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EL-14-2320Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-222015 Scheduled Inspection Date: March 23, 2015 Inspector: Devaney, Michael Owner: DALEY, EUGENE Job Address: 467 NE 100 Street Miami Shores, FL 33138-2446 Project: <NONE> Contractor: ON CALL ELECTRICAL CONTRACTORS INC Building Department Comments ELECTRICAL WORK FOR POOL Permit Number: EL -10-14-2320 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number Parcel Number 1132060170530 INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Phone: (786)388-5880 March 20, 20115 For Inspections please call: (305)762-4949 Page 5 of 31 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax (305) 756-8972 INSPECTION UNE PHONE NUMBER: (30S) 762-4949 ❑BUILDING f� ELECTRIC ❑ ROOFING FIR- -II JAN 2 a nJ15 I FBC 20 t Q� Master Permit Noll P- 1 Q - I q--23 i ct Sub Permit No. eL- -t o w 14 -2-3 ?-0 REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: Lf 0 5-7 ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade zip:"�� 13 $ Folio/Parcei#: l 3 2 r ® l0 % 0 S 5 ® Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder)._ (--', lJ I 'e r-, 'e- D A (P Phone#: Address:.._ 4(0-T i0 a (0 0 ST City: " S h o j2 -`e S State: 'F -L_ Zip: -5 v 1 3 $ Tenant/Lessee Name: Phone#• Email• I CONTRACTOR: Company Name: _v l n 1 II C / p G'/� l ( , I C- r Z 1. C, Phone# 10 �� O O lJ Address: �/I`-1'®(,1 !� ((� % S T � I l 1 �� City: 1AA 1 State: Q Qualifier Name: 0le'/ I () G I I ( e. 5 Phone#• 7Yi 2218 0 5 8 9 0 State Certification or Registration #: Certificate of Competency #: E C ®000 9 (4 -7 DESIGNER: Architect/Engineer: Phone#: Address- City: State: Zip: Value of Work for this Permit- $ Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: C)F Specify color of color thm We: Submittal Fee $ Permit Fee $ CCF $ CO/cc $ Scanning Fee $ 'Z Radon Fee $ DBPR $ Notary $_ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ , v TOTAL FEE NOW DUE $� C7 " W (Rev1sed02/24/2014) ling Company's Name (if applicable) Bonding Company's Address city State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address CitY State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 reinspection fee will be charged. I IS OWNER or AGENT The foregoing instrumen was acknowledged before me this day of Cit.- 20 ( S by �^ . who is personally known to me or who has produced L= u g 2, <- 04 �� as identification and who did take an oath. NOTARY PUBLIC: Signature CONTRACTOR The foregoing instrument was acknowledged before me this I day of 20 t,:S by who is personally known to me or who has produced ,J ca i%!� as Identification and who did take an oath. NOTARY PUBLIC: Sign: Print: ", "•,, W ADYS BORGES Seal: EXPIRES: December 17, 2018 '•• Bonded Thiu Nfty Pulte Underta ma ssssssss*ass*s**assess*ass*ssssssssssssssssssss*ss*ssrsssssssssss*sasses:sssssssss*ssssssssss*sssssss**sssss APPROVED BY Plans Examiner Zoning Structural Review (ReyWed02/24/2014) Clerk A+C[3RL7DATE (Mi DWM - CERTIFICATE OF LIABILITY INSURANCE _1/2s/15 PRODUCER JVS Insurance Agency THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA'nON 9600 SW 8th $t, Supe 27 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami, FL 33174 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL E COVERAGE AFFORDED BY THE S BELOW, Phone {305} 552-5250 Fox (305} 55Z-5292 INSURERS AFFORDING COVERA09 I NAIC S INSURED ON CALL ELECTRICAL CONTRACTORS, INC 7640 NW 25th Street 0105 Miami, FL 33122 - COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED HAVE BEEN �= 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. AGGREGATE LIMITS SHOWN MAY HAVE REPN FMnl ulGn MV owm n, . Sue ine A El TYPE OF INSURANCE GENE- LL490 Y �] COMMERCIAL GENERAL LIABILITY CLAIMS MADE R OCCUR r-1 r-1 ❑ ,— POLICY NUMBER 0185FL00055700-0 DATE 01/10/15 111L1YIOx DFM 01/10/16 LIMITS EACH OCCURRENCE 1 �S� MED EXP (Anyone pwm) PERSONAL A ADV INJURY � GENERALACOMOATE 2 _ GEN'L AGGREGATE LIMIT APPLIES PER. ❑ POLICY ❑ PROJECT ❑LOG PRODUCTS - COMPIOP AGG 2 ❑ AUTOMOBILE LIABILITY ❑ ANY AUTO} ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS COMBINED SIWGI.E LIMIT (ENI BODILY INJURY (Per ) BODILY INJURY (Per aoddent) ❑ NON OWNED AUTOS ❑ PROPERTY DAMAGE ❑ GARAGE LIABILITY FJ ANY aUTO ❑ EXCESSAIMBRELLA LIABILITY C] OCCUR ❑ CLAIM MADE AUTO ONLY- EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE ❑ AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION 5 ANY PROPRIETOR I PARTNER I EXECUTIVE OFFICER I MEMBER EXCLUDED? If yes, describe under SPECS PROVISIONS below OTHER — ur-OU "'THM OF OPERATIONS 1 L=1 ELECTRICAL CONTRACTOR CERTIFICATE HOLDER City of Miami Shores Villqge 10050 NW 2 Ave Miami Shores, FL 33138 EI-, EACH AC=WT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - Policy LIMIT BY ENDORSEMENT I CANCELLATION 100,000 SHOULD ANY OF THE ABOVE DESCRIBED POLIMS BE CANCELLED BEFORE THE EWIRATION DATE THEREOF, THE I IN R WILL ENDEAVOR TO MAD. DAYS WRITTEN N TH ICATE HOLDER NAMED TO THE LEFT, BUT FAIWRE I SO E NO OBLIGATION OR LIAMdTY OF ANY KIND UPON THE i uRER, OR RLwhESENTATWES. 1"s J 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 JA ELECTRIC ❑ ROOFING FBC 2010 Master Permit Noll�?�) -- Sub Permit No. l L4 e ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP l , t CONTRACTOR DRAWINGS JOB ADDRESS: r f 1 (O -T � ! O ST - City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Feenv Simple Titleholder): � U Address: W- (07 6 ?, i nn -e. n .e-- Z)( / -e_ C City: M / 1 V 1 0-2kState: EC- Zip: 5313% Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: C Phone#: ! KG ,91O '� g E0 Address: _ / 4oo iA W i,S 1 -W i l l City: Irl l iM 1 State: Qualifier Name: IKQ_ y I r) Phone#: State Certification or Registration #: Certificate of Competency #: C C c) ® ® y 9 —7 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ oo -, Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: "--%_ Specify color of color thru tile: Submittal Fee Permit Fee $ CCF $ CO/CC $ Scanning Fee $eb S • Radon Fee $ � - S y DBPR $ � - S Notary $ Technology Fee $ Training/Education Fee $ 0Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 41 . 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. 1 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 reinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this O'Z 0 day of C.�T- 20 by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Print: Signature k CONTRACTOR The foregoing instrument was acknowledged before me this 60 day of 0 (i�C , 20 1 S • by i, t1 G L � ILS who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: VPW O° MY COMMISSION # EE 048167Seal:°6 EX4'IREB: ember 17,2014 Seal' Bonded Thru Notary Public Underu dters.. Z G /G� APPROVED BYA;�2 'PA �/ �"-e�` Plans Examiner Structural Review (Revised02/24/2014) MY COMMISSION # EE 04cl67 EXPIRES: December 1?. ?C14 Bonded Thru Notary Fublu Urfdcr rlrrgrs as Zoning Clerk r:lArla MIAMI-DADE COUNTY - STATE OF FLORIDA N/A October 21, 2014 MEOW LOCAL BUSINESS TAX RENEWAL 5308853 2014 - 2015 APPLICATION RECEIPT: 2051613 STATE # ECO000947 DBA/BUSINESS NAME: BUS. COMMENCEMENT DATE: 10/01/1988 ON CALL ELECTRICAL CONTRACTORS INC SEC TYPE OF BUSINESS BUSINESS LOCATION: ELEC ELECTRICAL CONTRACTOR 7593 NW 8 ST 7 2 MIAMI, FL 33126 OWNER/CORP, ON CALL ELECTRICAL CONTR INC PHONE # 786-388-5880 20947 SW 122 PL MIAMI, FL 33177 NAICS CODE: 23821 If no longer in business, please notify us in writing. Review and correct the information shown on this application. A 25% penalty will be assessed to anyone found operating without a paid local business tax, in addition to any other penalty provided by law or ordinance (Sec 8A-176(2)). A Certificate of Use and/or City Business Tax Receipt may also be required. APPLICATION DETAILS FEE AMOUNT Receipt Fee 30.00 UMSA Fee 30.00 Beacon Council Fee 15.00 Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi -Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 Transfer Fee 0.00 Doing Business without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0.00 Prior Years Due 0.00 Amount Recently Paid TOTAL AMOUNT DUE: 0.00 To pay online go to www.miamidade.nov/taxcollector To pay by mail, make check payable to: Miami -Dade County Tax Collector Business Tax 200 NW 2nd Avenue Miami FL 33128 To pay in person go to: 200 NW 2nd Avenue (305) 270.4949, fax (305) 372-6368 A service fee of not less than $25.00 up to a minimum of 5% will be charged for all returned checks. I' RETAIN FOR YOUR RECORDS t ................................................................................................................................................................................................................................................................................................................. MIAMI-DADE COUNTY - 1 DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT 1 N/A October 21, 2014 STATE OF FLORIDA LOCAL BUSINESS TAX RENEWAL RECEIPT 2014 -2015 APPLICATION I III E#EC0000 STATE # EC 5308853 I I I (I 00947 II II� IIIIII�IIIIII BUSINESS LOCATION: 7593 NW 8 ST 7 MIAMI, FL 33126 BUS. COMMENCEMENT DATE: 10/01/1988 OWNER/CORP. ON CALL ELECTRICAL CONTR INC ON CALL ELECTRICAL CONTR INC KEVIN F GILLIS PRES 20947 SW 122 PL MIAMI, FL 33177 SEC TYPE OF BUSINESS ELEC ELECTRICAL CONTRACTOR APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPATION DESCRIBED HEREON. I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT. I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT. SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE Please pay only one amount The amounts due after Sept 30th include penalties per FS 205.053. If Received By Oct 31, 2014 Nov 30, 2014 Dec 31, 2014 Jan 31, 2015 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000002051613201500000007500000000000005 Miami shores Village 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 personally liable for the worker compensation iniuries of any person allowed to work under this permit. Please check with your insurance carver since mogt property insurance policies DO NOT cover this type of liability, BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Print Name: Si State of Florida ) County of Miami -Dade) Q Sworn to and subscribed before e s %� day of—�� p , ?0• By 'TXPIR •August 11, 201$ Bonder Notary Put�C undervirAers Contractor Print Name: ! Signature: ' `' ` _ State of Florida ) County of Miami -Dade ) Sworn to and subscriRked before this day of , A 4 . 11, 2018 i Undembrs