EL-12-2216Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-228917
Scheduled Inspection Date: February 26, 2015
Inspector: Devaney, Michael
Owner: PERKINS, GERTRUDE & HARRY
Job Address: 96 NW 92 Street
Miami Shores, FL 33150 -
Project: <NONE>
�—12—22dS
Permit Number: EL -11-12-2216
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1131010160070
Contractor: AD ELECTRIC SERVICES INC Phone: (305)896-3402
Building Department Comments
REPLACE OUTLETS IN BATH AND KITCHEN Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-228791. Panel is not U. L. listed.
2T the interior of an old panel was removed and the interior and cover of a G,
E. panel was installed.
Dedicated circuits need receptacles rated for their amperage.
Failed ❑ Garage receptacles to be G. F. I,
Correction
Needed ❑ �� fs�'"
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid
February 25, 2015 For Inspections please call: (305)762-4949 Page 25 of 40
.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
-It-la 1Y ,yam
LIAR 2 Q 2014
0�
FBC 20 CD -
Permit No. ELI
.2
Master Permit No. 1<<'fZ - 2_ZtG
I ADDRESS: cS�$
Miami Shores County. Miami Dade Zip: te=,;0
/Parcel#• U-®3 to I _0* -0010
the Building Historically Designated: Yes NO -)4. Flood Zone:
Name (Fee Simple
City: f 1 owt -t-1 State: �LQ �-� 4�T� Zip: M7?�,
Tenant/Lessee Name: Phone#:
Email: o
CONTRACTOR: Company Name: e4,-Z2U Phone#: TB6 -" -QPJA
Address: I 04412 Lae' PL
City: t.kt IN.t-&k State:
Qualifier Name:
State Certification or Registration #: A20, P VL-Q0S't'-"Z Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: - Phone#:
Value of Work for this Permit. $ � t2o.. a d Square/Linea�• Footage df Work:
Type of Work: ❑Address UAlteration ❑New ❑Repair7Replace ODeriiolition
Submittal Fee
Scanning Fee $
Notary $
Permit Fee V. J25•4,CCF $ CO/CC $
Radon Fee $
DBPR $ Bond $
Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
A
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 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 cer* that all the foregoing information is accurate and that all work will be done in compliance with
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
IMPROVEMENTS T PROPERTY. IF YOU INTEND TO OBT
FINANCING, CONSULT -A LENDER OR AN ATTORNEY BEF(
RECORDING YOUR NOTICE OF C NCEMENT."
*Votice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant i
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the peg
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job
for the first inspection which occurs seven (7) days after the building permit is issue absence of such posted notice,
inspection will not be approve4,ajiinspection fee will be charged. t
C
Ow Agent T
The forego strument was0acknowledged before me this��r
day of 20 _qby 0/�I%� ,
who is personally known to me or who has produced
As identification and who did take an oath.
MY GaM1N18 M #eEWW1
Sign:EXPIRES ,Mnu+nl►13.2017
ao7 3.9183
Print:
My Commission Expires:
The foregoing instrument was acknowledged before me this 2a
day of Z 6 , 20 I!J, by W—W-oke 42641 &Z
who is personally known to me or who has produced
as identification and who did take an oath.
N, 6TARY PUBLIC:
of a
Sign:41
s
Print: IC t •
My Commis
�rdrdedrrk�raYaY�r�e&sY�r�r�YsY�ede�r&�r�Ydedr�trirnY�ir��e�YaF�raYde&a&steaktskstrrk&�r�o�aYdraY�rdrkdrskdestr�: �Y-x�v4n+talc,Ya�eiraYaratnraY�aa�ak�adesY& aY�4�ra�e�Ydr�Y�:3r�tr�e4r4nWrvraYa�,a�rrk�edrrkaY
APPROVED BYj�2� -O.O d/ laps Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012XRevised,07/10/07XRevised 06/10/2009XRevised 3/15/09)
Miamishores V11age
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR /ARCHITECT
Permit N. Rd, -11-12- 215
Oker'S Name .(Fee Simple Title Holder) %lir Phone #: ��?��' �
Owner's Address: c a2
City: - ��� / State: Z=' / e Zip Code.-
Job
ode:
Job Address (of where work is being done): . 41W 92 -%E3,7
City: Miami Shores State,
_Fiorida Zip Code:_/
Contractor's Company Name: Al) OQ AL U- s Phone #;
Address: 1®14 q Z-Sw l Z IA 9 L
City: Int ck"A` State: (7- L
Qualifier's Name: � �c.an, tom, dip Code:33t Y G
Lic. Number: Er l Xo ®s i S ?-
Architect/ Engineer of Record Name: Phone #
Address: -
City:
State: Zip Code:
I hereby certify that the work has been abandoned and/or the contractor/architect Is
unable or unwilling to complete the contract. I hold the Building Official and the
.01aml Shores harmless for all legal invoiv t.
Signature S nature
torAg�nt �Q�radororArct
The foregoing Instrument was'aknbwledged before me The foregoing Instrument was aknowledged before me
this t qday of ARAN64 20`0,by,¢��0'+ this 9 day of 8LC4 .20 by4izwt
Who is personally known to me or who has produced who is personall 1 known to me or who has produced
as Indentitication. _ l 1 so i
Notar!*�
`
Sign:
Notary Pubil
Seal: 190�9
l+N Jm 19.3018
n on.
spa FWIft
I
Jan 13, 2014
Re: 96 NW 92 ST Miami Springs, FL 33150
Fernando R Loza Lic: EC13004481
Premier Electric, LLC 20745 SW 256 ST Homestead, FL 33031
We, Property Consultant Group, Corp, are writing to inform you that we will no
longer be having you as Electrical Contractor for the repairs/remodel of our above
referenced property. As per current building code policy/procedure, your reception
of this letter shall initiate what is the 10 day period necessary to have you removed
as current qualifier.
Carlos Cienfuegos
Property Consultant Group, Corp
9415 SW 72 ST Miami, FL 33173
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POSTAGE1
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SECTION ON DELIVERY
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:Prrrrt your, a and address on the reverse
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B. ''Refeived by (Pd tited Merriej C. Date of"De6*
■ Attich this"card to the back of the maitpieoe,
or on the front if spape permits.
lx is deAv"y addre dtffeter�fi from Item 1�i i=1 Yes
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UNITED STATES POSTAL SERVICE First -Class Mail !
Postage & Fees Paid
USPS
Permit No. G-10 ;
• Sender: Please printf your name, addresq, and ZIP+4 in this box •
Fir. P
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PEM: 2M7320 ; E
BUSINESS NAME AND ADDRESS:
AD ELECTRICAL SERVICES INC
8860 SW 171 ST
PALMETTO BAY FL 33157
SCOPES OF BUSINESS OR TRA
1=LECTRICAL WIRING
WITHIN BUIL
-------------------------------------
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Pureua�hhnt to Chapter 440.05In* F.S.. an officer of a WrPff"ea aMn
Mro by sling a cedmeate of
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recover benelee or
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DEPARTMENT
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be etempt apply nnty;Rhin the uapa of the business Or Made
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cENnFlaate ov e�eDTroN TD BE EXEMRT an0at aLDNrp4
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and eeReles at OI eteelbn IO ae eeempi fuse ae
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nark. m CenOkate rap ranger meets Ma reaunemann 'In
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PEM: 2M7320 ; E
BUSINESS NAME AND ADDRESS:
AD ELECTRICAL SERVICES INC
8860 SW 171 ST
PALMETTO BAY FL 33157
SCOPES OF BUSINESS OR TRA
1=LECTRICAL WIRING
WITHIN BUIL
-------------------------------------
:
---------------- -----
000656
At
Local Busra
iness Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOT A BILL- DO NOT PAY
6458418
BUSINESS NAME/LOCATiON
AD ELECTRICAL SERVICES INC
8860 SW 171 ST
PALMETTO BAY FL 33157
LBT
RECEIPT NO. EXPIRES
RENEWAL SEPTEMBER 30, 2014
6726948 Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED
AD ELECTRICAL SERVICES INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR
Worker(s) 1 EC13005157 $45.00 09/04/2013
CREDITCARD-13-007148
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 holders qualifications, to do business. Holder must comply with any governmental or
nongaremmental regulatory laws and requirements which apply to the business
The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec Ba- 76
For more information, visit ww miamidade oovltnrcollector
https://apps8.fldfs-com/crreportvlewer/reportV iewer.aspx?data--kdvpginc9D7Q3gH6TER... 10/21/20 13
a:
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tf
o
03 1
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000656
At
Local Busra
iness Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOT A BILL- DO NOT PAY
6458418
BUSINESS NAME/LOCATiON
AD ELECTRICAL SERVICES INC
8860 SW 171 ST
PALMETTO BAY FL 33157
LBT
RECEIPT NO. EXPIRES
RENEWAL SEPTEMBER 30, 2014
6726948 Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED
AD ELECTRICAL SERVICES INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR
Worker(s) 1 EC13005157 $45.00 09/04/2013
CREDITCARD-13-007148
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 holders qualifications, to do business. Holder must comply with any governmental or
nongaremmental regulatory laws and requirements which apply to the business
The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec Ba- 76
For more information, visit ww miamidade oovltnrcollector
https://apps8.fldfs-com/crreportvlewer/reportV iewer.aspx?data--kdvpginc9D7Q3gH6TER... 10/21/20 13
MAR -27-2014 11:01 From:GIL&ASSOCIATES 3052799705 To:1 600 685 7530 P.2/2
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CERTIFICATE OF LIASI_LITY INSURANCE �7/ 4°°"'"r"'
THIS,¢EFITIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDER, 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 CER'T'IFICATE HOLDER.
IMPORTANTI H the certificate bolder Is an ADDITIONAL INSURED, Tato P01"iss) must be endomod. If SUBROGATION IS WAIVED, suDJeet to
the terms and condition of the Polky, cs tain policies may require an endorsement. A statement on this cortilicate does not confer rights to the
cartlflcate hwof in !Eau of such endor3o"Atts).
PRODUCER David Gil
GII & Associates insurance *PKQNK (305) 278.7885- �� Y (305) 279.9745
5485 S.w 72 St Suite A•124INC0116gilinsurance.comMiami, FL 33173 ER -
Phone (305)279-7668 Fax (306)279••5708 -CUSTOMAR ID W:
- INtRER(s) JIPPORDING cOVERAOF
AD
INSURED - -- �'_4'3T11U:1'FR
m.k. The Travelers insurance Company_
AD EleariC81.5@NIC@S.1nC. R
9135 SW 182 SL
Psimetto Bay, FL 33157-
INSURER C: .
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COVERAGES CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY TI1AT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICAT111). NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT
OR OTHER DOCUMENT
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
WITH RESPECT TO WHICH THIS
1,19PON,13 SUBJECT TO ALL THE TERMS,
E)(CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY BEEN REDUCED BY PAID CLAIMS.
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CE`3CRiPT1pN OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 141, AddWmml Rama**, Schedule, If more specs Is required)
work-%rv)Ces
CERTIFICATE HOLDER
MIAMI SHORES VILLAGE BUILDING DEPT
10050 NE 2 AVE
+ MIAMI SHORES, FL 33138
1
ACORD 23 (2009109) OF
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORMD RVANSIINTATNE
®1988 2009 ACORD CORPORATION. All rights reserved.
The ACORD name and 1090 ars registered marcs of ACORD