. install new tub, new water valve.
4. Install cement boards(1/2") and tiled
walls .
Note: no mechanical work will be '
performed within this permit. '
Mr
�,S�b,�orwer head mmmwm 70"
LLVIu dram
Note:
oo 1W sq inches , meets show
compariament cAmpliance
oo plb 417.4
oo
Height 38"/48" complies with FBC plb
room 424.4 and will comform requirements
of ASSE 1016 and ASMEA12 to be
installed at point of use.
Shower seccdon
Shower
1/2 Cementious bars irt
Furrring 2X1 PT 12 OC girl
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