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EL-13-2289Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-221180 Permit Number: EL -10-13-2289 Scheduled Inspection Date: December 02, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: NUGEN, JOHN Work Classification: Pool - Private Job Address: 375 NE 99 Street Miami Shores, FL 33138-2436 Project: <NONE> Phone Number Parcel Number 1132060135530 Contractor: ELECTRICAL MASTERS INC Phone: 305-265-7996 Building Department comments NEW POOL ELECTRIC WORK INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-200775. Not ready and pump is Ea, not in line of site of switch. Failed r, t. Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 01, 2014 For Inspections please call: (305)762-4949 Page 7 of 36 EL.C. 't- Ac.A42-T1 Miami Shores Village Building Department 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 JOB ADDRESS: FBC 20 zo13 Permit No. Master Permit No. City: Miami Shores County: Miami Dade Zip: r 3 Folio/Parcel#: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple NO �� Flood Zone: _ � ' hlC: r✓ l L4 , &/ Phone#- C City: �� E• i1- � �Lyvv--c° 15 State: f—lr Zip: �I Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: �4 O 4 _`� CA_1 City: State,' Zip: 3 3fSG Qualifier Name: s &.1 n1czea Phone#: '7616 '-3 9 7-9 Z5� 6 State Certification or Registration #: Z' 1, D O 1: O's 7 Certificate of Competency #: Contact Phone#: Jr^o ►^ rte, Email Address: 0/6A �G4®16 �e�/ 5 z DESIGNER: Architect/Engineer: Phone#: 0 Value of Work for this Permit: $ /1S_0 U ;�: ,, Square/Linear Footage of Work: Type of Work: ❑Address OAlteration INNew ORepair/Replace ODemolition Description of Work: N o w 00 � �= / Q �T < -i 1 ,� *�*�**********•�*****��***********,�*****Fees*********•�******�******�*�*�*************�** Submittal Fee Scanning Fee $ Permit Fee $ ��®ls�� CCF $ CO/CC $ Radon Fee $ DBPR S Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 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 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 wi11 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 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 pp ed and a reinspectiolfee will be charged. Signature. i Signature or Agent Contractor The foregoing�nt was acknowledged before me this —'93 The foregoing instrument was acknowledged before me this day of d , 201 , by lk�-A N N00= day of OUD 20 L!�, by , who is personally known to me or who has produced AA who is personally known to me or who has produced %1115111 Ulr//// As identification and who di\c�.l& IV' j �;'%,,�� _ NOTARY PUBLIC: Sign: Print: 0 My Commission Expires: as identification and who did take an oath. NOTARY Sign' Print: My Commission MY COMMISSION # EE 858950 EXPIRES: December 9, 2016 Bonded Thru Notary Pubk Underwrk s APPROVED BY 29, Zt i��E/ Tans Examiner zoning AkItall) Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07XRevised 06/10/2009XRevised 3/15/09) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET �,.• TALLAHASSEE FL 32399-0783 RODRIGUEZ, OSVALDO ELECTRICAL MASTERS INC 8400 SW 14TH ST MIAMI FL 33144 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and team more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE STATE OF FLORMA AC# " 6335647 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ER0013057 Og/Q4f12 127009317 REG ELECTRIC ,C0WMCTOR } (INDIVIDUAL"1099. TALL LOCAL LICENSING REQUIi�8>!IGSNTS PRIOR TO CONTRACTING IN ANY AREA) j HAS REGISTERED under the provisions of ch.489 I zviration date: AUG 31, 2014 L12090402106 THIS DOCUMENT HAS A COLORED BACKGROUND - MICROPRINTING - LINENIAR& PATEATED PAPLR AC# 6335647 STATE OF FLORIDA DEPARTMENT "OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORSLICENSING BOARD SEW L12090402106 MIAMI FL 33138 RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY Municipal Contractor's Tax Receipt Miami—Dade County, State of Florida THIS IS NOT A BILL -DO NOT PAY CC NO: 97EO00003 BUSINESS NAMEMOCATION ELECTRICAL MASERS INC 8400 SW 14 ST MIAMI, FL 33144 OWNER ELECTRICAL MASERS INC MIAMIDADE MC RECEIPT NO. EXPIRES NEW BUSINESS SEPTEMBER 309 2014 7436805 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 TYPE OF BUSINESS ELECTRICAL CONTRACTOR For more information, visit www miamidade gDyttaxcoliector Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 3693075 BUSINESS NAME/LOCATION RECEIPT NO. ELECTRICAL MASTERS INC RENEWAL 8400 SW 14 ST 3857902 MIAMI, FL 33144 PAYMENT RECEIVED BY TAX COLLECTOR 200.00 09/05/2013 0222-13-001244 EXPIRES SEPTEMBER 309 2014 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED ELECTRICAL MASTERS INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR 75.00 09/05/2013 Worker(s) 3 97E000003 0222-13-001244 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles -Miami-Dade Code Sec 98-M MIAMMADE For more information, visit � ww miamidaae oov/taxcollector t U Z �z LU CL 0 FO W SO M N Coo C Q w /"� _ 1-_§ O iL c �W WOZ v U j OR EXPIRES SEPTEMBER 309 2014 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED ELECTRICAL MASTERS INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR 75.00 09/05/2013 Worker(s) 3 97E000003 0222-13-001244 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles -Miami-Dade Code Sec 98-M MIAMMADE For more information, visit � ww miamidaae oov/taxcollector t OP ID: TC i CERTIFICATE OF LIABILITY INSURANCE °�10102/20p 3Y' 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. 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 policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 endorsements). PRODUCER CONTACT NAME; iSure Insurance Brokers 2700 SW 137 AVE PHONE FAX .__.--.----__._.____. Miami, FL 33175 ADoreEss Teresa R. Carmona, Agent ELECT -1 2,00,M cy . $ INSURER(S�AFFORDING COVERAGE NAK INSURED E{ectrica{ Masters Inc. INSURER A,Florida Citrus, Business (FUB) 8400 SW 14TH Street INSURER 0. Travelers Property Cas.Co. -- Miami, FL 33144 INSURER C : Pr ressive Ex rens ins. c0 08/1212013 i 08/12/28014 ;(ea { INSURER D $ INSURER E : t ALL OWNED AUTOS I INSURER F ,+nvcowr_ca f%=OVIctrA7c U111MIR5:12- KE-VLSION NUMBr_K: 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. N iPPUCY LTR TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITYEACH EFF PSC PXP LIMITS M OCCURRENCE $ TOIZENTED _ 1,000,00 8 ` X COMMERCIAL GENERAL LL41MITY 1660-7A846384 I 10109120? 3 10/0912014 j -PREMISES (Ee perx e!tce� $ City of Miami Shores k � CLAIMS -MADE OCCUR 4 ! ; MED EXP (Any One P?_ I $ j ( X I ISLANKET ADD -L INSURED I PERSONAL & ADV INJURY # GENERAL AGGREGATE ! $ 1-- 2,000, GENAGGRE{{GATE LIMIT APPLIES PER ----- PRODUCTS COMPIOP AGG li . _ _ _-- 2,00,M POLICY 4� PRO- - LOC { $ AUTOMOBILE LIABILITY I { COMBINED SINGLE LIMIT acadent)� $ 1,000,00( I -- ANY AUTO { ; 102353502-0 { 08/1212013 i 08/12/28014 ;(ea { BODILY INJURY (PO( Person} $ ALL OWNED AUTOS I BODILY INJURY (Per acelde(d) i S CX I SCHEDULED AUTOS i r I HIRED AUTOS j t � � PROPERTY DAMAGE (PER ACCIDENT) $ i i PIP $ 101 NON -OWNED AUTOS UMBRELLA LIMBOCCUR EXCESS LIAR 1 ? i EACH OCCURRENCE — AGGREGATE$ 1 $. - CLAIMS -MADE ! y DEDUCTIBLE { . _. I_ _------ ' RETENTION $ 1 WORKERS COMPENSATION 1�( YVC STATU- TH , I AND EMPLOYERS LIABILITY f ( ! A I ANY PROPRIETOWPARTNERIEXECUTIVE Y� 10640035 N t A I 04101/20131 04101/2014 � E L EACH ACCIDENT $ -- 1x000+ j OFFICERIM EXCLUDED? { # E 1. DISEASE - EA EMPLOYE $ _ 11000,(Mandatory00( in H) N desaibeunder j I E.L. DISEASE - POLICY LIMIT $ 1,00,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLE$ (Attach ACORD 101, Additional Remarks Schedule, it more *Pace is required') Electrical Contractor aa:l�rrl�rrranl? (P} Ifttg-;Ct111l/ A%,VKU tiVKr'MKA I w1r. A11 rlBr>us reraerrreev. ACORD 25 (2008109) The ACORD name and logo are registered marks of ACORD - CITYM{1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ExPlRAT*N DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Miami Shores Fax:305-756-$972 AUTHORIZED REPRESENTATIVE 10050 NE 2 Ave Miami, FL 33138 f}% (P} Ifttg-;Ct111l/ A%,VKU tiVKr'MKA I w1r. A11 rlBr>us reraerrreev. ACORD 25 (2008109) The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 RODRIGUEZ, OSVALDO ELECTRICAL MASTERS INC 8400 SW 14TH ST MIAMI FL 33144 (850) 487-1395 Congratulations! 1. With this license you become one df a nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses rangeSTATE OF FLORIDA from architects to yacht brokers, from boxers to barbeque restaurants, �r DEPARTMEN , OF BUSINESS AND .and they keep Florida's economy strong. PROFS GULATION Every day we work to improve the way we do business in order to ER0013057 iap9/43/2014 serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information REG ELECT about our divisions and the regulations that impact you, subscribe RODRIG s 2 to department newsletters and learn more about the Department's ELECTRICAL initiatives.`- (INDIVIDUAL R40R� Our mission at the Department is: License Efficiently, Regulate Fairly. s. LICENSING RECUt We constantly strive to serve you better so that you can serve your TO CONT RACTINO')NiARGY) customers. Thank you for doing business in Florida, NAS REGISTERED under the provisions of Ch.489 FS. Expiration date -,AUG 31, 2016 L1409030002426 and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR STATE OF FLOI ftl 1011aC00 Akin PF ER0013057 KEN I.AWSON, SECRETARY ;NATION W Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 3693075 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES ELECTRICAL MASTERS INC RENEWAL SEPTEMBER 30, 2015 8400 SW 14 ST 3857902 MIAMI, FL 33144 Must be displayed at place of business Pursuant to County Code Chapter BA - Art, 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED ELECTRICAL MASTERS INC 196 ELECTRICAL BY TAX COLLECTOR CONTRACTOR 75.00 09/25/2014 Worker(s) 3 97E000003 0224-14-007192 This Local Business Tax Receipt only confirms payment of the Local Business Tax, The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles - Miami -Dade Code See 8a -27g. MIAM6DE For more information, visit www.miamidade.goylt pXF,gllg_gtgr Municipal Contractor's Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY CC NO: 97E000003 MC � BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES ELECTRICAL MASTERS INC NEW BUSINESS SEPTEMBER 30, 2015 8400 SW 14 ST 7455357 MIAMI, FL 33144 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 9 & 10 OWNER TYPE OF BUSINESS PAYMENT RECEIVED ELECTRICAL MASTERS INC FI ECTRICAI. CONTRACTOR BY TAX COLLECTOR 200.00 09/25%2014 0224-14-00/19') MIAMI For more information, visit yyWWmiamidal o.,gQvttaxc-ol.toCtgr 'Q�.i�l�i ~ U V Q w q Z m0- J m 00 LLQ Coo U W M o M N W� w W CPf— 0 r2 n O J Lu L _ ~oma Q VuU W ~ Vi u7 C: w V Q Z OF q --I J m 00 LLQ O N W 0 W P1, E 0 0 O