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EL-12-2045Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 11 0 Inspection Number: INSP-195992 Permit Number: EL -10-12-2045 Scheduled Inspection Date: July 30, 2013 Permit Type: Electrical - Residential Inspector: Devaney, Michael Owner: DENIS, CAMILLE AND MARIE Job Address: 10330 NW 2 Avenue Miami Shores, FL 33150 - Project: <NONE> Inspection Type. Final Work Classification: Alteration Phone Number (786)426-7904 Parcel Number 1121360161090 Contractor: ALL CONSTRUCTION & DEVELOPERS INC Phone: (786)768-4330 comments REPLACE OUTLETS IN BATH AND RENOVATED WALLS, SMOKE DETECTORS AND FANS 07/08/2013 - PERMIT EXTENDED PER LAST APPROVED INSP. INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-194930. dd receptacles by glass 10 doors or remove doors and track. Put closet fixture on wall over door or hi hat. Failed Correction ' Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 29, 2013 For Inspections please call: (305)762-4949 0 Page 25 of 34 Miami Shores Village Building Department OCT 2 9 2012 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical FBC 201 Permit No. e U 2-`Z,OL Master Permit No f2 -C-12- -,-)c44 /0,330 IVMI oqa 4VEX.J64E City: i Miami Shores County: Miami Dade Zip: 53 Folio/Parcel#: Is the Building Historically Designated: Yes mple NO Flood Zone: Phone#: ®� City: State: Zip: Tenant/Lessee Name: Phone#: Email: Name: / !'//" Gay CRU l C Address: City: State: �� Zip: 33//55- Qualifier 31/65- Qualifier Name:s Q Phone#: .305--303 State Certification or Registration #:� �1 Certificate of Competennccy� #: CC0�0oV 31-/ Contact Phone#: -30.--303 r�g� Email Address: DESIGNER: Architect/Engineer: Phone#: o OU Square/Linear Footage of Work: Type of Work: ❑Address Alteration ❑New ARepair/Replace ❑Demolition Submittal Fee Scanning Fee $ Permit Fee $ l '�FmG� CCF $ CO/CC $ Radon Fee $ DBPR $ Bond $_ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ' o 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 $2500, the applicant must promise in good faith that a co o th notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to a ach . Also, a certified copy of the recorded notice of commencement must be posted at the job site for the fi t inspection is oc seven (7) days after the building permit is issued. In the ab ce of such posted notice, the inspectio r'wil ry d a reinspection fee will be charged. �---•� The foregoing in trument was CAM before meetthis ` 22 The foregoing instrument was acknowledged/before me this day of t(3 ,, by �**1 ', I t---- Y� �� day of 2 g 20�, by OC TCi�e e who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. ARIA7BANOS Si n: = '.0 ' A15 D939360 Sign: Sign: u.tcr Print: -- — Print: My Commission Expires: - ofd �� •.' My Co xplres: APPROVED BY U ®�-t"Plans Examiner Zoning Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk 11/27/2012 22:53 3052636641 BARBARA INSURANCE PAGE 01/01 A� " CERTIFICATE OF LIABILITY INSURANCE cAT128/201YYY) 91/28/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEHR. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. it SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, cartaln policies may require an endorsement A statement on this Certificate does not confer rights to the certificate holder in lieu of such ondorsement(s). PRODUCER CO NAME: BARBARA INSURANCE INC. PHONE , 305-263-6640 FAX AICNot, 305-283.6649 7105 SW 8 ST ADD 1� MIAMI,FLZ3144 INSURER(S) AFFORDING COVERAW NAIL 4 INSURER A : INSURED INSURER 8: GRANADA INSURANCE COMP. TOP ELECTRIC SERVICES CORPORATION INSURER C: 10130 SW 46 ST INSURER D MiAMI,FL.33165 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 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. ILTRR TYPE OF INSURANCE Walk WM pOUCY NUMBER /YYW ImP I�rX LIMITS ©ENEMAL LIABILITYEACH OCCURRENCE S 500,000 CO" MERgAL GENERAL LIABILITY MISE$ E6 nca S 100,000 CLAIMS -MAGE F� OCCUR MED EXP (Any one parson) S 5,000 0186FL00029165 09/16/2012 09/18/2013 PERSONAL 8 ADV INJURY S 500,000 6e1,1ERALAGGRE0ATG S 1,000,000 GEN!L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG S 11000,000 71 POLICY 7 PRO. LOC y AUTOMOMLELIABILITY ='D SINGLE S ANY AUTO 9ODtLY INJURY (Per person) S ALL OWNED AUTOSr7 ASCHEDULF-D BPO�DILY INJURY (Par socidet) $ UTOS NE AG $HIREDAUTOS H AUT08 -- "rRS UMBRELLAUAS OCCUR EACH OCCURRENCES EXCESS UAB H0LALMS4JADE AGGREGATE $ OED RETENTIONS $ WORKLRS COMPeNsA710N 1/JC STATU- OTM. AND @MPLOYERS LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE F.L. EACH ACCIDENT S OFF109KMEMBER EXCLUDED? N I A (Mandatory in NMI E.L. DISEASE - EA EMPLOYE $ If yes descobe undet DF5341PIlON OF OPERATIONS below E.L. DISEASE • POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Atlaoh ACQRD 101, Additional Remarks SGWuls, IT mora spasa Is required) ELECTRICAL WORK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DLIVERED W BUILDING DEPARMENT, ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 AVE + MIAMI S1-10RES,FL-33138 AUTHQ E SVJTATfVC :010105) 01988-2010 AC RD CORP O TION. All rights reserved. The ACORD name and logo are registered marks of ACOR