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EL-14-2367Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-225825 Scheduled Inspection Date: December 30, 2014 Inspector: Devaney, Michael Owner: CONTESSA, MICHELE Job Address: 9220 NE 2 Avenue Miami Shores, FL Project: <NONE> Contractor: SUNSHINE ELECTRICAL CONTRACTORS CORP comments Permit Number: EL -10-14-2367 Permit Type: Electrical - Residential Inspection Type: Unde6und Work Classification: Alteration Phone Number (305)761-5243 Parcel Number 1132060133060 Phone: (305)265-4958 CHANGE OF SERVICE TO UNDERGROUND. INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 29, 2014 For Inspections please call: (305)762-4949 Page 29 of 32 a. Miami Shores Village Building Department artment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ELECTRIC ❑ ROOFING BY: FBC 201 Master Permit No. f"� 14 1 �o -t Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �� "10 /C)&, � Com: Miami Shores County Miami Dade Zio• Folio/Parcel#. Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: e �> OWNER: Name (Fee Simple Titleholder): p�wi �o . �% �% ��Z,� Phone&t)o S—) -741, rp L Address: City: 120 / � � � l i tate: r"1 C4--- 7! P: Tenant/Lessee Name: Phone#: Email: - X2 )2w(lew CONTRACTOR: Company Name: J,J0 S �7 1 Phone -0f, Address: �� `�� ` � City: o I State:,�-- Zip: Qualifier Name: �- �t �© AA -j 12 LS rQ; 614icl) Phone#• State Certification or Registration M C— 5C6 L�' Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State Zip: Value of Work for this Permit: $--2. o ®n Square/Linear Footage of Work: i 2_ 0 Type of Work: ❑ Addition ❑ Alteration ❑ New IBJ air/Re lace Re p p 11 Demolition Description of Work: Q .tqa;� ® ( u w 1 6LG a ) Specify color of color thru tile: n Submittal Fee $ Permit Fee $ _ 9S`� �f �' c CC $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ d� Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $421--:40 (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 Zip. AR 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 qpproved and a reinspection fee will be charged. Signature Signatur ` OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before rpe this ov___ day of 20 /f by 7 ®m,41e is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign The foregoing instrument wass acknowledged before me this day of �C� 20 by who is personally known to me or who has produced as identification and who did take an oath. �� FEPNAROQ RY PUB LA PUBLIC: _°`.'" �` * MY * CIORMMSION# EE MAN So2016Nev NS.sEXP �Tqr °P: Bo Sign 1 Print: ,eIVxJ Joann � 14 create � Florida Seal: Q a M Feliciano Seal: �p ��oP P4o�� MY Commission FF 082753 � '� O"' # EE83a19Q Expires 0 117 2/2 0 7 8 SPRY Pus�,o 1 2Q aembei 16e * 1Note�Y Sery� reTf OF F APPROVED BYPans Examiner Structural Review (Revised02/24/2014) Zoning Clerk RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD KEN LAWSON, SECRETARY me ELECTRICAL CONTRACTOR Named below IS CERTIFIED •,� Under the provisions of Chapter 489 FS. Expiration date: �, AUG 31, 2018 SANTIESTEBW MARIANO -SUNSHINE ELECTRICAL -0, TORS CORP 1300 SW 88 CT Wry ^*k �• MIAMIu' -.FL 33144-,, u _ v , ,rr y - , ISSUED: 0811412019 DISPLAY AS REQUIRED BYLAW SEQ a L14081400MIS STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION EC13006807 -; I SUED, .08/14/2014 CERTIFIED ELE0TR CAL CONTRACTOR SANTIESTEBAANO J' s SUNSHINE ELCTRIAL �ON�fRAC,ORS CO �k.MR.,ai14%Yj 1 IS CERTIFIED -under thw provisions of Ch.489 FS. E ," : AUG 31, 218 L140814MM16 I I L dim luta »i1a 'j +T�• F.' CERTIFICATE OF LIABILITY INSURANCE I DAIE(AAAAfDD1YYYY) 04/08!14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Ttils 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. 9 SUBROGATION IS WANED, subJect to the time and conditions of the Policy, certain policies may require an endorsement. A statement on this certificate dam not confer rights to the certificate holder in lieu of such endomement(s). CONTACT DUCER - Maria L Diaz Discovery Entr. Insurance Agency PHONE ; (305) 718-8919 aC No): (305) 718-3584 10733 N.W. 58th Street L marilu@discodoralins.com Miami, FL 33178 INSURER(S) AFFORDING COVERAGE NAIL e Phone (305) 718-8919 Fax (305) 718-3584 INSURER A: ACCIDENT INSURANCE COMPANY INSURED INSURERS SUNSHINE ELECTRICAL CONTRACTOR, CORP. INSURER C : 1300 S. W. 85 COURT INSURER D: INSURER E: INSURER F : MIAMI, FL 33144 CERTIFICATE NUMBER REVISION NUMBER: COVERAGES U$TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF NOTWITHSTANDING ANY REQUIREMENT, INSURANCE TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS iLR TYPE OF INSURANCE ADD R UB POLICY NUMBER POLICY EFF IDD POLICY EXP MIDD OMIT$ EACH OCCURRENCE $ 1.000,000.00 GENERALLIASILITY PREMt �IDrenee 100,000.00 Q COMMERCE4L GENERAL LIABILITY ES (Ea $ 5+OW•00 ❑ ❑ CLA6NS44ADE ® OCCUR N CPPOD13126-00 04/07!2014 04/07/2015 MED EXP (Arty one pesan) $ PERSONAL a ADV INJURY S 1,000,000.00 A © P.D. a£ B.1. $500. GENERAL AGGREGATE $ 2,000,000.00 ❑ PRODUCTS-C�APIOPAGG $ 1,000,000.00 GEMLAGGREGATELNARAPPLIESPER $ ❑ POLICY ❑ PRO- ❑ LOC JECT AUTOMOBILE LIABILITY E0& EDD SINGLE LNflR $ BODILY INJURY (Per parson) $ ❑ ANY AUTO ❑ ALL OWNED ❑ SCHEDULED BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ er AUTOS AUTOSWNED $ ❑ HIRED AUTOS ❑ EXCESS UAB ❑ CUMBRELLA LIAS �LAHNS AAADE + I I AGGREGATE $ woRKERS COMPENSATION AND LIABILITY ICERIMEEMPLOYERS' EXCLUDED? Yr--Ij.1Aj I I E.L. DISEASE ! EA EMPLOYE $ ANYPROPRIETORIPARTNERIEXEctnWE E.LEACHACC®ENT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Afch ACORD 101, Adt6licnal Remarks Schedule. H rare space le requires ELECTRICAL WORK- WITHIN BUILDINGS CERTIFICATE HOLDER MIAMI SHORES VILLAGE BUILDIND DEPARTMENT OF RER 10050 NE 2ND AVE MIAMI, FL 33138 FAX: (305)756$972 ACORD 26 (2010106) QF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTAM r ©1988-2010-ACORD CORPORATION. All rights rOServed. The ACORD name and logo are registered marks of ACORD To. Pegs 2 of 2 201408-0213:87:+41 (GMT) 17883530984 From JWAW Gutierrez JEFFATWATBt CHIEF FDMCL1LOFFICER s * CIEtWNWATE Olt MJ QN * M M�TMWM F LQFNA Tf0PJWW 00111WlGATION Ii/'fW - This cerdiles that the kO tiet Mod below has e100ted to be exempt irom F10t1da WorkeW Compensation IaW. EFFECTWE DATE: 7117=3 EXInRATEON DATE: 7/172015 PERSON: SANTIESTEBAN MARIANO J FOM: 651009473 BLISiNESS NAME AND ADDIWAL SUNSKNE ELECTRICAL CON' 1300 SW 85TH COURT MIAAIU FL 33144 SCOPES OF SUSINESS OR TRADE: ELECTRICAL- VI&RING ELECTRIC LIGHT OR BURGLAR AND FIEF SON INSTALLATION. WITHIN BUIL POWER LINE G ALARM INSTALL MAINTENANCE Ptasuntto0bzpWt ►L FA, fmo11PoBoraamponalmadtoWasa q, d,►UomuftdaI 'Tuff8aaffllM, 1, of - tjmswuwtft Wk am aettaeo+asr oraongisnssDaaruzdslldst�spiYe Pm>qm>RloG�pler'i40116(121,F.S.Car191oat0aasfs imp--i�plYot a ►8telsaopa ossim ixrsads5.06dtm tltaao9os adeteo9oao•boealaa� Pmsf�to Gl�44D.05(i3� RHI.. � to611eo�pte�lda�rksat ffil ele�nm is Sm911e t►18I if, �f�er4ler�el�m6ie nye �9�eis�taeot9mc.6ro p�tti9nffiet�e� eel9Bas0• nomeeShceor9ioaarSOn Hora�ao Tbedepa�UsB rw�alalla offinp19110T8t916 p81�Ai�lllBdf BBt is medft mqwmmnbofd&=Cgm CERTIFICATE OF ELECTION TO BE E MPT 07-12 QUESTIONS? (850)413-160 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be personally liable for the worker compensation iniuries of any person allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Print Name: State of Florida ) County of Miami -Dade ) Sworn to and subscribed before me s e;< day of , 20 By �� If -� 1 p t'3m p a ? c �N SSE N O N �m co _n 51 O N) 14 M C4 d m Contractor X Print Nan Signature: State of Florida ) County of Mi -Dade Sworn to s b rib day of By L (SEAL) C Tune of Identification i kQ O��etiO ZNZ IV 65X .Sunshine Electrical Co NOV 2 0 2W I Gctors Co. 'ied Electrical Contractors Lich# 1300580' Mariano Santiesteban M AV 1300 SW 85 CT Miami, FI 33144 Cell: 786.273.6194 Office: 305.265.4958 Fax: 786.536.1804 Overhead to underground electric service conversion E70--ov, CXA:H�er Ham ►rrlev- 2.00 A11 P 1-3D/z40 moijyi Lo ZW IPM P2 2►1 PVC -�,ro -0, FPL Sro and r4i 17 "OnQ * 4 crour-j sercv► ce— .4.- 8 -� E'/8 x $ CIrnund ri h1 1 Meter Combo 200 AMP 120/240 8/16 1 Main Braker 200 AMP 2P 2 Ground ring 5/8 x 8 2 Pool Clamps for ground ring 1 Pool clamp for ground service 1 Bar ground for TV & phone grounding 20 Ft cable #4 for ground service 1 connector with plastic bushing 80 Ft PVC 2" from FPL 1 90 degree PVC from FPL 1 PVC connector from FPL E/S x- 8 around rt h,,3 PERMIT #: _ Miami Steres Village_ APPROVED BY DATE ZONING DEPT :BBLDGDEP`,�� SUBJECT (0 CCMIPLV`I110E W1 rH ALL FEUERAL STATE ANL) Cr IjN, Y HLLL-LS AND REGULATlo�iS Note: The underground service will come through a 24" to 30" deep trench connecting from existing FPL handhole to the new meter combo. The job will be 10Ft away from the neighbor's property. �a 0 0643 N LOT 2 a`a, BLOCK 23 p a 0 • w °z o130.00' ( R & 5f1) 0 3' C•B.S WALL u .. 00OOH 0.10' 9p0 X01 +g4 U + s V' 9401 36.65' 15.00' w• M CH 9.00'~ 14' ..'g U 12.90' TWO STORYCH C.B.S. RESIDENCE `^ 5.00 LOT 3 +r f >f�9220 K BLOCK 23 N 40• F.F. ELEV. =11.60' �0 9.10' i ® : tn en 85' 12. c ` A 31.30' —77 �•''' — --- --�— �- — 6=--- '• ,�t1y O?09 z.. 00��0 +9 . tU C�0 �'rytV .4:cOo M; t 5' �� 1 N2 4 N U0Opp �9 �A:•' LOCK 23 'v, 0„ ro..... • • :�-e :. QI• UTILITY • :, • . .8;56• .0 6 wIF 130.00' { R & fVf) z N d •` ' U REMAINDER -- O LOT 4 r O BLOCK 2 ` f wZ 3 o • p Oo wZ Ln ABBREVIATIONS: SVW=SIDENWLK, CBS=CONCRETE BLOCK STRUCTURE, CL.F=CHAIN UNKFENCE, PL -PROPERTY UNE, DUE=DRAINAGE UTILITY EASEM ENT, IP=IRON FIPE. F=FOUND, AIC=AIR CONDITIONER PAD, P/C=PROPERTY CORNER D/H=DRILLED HOLE, VWF-MODEN FENCE, RES=RESIDENCE• CL -CLEAR. RB=REE:AR UE=Ln•1LITY EASEMENT. CONC=CONCRETE SLAB. RNV- -RIGHT OF NAY, DE=DRAINAGE EASEMENT, CIL=CENTER LINE, O=DIAMTER TYP=TYPICAL, t M=MEASURED. R=RECORDED. ENCR=ENCROACHMENT. COMP=COMPUTER, ASH=ASPHALT, N/D=NAIL & DISC. 5=SET, FEE=FINISH FLOOR ELEVArON. 015 --OFFSET, P/P=POV%ER POLE. OHP=OVERHEAD POAERLINE, VW4=VATER METER 4090 FENCE- MA,90NRYVV-kLL=l I I I I I ELEVATION BASED ON LOC. # 3100 NOT VALID UNLESS EMBOSSED WITH CONCRETE= +•• 0.+••+.•� = +.=•••i • '•_ -'•_• ••t MAINTENANCE& DRAINAGE EASEMENT- M & D.E. CBM# ]1j-568ELV. 9.65' TYPE OF SURVEY: BOUNDARY SURVEY SURVEYOR'S SEAL SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OFA FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT -•- O COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929.. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS'NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED REVISED: 10/13/14 INSTRUMENTS, IFANY, AFFECTING THIS PROPERTY. •FUR ELEVATIONS Additions or deletions to survey maps or reports by other than the Signing party or parties is prohibited without writren consent of tt>e signing party or parties. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUEOF SAID PB " 10 PAGE 70 ':40.00' �' ' •g"•}' '. C 1. 1-4- ': ''• '':'' :'':.':': •'..� . Miami Shores Village O. APPROVED BY DEPT LOCATION SKETCH SCALE: NTS DATE BLDG DEPT 9r' ' SUBJECT TO COMPLIANCE ' �•' • ••' '•' ' •' ' ' ''•' ' ' ' WITH ALL FEDERAL A4 STATE AND COUNTY RULES AND REGULATIONS 00 C N z UC 12 7 2014 • • %6069• ° • • 6666 Property Address: 9220 N.E. 2"d Ave., Miami Shores, FL. 33138. '• • 6.66 ° 66.66• 6666 fell* Certified To: Michele Contessa and Leslie A. Neine; Green and Kahn, P.L.; Old RegtLl;lac Natiopaliitle Insurance Company; Flagstar bank, FSB its successors and/or assigns, appearinglof rac°ord as;Mb4gage g •�, Electronic Registration Systems, Inc. as the insured 000060 5151 Corporate Drive • ° • • • • r • • • Troy, M 148098 •94 .6666• Legal Description: Lot 3 and the North 21 feet of Lot 4, Block 23, MIAMI SHORESSCIACIN ONF, AMENDED, according to the Plat thereof, as recorded in Plat Book 10, at Page 70, of the Pub"; Records of Miami -Dade County, Florida. 1 HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. �Av � ALINEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 SINCE 1987 BLANGO SURVEYORS ING. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 (305) 865-1200 Emall: blancosurveyorsinc@yahoo:Com Fax: (305) 865-7810 :UNE: $ SUFFIX: L DATE: 0302 ICOMMUNrrY# 120652 /14 11-=20' IF_ S'I. a,o • L 10 ti� 14-791