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EL-14-2724Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-226461 Permit Number: EL -12-14-2724 Scheduled Inspection Date: January 14, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Owner: , Job Address: 873 NE 96 Street Miami Shores, FL 33138 - Project: <NONE> Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060142840 Contractor: PRECISION SOURCE INC Phone: 305-260-4444 5uilaing Department comments SAFETY Inspection FOR FPL RECONNECT INSPECTOR COMMENTS False Inspector Comments Passed DI Failed Correction 44, Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. January 13, 2015 For Inspections please call: (305)762-4949 Page 28 of 28 Licensing Portal - License Search Page 1 of 1 1:24:16 PM 1211912014 Data Contained In Search Results Is Current As Of 12/19/2014 01:23 PM. Please see our cilossary of terms for an explanation of the license status shown in these search results. For additional information, including any complaints or discipline, click on the name. License Name License Type Name Number/ Status/Expires Type Rank Registered ER0014974 Current, Active Electrical I LF Primary Reg Electrical 08/31/2016 Contractor License Location Address*: 1055 NW 128 CT MIAMI, FL 33182 Main Address*: 1055 NW 128CT MIAMI, FL 33182 Registered ER0014974 Current, Active Electrical PRECISION CEI DBA Reg Electrical 08/31/2016 Contractor License Location Address*: 1055 NW 128 CT MIAMI, FL 33182 Main Address*: 1055 NW 128CT MIAMI, FL 33182 413M 42W * denotes Main Address - This address is the Primary Address on Ole. Mailing Address - This is the address where the mail associated with a particular license will be sent (if different from the Main or License Location addresses). License Location Address - This is the address where the place of business is physically located. 1 4 h r T ti h FL 23 :: Email: Gras mer nt n r :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer, iYria t?47 ion§? Sta1P of F gt`ida Privacy statement Under Florida law, email addresses are public, records. If you do not want your email address released in response to a public records request, do not send electronic mail to this entity. Instead, co€jtact the office by phone or by traditional mail. If you have any questions, please contact 850.487,1395, *Pursuant to Section 455.275(1), Florida Statutes, effective October, 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our chaj= 43-a page to determine if you are affected by this change. https://www.myfloridalicense.com/wll 1.asp?mode=2&search=LicNbr& SID=&... 12/19/2014 BUILDING PERMIT APPLICATION Miami Shores Village Building Department DEC 12 014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 1 Master Permit No. C L/(—f-" Z-7 2 V Sub Permit No. F-1 BUILDING ❑E ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [:]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 873 NE 96 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-014-2840 Is the Building Historically Designated: Yes NO Occupancy Type: SFR Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): WELLS FARGO BANK N A Phone#: Address: 4101 WISEMAN BLVD City: SAN ANTONIO State: TX Tenant/Lessee Name: N/A Phone#: Zip: 78251 Email: t t C CONTRACTOR: CompanyName: PRECISION SOURCE Phone#: Address: City: I 1 State: t" L Zip: I?> --3 Qualifier Name: RODOLFO DIAZ Phone#: State Certification or Registration #: Certificate of Competency #: �� ®QL? f 7 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $�Sdo - CD `�:) Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration❑� F-1Repair/Replace Description of Work: SGft� "n.S(1�C�tV� 1_17/_ i?, crf) /1/1-2 Specify color of color thru the: Submittal Fee $_ Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revised02/24/2014) Permit Fee $ Radon Fee $ 1 CCF $— DBPR $ Training/Education Fee $ ❑ Demolition CO/CC $ 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. t Signature BRADLEY W. JENS or AGENT dent Loan Dooum he oregoing instrument was acknowledged before me this ppb%84' i( day of �Cn/ Jaer— 20 by 0J/ -t,/ k") , who ispersonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: A`+/ 77Xge-,--- The fo�oing instrument who is personally known to me or who has produced as Seal: WTHEW HAGEN seal: Commission Number 755526 My Commission Expires *************** **************** APPROVED BY FX /Plans Examiner Structural Review (Revised02/24/2014) State of, ******************* Zoning Clerk Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 4103974 BUSINESS NAME/LOCATION PRECISION SOURCE INC 1055 NW 128 CT MIAMI, FL 33182 RECEIPT NO_ RENEWAL 4285839 EXPIRES SEPTEMBER 30, 2015 Must be displayed at place of business Pursuant to County Code Chapter SA — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED PRECISION SOURCE INC 196 ELECTRICAL BY TAX COLLECTOR CONTRACTOR 75.00 09/29/2014 Worker(s) 1 99E000157 0228-14-009377 This local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a codification of ft haldar s qualifications, to do business. Holder most *amply with any governmental or nongovernmental regulatory )awe and requirements which apply tothe'busloarss. The RECEIPT NO. above mad be displayed on all commercial vehicles -Mia"ade Coda Sec Sa-276. HIAM For more information. visit btu! __ Miami shores V 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 - 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; The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 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 injuries 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: & � je • (,.� Print Name: Signature: "% y.. Signature:_ r , I ►��7n�) t I� (SEAL) — — 77=i 6 (SEAL)_ Typeof Identification produc Tvpe of .�� %� .. 5\\G�:\v \\yam \� }� \�� \ \\\� \ \� z \ \ / \ k�. �>.��> <. . «-�� x� w� a . v. v��» � � <� »«. .yw w v x,q ,. 4� � « . PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE ` — — — — — — — — — — — i STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION 1 CONSTRUCTION INDUSTRY EXEMPTION CERi1FlGTE OF ELECTION TO nE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW 7 EFFECTIVE DATE 17/152013 EXPIRATION OAT- PERSON: DIAZ RODOLFO i FEIN: 050885611 BUSINESS NAME AND ADDRESS: PRECISSION SOURCE INC ----- i ------- IMPORTANT---- Pursuant to Chapter 440.05(14), F.S_, an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or a®� F 10 compensation under this chapter. L Pursuant to Chapter 440.05(12), F.S., Certificates of election to D be exempt.. appy only within the scope of the business or trade y1 y5 l listed on the notice of election to be exempt. G H Pursuant to Chapter 440.05(13), F.S_, Notices of election to be 1 E exempt and cerfdicetes of eledicn to be exempt shag be R subject to revocation r% at any time after the fling of the notice E or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this i section for issuance of a certificate_ The department shall revoke 1055 NW 128 CT I a certificate at arty time for falure of the person named on the MIAMI FL 33182 certificate to meet the requirements of Otis section. SCOPES OF BUSINESS OR TRA I I i LICENSED GENERAL LICENSED ELECTRICAL i CONTRACTOR —CONTRACTOR — DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413-1609 uec, iz, 2uNo, 3441 P. 1 A CERTIFICATE OF LIABILITYDATE(MM/DDNM) INSURANCE 12/12/14 THIS ct:RTIFICATt: IS ISSUED As q 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 poltcy(les) must b9 endoraed, If SUBROGATION IS WAIVED, subject to the terms and condillons of (he Polley, certain policies may require an endorsement A statement on this Certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER CONTACT MARTA ALONSO Florida Bankers Insurance PHONE (305)266 ti493 i °X Nor (30562-0879 7278 SW 8 Street MAIL manta® nondabankerainsuranoe,Com Miami, FL 33144 rax I INSURERA: FEDERATED NATIONAL INSURANCE CO. INSURED - IN9URER B PRECISSION SOURCE INC. RERC: 1055 NW 126 CI INSURER D: Miami, FL 33182- (305) 552.8500 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 REOUIREMENY, TERM OR CONDITION OF ANY CONTRACTOR 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. _ INA R TYPE OF INSURANCE ADDU UBR _ P LIC E POLICY EXP ._. POLICY NUMBER MM DDl LIMITS GENERAL LIABILITY -- EACH OCCURRE E 1 1,000,00 © COMMERCIAL GENERAL LIABILI`IY DAMAGE TO RENTED 100,00D. A ❑❑ ❑ CLA,ms- IADE © OCCUR GL -0504011880-01 PRFMISFPEO EXP ice) Y N 03/23/2014 03/23/2015 _____ �n one arson E 5,000,00 GEN'L AGGREGATE LIMOI_Y APPLIES PER: © POLICY ❑ .PR ❑ LOC AUTOMOBILE LU181LIYY ❑ ANY AUTO ❑ ALL UTOSEO ❑ SCHEDULED ❑ HIREOAUTOS p SWNED UMbRELLALIAS El Occult EXCESS LIAR 171 — WORKERS COMPENSATION AND EMPLOYERS'LLUILITY YIN NIA GENERAL S BODILY INJURY (Per person) 16 BODILY INJURY (Por accident) S OPE YD W, 3- S EACH OCCURRENCE e 24-1 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (AIIaeA ACORD 101, Additional Remarks Srhedula, If more apace la required) LICENSE # 99EODO157 ER0014974 ELECTRICAL CONTRATOR CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10060 NE 2 AVE MIAMI SHORES, FL 33138 866-2172 ACORD 26 (2010/06) OF 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. 1171888. burp "'Q 4988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD (; I W5 Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY � ::to I *1441 PRECISION SOURCE INC. r Oerfifwd under the Provisions of Chapter 10 of Miami -Dade County .,: Tam. APR.11.201210:54AM N4.2237 P. 1/2 WELLS FARGO BANK, NATIONAL ASSOCIATION MORTGAGE BANKING COMM1TEE I OF THE BOARD OF DIRECTORS ACTION BY WRITTEN CONSENT Eftetive as of April 1, 2012 The sole member of Mortgage Banking Committee I of the Board of Directors of Wells Fargo Bank, National Association (the °Bank`), a national banking association, hereby consents to the adoption of the following resolutions: WHEREAS, In the normal course of business, employees of the Bank need to execute various documents in connection with closings for the sale of real property, contracts and addenda, and are required to present certification of their authorization authority; . WHEREAS, these actions will be best and most efficiently accomplished by a confirmation of existing corporate officer authority to execute individual documents on behalf of the Bank, and the appointment of Designated Signers with authority to execute Individual documents on behalf of the Bank RESOLVED, that the Bank confirms the authority of the following officers to execute all Instruments as authorized under Melr officer title pursuant to the general Signature Resolution of Mortgage Banking Committee I on behalf of the Bank: Baker, Jeremy Michael a/k/a Baker, Jeremy- Vice President Loan Documentation Bremer, Kristen A. a/k/a Bremer, Kristen - Assistant Secretary Brennan, Janene - Vice President Loan Dorumentation Brennan, Nathan L. -Vice President Loan Documentation Carder, Lynn A. - Assistant Vice president Cornish, Jodi L - Vice President Cross, Kathryn Mary We Cross, Kathryn - Vice President Loan Documentation Duffy, Amy Leigh -Vice President Loan Documentation Geist, Scott - Assistant Secretary Hopke, Melanie J. -Assistant Vice President .wUensen,Bradley W. a/k/a Jensen, Brad -Vice President Loan Documentation McFadden, Anne E. - Vice President Loan Documentation Scheffert, Michael C. -Vice President Loan Documentation Smith, Tyler N. - Vice President Stone, Tamara Ann alkJo Stene, Tamara -Assistant Secretary Thelin, Allison Diane - Vice President Loan Documentation Van Hauen, Angela Kay a/k/a Van Hauen, Angela - Vice President Loan Documentation Wright, Leah A. - Assistant Secretary RESOLVED, that the following employees of the Bank are elected as Designated Signers for the Sank and authorized to execute any instrument relating to the origination, closing and servicing of Conventional, FHA -insured, or VA- guaranteed Aguaranteed mortgages, including deeds and conveyances of real property acquired through foreclosure on behalf of the Bank: Aguiniga Jr., Ray R. a/k/a Aguiniga, Ray -Avery, Tara M. Beamer, Joy Noel Blue, Nolan Brown, Susan I. Buntenbach, Edward A. Busch, Megan Coon, Craig S. Crass, Scott James aWa Cross, Scott Divan, Paul Doud, Cheryl L. a/k/a Doud, Cheryl Edgington, Justin Michael Fields, Hubbel Lyn a/kla Fields, Hubbei Freese, Brad A. Frost David Frydendali, Eric M. Gaspar, DeeAnn Marie Gentzler, Dusty Le e/k/a Qentzler, Dusty Gibson, Georgia Marie Godman, Sara M. Gonzalez. Erin R. a/k/a Gonzalez, Erin Gulick, Zachary Neal Hagen, Matthew Mark a/k/a Hagen, Matthew Hansen, Mark John alk/a Hansen, Mark 04/19/2012 8:58AM (GMT -07:00) -APR. 11. 2012 10:55AM Barris, Tyler Jake Harrison,. Gail A. alk/a Harrison, Gail Harryman, Kalli M. alkla Harryman, Kelli Hatcher, Jayne Elizabeth aikla Hatchet, Jayme Hem. Nic olas Calvin Holmberg Joey bean aWs Holmberg, Joey Holmes, Raul Hudson, dike E. a/k/a Hudson, Mike Johnson,` Jacob Edward Johnson; Michelle Lyhr, Kiger, Kenneth L. a/k/a Kiger, Kenneth Koll, Melinda J. a/k/a Koll, Mindy Kooistra-Sullivan, Elise M. Krog, Alexandra Nicole alkla Krog, Alex Kahl, Chad Michael a/k/a Kuhl, Chad M. Leichty, Faith Marie Lem, Ching Livingston, Donald B. May, Tobias R. allcla May, Toby R. Miller, Nathan Lee Moeder, Amanda Rae Newhouse, Shawn S. a/kla Newhouse, Shawn Pannkuk, Patrick Joseph Parlett, Benjamin A Peek, Jeffrey J. Phillips, Jessica Suzanne Pritchett, Nichola L. Pyle, Damn N0.2237 P. 2/2 aWa Phillips, Janice Quick, Donae Raymond, Ryan Reimer, Gregg A. Rohrer, Natalie Sue Rowe, Heather Renee Sandy, Matt Schamberg, Kristine Lee Schoakemoehl, Ryan Louis aW Schockemoshl, Ryan Shoekey, Heather Schultz, Aeja M. etk/a Schultz, Aeja Sheldon, Michael A. Spratt, Use. L. Stover, Erin M. Trenhaile, Tracy A. Wambold, Abbigall S. VanHaaften, Use Wheat, Morgan Harrison alkle Wheat Morgan RESOLVED, that each individual's authority as an Officer or Designated Signer of the Bank as aforesaid shall terminate automatically upon the termination of such individual from employment with the Bank. SECRETARY'S CERTIFICATION I, Deidre A Messenger, Assistant Secretary of Wells Fargo Bank, N.A., a national banking association, do hereby certify that the foregoing is a full, true and correct copy of the resolutions adopted by Mortgage Banking Committee I of the Board of Directors of Wells Fargo Bank, N.A., effective as of April 1, 2012; that said resolutions have not been amended or revoked and that the same are, on the date of this certification, in full force and of ecL WITNESS MY HAND AND THE SEAL OF THE BANK, this a day of April, 2012. (SEAL) KC idre Messenger, Assistant Secretary 04/11/2012 8:58AM (GMT -07:00)