EL-14-2497Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-229807 Permit Number: EL -11-14-2497
Scheduled Inspection Date: March 11, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: NAVARRO, MIGUEL Work Classification: Alteration
Job Address: 50 NE 96 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: ON CALL ELECTRICAL CONTRACTORS INC
Building Department Comments
relocate pl lines overhead to underground.
Phone Number
Parcel Number
INSPECTOR COMMENTS False
1132060130630
Phone: (786)388-5880
Inspector Comments
Passed izf
Failed 1'
Correction ❑
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 10, 2015 For Inspections please call: (305)762-4949 Page 26 of 29
Miami Shores Village
Building DepartmentIOU , 3 14
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 liBY11-
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20
BUILDING Permit No. i4- 2 L
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: S0 V46 Cup sm
City: Miami Shores County: Miami Dade Zip: 3
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): M qmA Nw1rim Phone#:
Address: SO Mt, OILIUT
City: w0we'� Sfi10t�S State: -ail Zip: 55125%
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
�1 flag�J►'Y2;�
Phone#: -10. SAS.
Address: 4400 low 4-k-�
S -T
City: M,WQtfYl1
State:
Zip: 3 12( 'F
Qualifier Name: %.1Lv1A
Phone#:
State Certification or Registration #:
Certificate of Competency #:
Contact Phone#: 416U. lgq:4.$S
'i-%. Email Address:
(2, DnC A\aA& A*!Q-'. Ak-A
DESIGNER: Architect/Engineer:
Phone#:
Value of Work for this Permit: $
A -AM. O— Square/Linear Footage of Work:
Type of Work: ❑Addition
❑Alteration ONew ❑Repair/Replace ODemolition
Description of Work: laq kaerod
L. -APL VA"—
Color thru tile:
Submittal Fee $
Permit Fee $ /`�`®�
CCF $ CO/CC $
Scanning Fee $
Radon Fee $
DBPR $ Bond $
Notary $
Training/Education Fee $
Technology Fee $
Double Fee $
Structural Review $
_
TOTAL FEE NOW DUE $ 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 conditionn 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.
Signature
c Owner or Agent
The foregoing instrument was acknowledged before me this 1.3
day of NOV 20i±�, by MigUA L&VaYD
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: , JAMUEJNECOBA
�'°` a= EXPIRES: March 222, 2016
My Commission L BcnedTMuNo" PuftLkdemkois
4br
Signature
Contractor
The foregoing instrument was acknowledged before
�m�e*this %/
day of 13 , 20 14, by ld-W41�Ct.Y
. W1 S,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: y�,�� C /�
Print: P • •°:•.
OBA
M I.OI+wM WON O FF ORW
My Commis:ices: I XPiRES: iwarch, 2018
,ate rnn� p an Pah tnai�arti�ra
APPROVED BY OU— Plans Examiner Zoning
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Clerk
FROM
PRODUCER JVS Insurance Agency
9600 SW 8th St, Suite 27
Miami, FL 33174
Phone (305)552-5250 Fax (31NO 652.5292
INSURED ON CALL ELECTRICAL CONTRACTORS, INC
7640 NW 25th Street #I o5
Miami FL 33122-
(TUE)FEB 11 2014 21:32/ST.21:31/No.7537538057 P 1
�rr�o>I �r r r I IV J u IWIV V C I 02/07/14
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED 8Y THE P0—UQr;3 DELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURERA: NOVA CASUALTY INSURANCE
EXCESS/UMBRELLA LIABILITY
❑ Ll OCCUR L I CLAIMS MADE
U DEDUCTIBLE❑ RETFNTION 3
WORKERS C695-ENSATK)N AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER / MEMBER EXCLUDED?
N Yes, Oerscribe under
SPFCIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATION$ / LOCATIONS /
ELECTRICAL CONTRACTOR
CERTIFICATE HOLDER
City Of Miami Shores Village
10050 NW 2 Ave
Miami Shores, FL 33138
ACORD 25 (2IF01/08) QF
I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL
CANCELLATION
SHOULD ANY OF THE A130Y
EXPIRATION DATE TH OI
DAYS WRI N N
THE LIFT, BUT FAILUR TO
OF ANY KIND UPON TH W$
AUTHORIZED pPRESE T.
OTHER THAN -0 ACC
AUTO ONLY: AGG
EACH OCCURRENCE
AGGREGATE -
I❑ WC STATU IJ TI -
TORY LIMITS R
F.L. EACH ACCIDENT
E.L. DISEASE - EA CMPLOYE
E.L. DISEASE - POLICY LIMIT
,RISED POLICIES BE qANceLLw BEFORE THE
ISS G INSURE Wi ENDEAVOR TO MAIL
TO CERTIFI TE OLDER NAMED TO
S IMPOSIE SLIGATION OR LIABILITY
CN:
IN RER D:
-- �- -• _ __,
INSURER E:
COVERAGES
�--
THE POLICIES OF INSURANCE LISTED HAVE BCEN ISSUED TO THE
INSURER R
INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT
OR OTHER DOCUMCNT WITH RESPECT
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN
TO WHICH THIS CERTIFICATE MAY BE ISSUW OR
POLICIES,
IS SUBJECT
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED
TO ALL THE TERMS, CXCLUSIONS AND CONDITIONS OF SUCH
NSR
,L
BY PAID CLAIMS.
LrR
IN„�Q�
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
oaTE lMMID
POLICY EXPIRATION
DATE MIAIDDIYr
LIMITS
GENERAL LIABILITY
_..
COMMERCIAL GENERAL LIABILITYDAMAGE
EACH OCCURRENCE 1,000,000
—
rl IJ CLAIMS MADE [V OCCUR
0185FL00055700-0
01/10/14
01/10/15
TO
PREMISES{F�peCuran�L 100,000
A
U
L7PERSONAL
MED EXP (Any one person) 8,000
H
&ADV INJURY 1,000,000
—
GENERAL AGGREGATE 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
I -J POLICY [_l PROJECT ❑ L_OC
PRODUCTS - COMP/OP AGG 2,000,000
AUTOMOBILE LIABILITY
-
I- I ANY AUTO
COMBINED SINGLE LIMIT
I ] ALL OWNED AUTOS
Ea aoc:dent)
F1
❑ SCHEDULED AUTOS
BODILY INJURY
L HIRED AUTOS
(Per penwn)
❑ NON OWNED AUTOS
BODILY INJURY
❑
(Per accident)
❑
PROPERTY DAMAGE
GARAGE LIABILITY
(Per aooldeM)
❑
❑ ANY AUTO
AU•1'0 ONLY - EA ACCIDENT
-
EXCESS/UMBRELLA LIABILITY
❑ Ll OCCUR L I CLAIMS MADE
U DEDUCTIBLE❑ RETFNTION 3
WORKERS C695-ENSATK)N AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER / MEMBER EXCLUDED?
N Yes, Oerscribe under
SPFCIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATION$ / LOCATIONS /
ELECTRICAL CONTRACTOR
CERTIFICATE HOLDER
City Of Miami Shores Village
10050 NW 2 Ave
Miami Shores, FL 33138
ACORD 25 (2IF01/08) QF
I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL
CANCELLATION
SHOULD ANY OF THE A130Y
EXPIRATION DATE TH OI
DAYS WRI N N
THE LIFT, BUT FAILUR TO
OF ANY KIND UPON TH W$
AUTHORIZED pPRESE T.
OTHER THAN -0 ACC
AUTO ONLY: AGG
EACH OCCURRENCE
AGGREGATE -
I❑ WC STATU IJ TI -
TORY LIMITS R
F.L. EACH ACCIDENT
E.L. DISEASE - EA CMPLOYE
E.L. DISEASE - POLICY LIMIT
,RISED POLICIES BE qANceLLw BEFORE THE
ISS G INSURE Wi ENDEAVOR TO MAIL
TO CERTIFI TE OLDER NAMED TO
S IMPOSIE SLIGATION OR LIABILITY
CN:
Miami Shores V11age
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
1. 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;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
3. 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 iniuries of anyper`on allowed to work under this permit Please check with your
insurance carver since most property insurance policies DO NOT rover this type of liability.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT `r'OL! HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Owner
Print Name: 1,,Attu1 k C3u ayU
Signature:
`� E�'e.�l �i.-�.4�-�•
State of Florida )
I County of Miami -Dade)
Sworn to and subscribed before me this L
day of DV. , 20 1.
M
By M% Qv1 JL1 V,�O. VGJ VC
0
(SEAL) O
Type of Identification produced 1 �, 01
Contractor
Print Name:yt,A
Signature: -
State of Florida )
County of Miami -Dade)
Sworn to and subscribed before me this _ A
day of ill. 20 14 .
of Identification
M
OWNER: MIGUEL A NAVARRO
JOB ADDRESS: 50 NE 96 ST. MIAMI SHORE . FL
ELECTRIC LOAD CALCULATION
PANEL 200
A
ITEM
DEMAND
GRL LIGHTING 2 372 (x3 WATT/SQ./FT.)
7 116 W
SMALL APPLIANCE
3 000 W
LAUNDRY
1500 W
DRYER
6000 W
RANGE
8500 W
WATER HEATER
7200 W
MICROWAVE
1200 W
TOTAL OF HOUSE LOAD IN WATTS
34 516 W
FIRST 10 KW. AT 100%
10 000 W
REMAINDER AT 40%
9 806 W
A/C # , 0 100%
8 500 W
TOTAL DEMANDED WATTAGE
28 306 W
TOTA 0 = AMP.
117.9 A
rnnno � tt,A rf-
J�� �J Via°
GT
KEVIN GIWS
QUALIFIER
NEW 200 AMP. METER /COMBO
0 1
200 A.
MAIN DISC.
NEW UNDER GROUND
JACQtsm CORA
MY OOMMMIONN # DD 972873
EXPIRES: Mann 92 8014
&MW fft NatS y pubifr9 UQ;tW-
NEW
3 # 2/0 THW CU.
IN 2" COND.
EXIST. 200 A PANEL
1'GROUND RODS
W/ (1) # 6" CONDUIT
6'
BOND TO COLD
WATER UNE
GROUND TO STL
REINFORCEMENT®
FOUNDATION
R I S}E,R D L R A M
LE
0.5' CONC._/
CURB
(Typ.) _T_ A_ 10.9* GRASS MEDIAN
''N.
•
E. 96TH STREET--.,
'RIGHT—OF—WAY`)'.-,`
(862'
C URB
S ASPHALT PAVE�ENY:' •
20 cil*
& GUTTER
(EAST BOUND)
LIGHT
75.00'
POLE cb.
6ONC WAIk
:4
181.20'
25.0'
&o.
50.0'O,dFOUND
1\11,
1/2-
4.4' CONC.
-IRON PIPE
FOUND 1/2",
IRON PIPE
I
L WEST 1/2
LOT 6
BLOCK 5
(NOT INCLUDED)
0.
4' C.B.S.
WALL
O.O:N
0.2'E
FOUND I
IRON F
o/s 0.25
0.22
EAST 1/2 LOT 5
LOT 6 BLOCK 5
BLOCK 5
PLANTER 26.78'
(TYP-)
FrL..
26.3¢'
IK
1 STORY C.B.S.
RESIDENCE #50
0
Lo
3.3'
WATER
PUMP
IA
1±73'
Cooic
cb
0.01
o/s 0.06 kNj
0.04'(W)
FOUND 1/2"
IRON PIPE
AND CAP
NO ID
AT P.C.
L0
N
jex t.,
4,ko r I c, i 4 ,v
LOT 4
BLOCK 5
I Val- .. ....
OVERHEAD
UTIUTY
WIRES I V CHAIN
(TYP-) —LINK FENCE
(TYPICAL)
&Nv
V_
0.2'E
402'.E
FENCE
'00
in 1 0.2'N
to
c� 0.2'W
T
P, P.
CHOR_
ND 1/2
'IRON PIPE
75.00..
19..�HA�T PAVEMENT..'.. '(S)
ALLEY RIGHT—OF—WAY'.. 0/s 0.12
3 ;4 AI
JEFF ATWATER
CHIEF FINANCIAL OFFICER
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WO "LKS` 'vv11111- ®ii:in I WWII 4.e+vr
CONSTRUCTION INDUSTRY EXEMP 1 I'�a�
_ . �......�._.....:...:......_.....�.....:...., . ^I: r.. I:a. PIected to he exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 1/22/2014
FEIN- 200345752
R!!R! ICQC MAMF AkM AL%L%RFRR-
ONCALL ELECTRICAL CONTRACTORS INC
7400 NW 7TH ST. UNIT 111
MIAMI
EXPIRATION DATE: 1/22/2016
FL 33126
SCOT€S OIF BUSINESS OR TRADE:
UGENSED ELECTRICAL
CONTRACTOR
P.rs..__. Chap._- un nein - r , _....a:_s........-....-s:.......e,....o..a......�...., a:..,.. sem.,.., <s.:__ ._t -.:__.i,., r.._ rr_:._ ,. - r. r.._..:,.::.t r_s: =.r.._..:.. _ _,_ _ ... •_ _ _ _"_ _-
utaumn iv Chapter �wv.v.ry an �w�.c� of a wINvwuvn w..v VMS * aAou.V— nim ur.a --y'w vy ...,,.y..: 3G: ifiw. ca .
within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be
exempt arud- certifffcates of election to t-- exempt shall be sub ect to revo4f atjon if, at ariv time after the r1"of the ittirA or the i_!z, mr-m! of it-.. ocrlifirtc'.
the CW_rsm named on tilt? itUtit_:.? Or r?rW4. dtc no Imtuet Ineelti the 10f1U e111+'•tit,7 of thi,u 0ujji+ll fot is. uance of a cuttii±cate. the department shall revoke a
pt ; 1_nttvt:_ _ c;1 E:TIF:Gat t� c)s- t-t.'C i ION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413-1609
Miami Shores Village
r Building Department RECEIVED
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 F99 9 7 9014
I Tel: (305) 795.2204 Fax: (305) 756.8972
I I INSPECTION'S PHONE NUMBER: (305) 762.4949 '
FBC 20 LO
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.Eu r`t"o��l�
Permit Type: Electrical
JOB ADDRESS: _ so rjr-: Is Te -
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel*
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder):' ''cNjCj�+� C� C� r e1 Phone#:
Address: 7, -3 TI�L
City: �4 rLCJ M ( State: 1 (. Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 6) /y -CAI ,646 ' c Phone#:
Address: `7 e-10 > p.°w s ' X000
City: V4 0A 6` State: 14 Zip: 73 0 $�
Qualifier Name: Amp) e IS Phone#:
State Certification or Registration #: 9 4� Q ®O 5rF 7 Certificate of Competency #: r
Contact Phone#: '7r o' l %' %6 7�' Email Address:�t' 6 •� DI✓ `( ��b4W c •1++
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ %db --QC> Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: "La C.*41tvQ f M L1vw'r;S C u C- tAQ .6 • 4 w0 COL &.-&y"-
�x�x�xmx��x�x��x�u�x���u�xx���x��x��x�x�m�����x�xx��u�x�xmmm�Fees�x����x���x��x��n�x���xx��x������u��x�x��x����x�x���x�x���n���
Submittal Fee $"�� Permit Fee $ ora CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
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
Zip
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 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 whigh 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.
L/ Owner or Agent
The foregoing ins meat was acknowledged before me this
day of , 20 Lf, by M i g opt. )MAIM ,
who is personally known to me or who has produced
As i • i n and ho did take an oath.
NOT aAecwELtntrcc..iff
MY commiss ON ' 3
1
EXP4RES: , # 7
�8ren 22 9�11t1Y4
Sign:
101 WUtary punik t Irntin mi?er:.
Print:�!�
My Commission Expires:
Signature -
Contractor
The foregoing instrument was acknowledged
acknowledged before me this
day of 1%tT , 201 -, by VEye—c�
who is personally known to me or who has produced
and who did take an oath.
NOT.
_ xxMyoaor
um
Sign: '
• 1ON4DD9726
u. TAs�uA�,r..:a1. •2014
My Commission Expires:
APPROVED BY `� 7e &P Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)