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EL-15-381l S_ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231786 Permit Number: EL -2-15-381 Scheduled Inspection Date: April 07, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Owner: LLC, CID 1050 Job Address: 1050 NE 91 Terrace Miami Shores, FL Project: <NONE> Contractor: RING ELECTRIC INC comments KITCHEN AND BATHROOMS. REPLACE OUTLETS SWITCHES IN WHOLE HOUSE. LIGHT PENDANT IN KITCHEN, PENDANT IN LIVING ROOM, REPLACE .OUTLETS, LIGHTS SWITCH IN BATHROOMS. Inspection Type: Final Work Classification: Alteration Phone Number (305)586-6050 Parcel Number 1132050010340 INSPECTOR COMMENTS False Inspector Comments Passed EJ f, Failed 41�� Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Phone: (754)610-4534 April 06, 2015 For Inspections please call: (305)762-4949 Page 61 of 63 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING )6 ELECTRIC ❑ ROOFING FEB 2 &2015 FBC 20id Master Permit No.� ' �� I� Sub Permit No. EL7 j _5- 3 ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP rCONTRACTOR DRAWINGS JOB ADDRESS: M Folio/Parcel#: I 1 _3 e.0 15 —0y V 1 _ Q 3 Q Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction �Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C:, o le G-0 z__ ( C Phone#: Address: 1101s� ,— sT YI f yyc� City: ' k_ I�'., J State: CZip: _ Tenant/Lessee Name: Phone#: Email: � C C.),� 1111 L�iAd► CONTRACTOR: Company Name: 1• Phone#: Address: City: State: Zip: Qualifier Name: Phone#:1� �P�"'2 State Certification or Re ation . Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: _ Address: City: State: Value of Work for this Permit: $ I Square/Linear Footage of Work: Type of Work: ❑ Addition �� Alteration ❑ New ❑ Repair/Replace Description of Work: Specify color'df eo%*'thr i e: Submittal Fee $ Permit Fee $ 2 k3;toP Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ _ Structural Reviews $ (Revised02/24/2014) Zip: ❑ Demolition Double Fee $ Bond $ TOTAL FEE NOW DUE $ �f Bonding Company's Name (if applicable) Bonding Company's Address. City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip State . Zip e r 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 reinspect;, 2a `will be charged. R or AGENT The foregoing instrument was acknokyledged before me this _ day of VAL20 by 'Y� �•a �' to who is rsonally known me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Signature _ Q, CONTRACTOR The foregoing instrument was acknowledged before me this _ day of A 20 by AIS'LIM , who i ersonally kno to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Sign: _�'�--1 Print: �-� Print: , �•iQt a BONETrI Seal: Seal: . NoMry PubIiC ••Stele of Florid„ MARCIA BEWR*n�g My C01W E#hes All 2 5 )1. Notary Public - Strie Of Rol" .1=j •r CCMr 13810n a 14 Plans Examiner Structural Review (Revised02/24/2014) Zoning Clerk Local Business Miami—Dade County, THIS IS NOTA BILL 4972]30 Tax Receipt State of Florida — 00 NOT PAY BUSINESS N"911.00ATION RECEIPT NO. EXPIRES RINq RECTRIC INC FmEWAL SEPTEMBER 30, 2015 16214 SW 63 ST 5191630 Must be displayed at place of business MAN RL 33193 Pursuant to County Code Chapter BA — Art. 9 & 10 OWNER RINGELECTRIC INC SEC. TYPE OF BUSINESS PAYMENT RECEIVED 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR Worker(s) I EC13001412 $75.00 09/11/2014 CREDITCARD-14-036599 This Local Business Tax Receipt only confiros paymem of the Local Basloaw Tax. The Receipt is not a licenes. permit, ora certification of the holder'squalificatiaaa, to do bush. Hohlermast comply with any govammeaml ar aongovemm=W regulatory laws audmgmmmems whwb apply todw basins The RECEIPT N0. above most he displayed on all commercial vehicles —1-0ade Cade Sec 8a-276. For more information, visitwww miamidadp4try taxoolleetar RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION . ELECTRICAL CONTRACTORS LICENSING BOARD OEM EC13001412 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 ANILLO, JORGEA RING ELECTRIC INC 16214 SW 63RD STREET MIAMI FL 33193 ISSUED: 06/10/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1406100001547 U CLASS E 64 4,211 9 S -C1 - :<4 sw9�p;: st k4AP t -"SA i"3-. W1'2 t35sn,n�r. 'Sri1.-i!r'E A 7 ` RINGE-1 OP ID: KH ,4`c�oRv CERTIFICATE OF LIABILITY INSURANCEOM/2015 -RLTA TYPE OF INSURANCE -- THIS CERTIFICATE IS ISSUED AS A (NATTER 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: H the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS 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 of such endorsement(s). PRODUCER ISure Insurance Brokers 8700 W. Flagler St., Suite 270 Miami, FL 33174L Javier A. Femindez NNMONE, m Javier A. Femindez Af°NE :305-223'2533 c NJ: 305.220-0785 nooaEss_Certiflcates@ISureBrokers.com __ - EACH OCCURRENCE $ 1,000,0001 tNSURER(S) AFFORDING COVERAGE MAIC 0 INSURER A: Western World Insurance Co. 13198 PERSONAL & ADV INJURY $ 1+000+ INSURER a: Florida Citrus, Business (FUS) _ INSURED Ring Electric, Inc. — ---- — — Jorge Anillo 16214 SW 63 Street Miami, FL 33193 — - INSURER c: Progressive Ins. Co. INSURER D: Scottsdale Ins. 41297 INSURER E. LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS NON -OWNED HIRED AUTOS AUTOS INSURER F: COVERAGES CERTIFICATE NUMRER-_ 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 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. -RLTA TYPE OF INSURANCE -- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE POLICY NUMBER-- -- app EFF POLICY EXP LIIITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR 10050 NE 2 Ave NPP8183491 i i 08/19/2014 08/19/2015 i EACH OCCURRENCE $ 1,000,0001 PREMISES Ea ocamenco $ 1�+ MED EXP (Airy are person) $ 5+ PERSONAL & ADV INJURY $ 1+000+ - - - - - - - - - - I G_ EN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJEC- --- LOC GENERAL AGGREGATE $ 2+w0+ PRODUCTS - COMPIOP AGG $ UNA $ C LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS NON -OWNED HIRED AUTOS AUTOS j0821598&3 09/23/2014 ! 09/23/2015 COMAUTOMOBILE EEa accident) nt) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ PER ACCIDE $ D X UMBRELLA UAB EXCESS LIAS X 1 OCCUR CLAIMS -MADE 1X850042853 08/19/2014 ! 08/19/2015 EACH OCCURRENCE $ 11000+ AGGREGATE $ 1+000+ DED RETENTION $ -- - _--- $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY B ANY PROPRIETOWPARTNER(EXECUTWE Y 1 N OFFICERIMEMBER EXCLUDED? F_] (11arWatory in NH) If yes. deserEbe under DESCRIPTION OF OPERATIONS below IN / A 110640008 li 04/01/2014 ". 04/01/2015 WC STATU- TH- X T Y MMR E.L. EACH ACCIDENT $ 1,000, E.L. DISEASE - EA EMPLOYE $ 11000+ E.L. DISEASE - POLICY LIMB 1 $ 1+000+ i DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101, Addltlonal Rernorks Schedule. I more Spam Is regldred) ELECTRICAL WORK— WITHIN BUILDINGS rcomprATc unl nco reNlrFt I ATION CITYMII SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE Will. BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Miami Shores 10050 NE 2 Ave AUTHORIZED REPRESENTATIVE Miami, FL 33138 (P19W2U1U AGUWU GUhVUr1A11 Nv. All ngnIS teserveu. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD