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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)