EL-14-1186Ll ,
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-228559 Permit Number: EL -6-14-1186
Scheduled Inspection Date: February 27, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: CARVER, CHRISTOPHER AND Work Classification: Alteration
Job Address: 1165 NE 91 Terrace
Miami Shores, FL 33138- Phone Number
Parcel Number 1132050010180
Project: <NONE>
Contractor: CONNECTIVE ELECTRIC INC
Building Department Comments
PROVIDE NEW UNDER GROUND SERVICE
INSPECTOR COMMENTS False
Inspector Comments
Phone: (954)782-7879
Passed CREATED AS REINSPECTION FOR INSP-227728. CREATED AS
El REINSPECTION FOR INSP-227680. 02/05/2015
CANCELLED BY MICHAEL
19 feb 2015
Failed ❑ Add switch and light fixture for master bedroom exit boor.
Add receptacle at kitchen counter.
Label outside panel.
Correction
Add receptacle for A/C maintance.
❑Needed
Re -inspection 45'115
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
February 26, 2015 For Inspections please call: (305)762-4949 Page 17 of 28
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
FBC 20 r c)
JUN 0 6 2014
Permit No. L-1, / y — // RIS
Master Permit No.gi�i /y—Xs"�p
JOB ADDRESS: P q � Tr cc
City: Miami Shores County: Miami Dade ZiP331,�
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO X Flood Zone:
OWNER: Name (Fee Simple Titleholder):Chhs'-j C ( Phone#:
Address: l I I nti N I::-- _Ie r P
City: M� ickn-)a hn'tc-S State: FL Zip:,33e38
Tenant/Lessee Name: Phone#:(,3 C6) CPS
Email: 1� I M . (n ("J Or A e, F�A rl @ 0 ^rte kn �-),r i$ n�l� P� �'n r U Pt-cf � 'QVo,. -
CONTRACTOR: Company Name: C/D/1t1/� Cwt Gee i F L �n C Phone#:
Address: 610 1`► ,,, ., 2Y$
D /
City: I OM Oho �� State: r-4.- Zip: 3 3 06 9'
Qualifier Name: jM 4 e �, Phone#: ;L -.'U I
State Certification or Registration #: chi 314—j Certificate of Competency #:
Contact Phone#: 2.n5 -- 7-S6) Email Address: A& to C'0 7e&_c4'r ; -L C C' n'
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $__ja4gV Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration JaNew ❑Repair/Replace ❑Demolition
Description of Work: an
dl
I !ewI'�/'i r►< r iL R&^, t
Submittal Fee $ Permit Fee $ e a CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $ r s-
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 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 pbe jgpproved and a reinspection fee will be charged.
4�W(�Signature-- -''` Signature.
Owner or Agent Co ctor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2.0
day of ' -° ) , 201 , by C�t�(}` �i(y�� day of G 2013 , by /1''li�^K 61.�Aexc
who is personally known to me or who has produced who is personally known to me or who has produced
As
NOTARY PUBLIC:
Sign:
Print:
MONICA RU811ERA
MY COMMISSION # EE 022431
EXPIRES: December 28, 2014
Bonded Thru Notary Public Underwriters
a
My Commission Expires: j
identification and who did take an oath.
NOTARY PUBLIC:
T
Sign: Alf*& -OR J. $ARIL
Sign:
Print: It
t F.7(PIRES February
t63
My CommissionExpires:
nn 2m �y
APPROVED BY ZJuA� Plans Examiner Zoning
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Clerk
Jun 89 2814 11:36:57 EDT FROM: FZM/76611941706 MSG# 5656897$-886-1 PAGE 884 OF 864
CERTIFICATE OF LIABILITY INSURANCE
"_
5/8`/2014 MIDD/yyyy'
THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED, subject to the
terms 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 or such endorsement(s).
IWODUCER
INTUIT INSURANCE SERVICES INC
CONTACT
NAME:
PHOac Nc,Ext): FAX
(AIC, (g$ 3) 443-6112
250822 P: F: (888) 443-6112
PO BOX 33015
AADORESS:
INSURER(B) AFFORDING COVERAGE NAIOd
SAN ANTONIO TX 78265
INSURERA: Twirl City Fire Iris Co 29459
INSURED
INSURER 6:
INSURER 0:
CONNECTIVE ELECTRIC INC.
INSURER D:
3907 N FEDERAL HWY STE 245
INSURER E:
POMPANO BEACH FL 33064
INSURERF:
.+vve:rwaaa� CERTIFICATE NUMBER:
REVISION NUMBER.-
THIS
UMBER'
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.
I.VSR
LTRPOLIC'Y.W.VRER
TYPE OF I.MTVRA.NCE
ADDL
SLIER
DELIVERED IN ACCORDANCE WITH THEPOLICY PROVISIONS,
POL1C'YEPP
MM/DD/YI'
POLICYEXP
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SHORES, FL 3:3138
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
CLAIMS -MADE ❑OCCUR
DAMAGE TO RPNTPb
PREMISES (Es occurrence)
MED EXP (Arty one person) s
PERSONAL & ADV INJURY
GEN'LAGGREGATE LIMIT APPLIES PER:
POLICY PRO- ❑ LOC
JECT
GENERAL AGGREGATE u
PRODUCTS •COMP/OPAGG
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Es sceldent) u
ANY AUTO
ALL OWNED SCHEDULED
_
BOD ILY INJU RY (Per person)
BODILY INJURY (Per accident) a
AUTOS AUTOS
HIRED AUTOS NON -OWNED
AUTOS
PROPERTY DAMAGE
(Per scclderM) u
U
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE e
EXCESS LIAR
CLAIMS -MADE
AGGREGATE
OEO I RETENTION 1
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WOR"'UNSLYAWMA.Y/7YON
.L,NDL'MPLOFURS'LLiulLI7'Y
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
OFFICER/MEMBER EXCLUDED? F7
(Nandafary In NH)
WA
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02/14/2014
02/14/2015
x PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE -EA EMPLOYEE 'lOO, 000
yes, describe under
D
DESCRIPTION OF OPERATIONS below
E.L. DISEASE• POLICY LIMIT 1'500, 000
DESCRIPTIGNOFOPERATIONS /LOCATIONS/VEHICLES ("ORD 107, Atldltlolll l Remerks Schedule, msy be seeeehed If more spite Is required)
Contractor ID: EC13003789 Those usual to the Insured's Operations.
CCATICII-ATC LIMI nose
(9) ivab-2014 AGvRU CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
Miami Shores Village
DELIVERED IN ACCORDANCE WITH THEPOLICY PROVISIONS,
AUTHORIiEDREFREBENTATIVE
10050 NE 2N❑ AVE
MIAMI
SHORES, FL 3:3138
(9) ivab-2014 AGvRU CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD