EL-14-2513Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-232252 Permit Number: EL -11-14-2513
Scheduled Inspection Date: April 16, 2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: LYTLE, JAMES & JOYCE Work Classification: Alteration
Job Address: 429 NE 101 Street
Miami Shores, FL 33138-3163
Phone Number (305)546-2376
Parcel Number 1132060170640
Project: <NONE>
Contractor: ELECPLUM ENTERPRISES INC. Phone: (786)295-4004
tsunamg uepartment comments
LAMP INSTALLATION AND GFI OUTLET
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-231790. CREATED AS
E�r REINSPECTION FOR INSP-231526. Add arc fault breakers and 1 kitchen
receptacke.
10 apr. 2015
Failed ❑ N. O. H. at 3:50p. m..
Correction ❑
Needed /e�X/7_
2- ep
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
April 15, 2015 For Inspections please call: (305)762-4949 Page 23 of 32
Miami Shores Village CF,1°
Building Department NOV 14 4 j
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: b
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (30S) 762-4949
FC 20 tO
BUILDING master Permit No. 9C 14 —Q t 1
PERMIT APPLICATION Sub Permit No. `E L-10-4 -as1
❑BUILDING (,ELECTRIC ROOFING REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING 7 MECHANICAL ❑PUBLIC WORKS 7 CHANGE OF CANCELLATION ❑ SHOP
CNTRACTOR DRAWINGS
��
JOB ADDRESS: Y �'a� 7
0
the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
I
OWNER: Name (Fee Simple T eholder): C 664 Phone#.
Address. A a9 k) 1 o� T
CltY= 5 rcs State: Tip:
Tenant/Lessee Name: Phone#:
Email: �1 aa��
CONTRACTOR: Company Name: ��T l��'1l7 °IS�' ° Phone#: /
Address: c13-�> nu.) iL4 10 i(,e-,� �3
City: 0 � ) State: Zlp-
` -a��
Qualifier Name: Al`du 0 're's Phone#:
State Certification or Registration #:0C- V00-0-1-3 ;97/ Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: p� 7� City: State: Zip:
Value ofWork for this Permit: $ = C7 C Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace LJ Demolition
Description of Work::Tn,5 C-41) ✓" X t 0,'-A
Specify color of color thru We:
Submittal Fee $®-� Permit Fee $ �' ®� CCF CO/CC $
Scanning Fee $ Radon Fee $— DBPR $ Notary $
Technology Fee $ - c-2jt4 _Training/Education Fee $ ~i90 Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ &19• 07
(ReviseM2/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
city
State Zip
Mortgage tender'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 Te notice of commencement and construction lien law brochure will be delivered to the person
whose pr rty is subject to c e Also, a certifred copy of the recorded notice of commencement must be posted at the job site
for the ft pection whit cc s n (7) days after the building permit is issued. In the absence of such posted notice, the
inspection wit t be approve n a J pe fee will be charged.
a
Signature Signature
OWNER or
The foregoing instrument was ackno4ledged before me this
day of -`" 20 % (4 . by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC: _
Seal: STATE OF FLORIDA
Comm# E044213
biros 1111312015
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of P� .20 by
who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seat: STATE OF FLORIDA
Gomm# EE144213
IM 11113/2015
as
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
........... . _...._........ _.. µ.m_ a_ ._.__.._......
RICK SCOTT GOVERNOR KEN LAWSON, SECRETARY
ECWM727
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
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i46C. i Y f3R iitlJ�lliH88 PAY�IIBNt
ISO cowmdoa 6Y TAX f OUACiiiR
$n.00 j07J2014
MECK-44-140619
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NOV-14-2014 23:46 From:Esui-Group
305 226 4864 To:3057568972 Pase:1/1
ACZR0r CERTIFICATE OF LIABILITY INSURANCE
�✓'
DATE(MM/DD/Y"-f)
11/14/14
THIS CERTIFICATE IS 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(its) must be endorsed. If SUBROGATION IS WAIVED, aubjecl 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 endorsemerd(s).
PRODUCER
Ensurgroup
E: CONTA T Marta Lopez Diaz
NAM
PHONE (305)559-0999FAX
No: (305)226-4864
'M L mana@ensurgroup.00m
12804 S.W. 8th Street
INSURER AFFORDING COVERAGE NAIC 8
Miami, FL 33184
INSURER A: GRANADA INSURANCE COMPANY
Phone 305)559-0999 Fax (305)226-4864
INSURED
INSURER y: CASTLEPOINT FLORIDA INSURANCE CO.
INSURER C,
ElecPlumb Enterprises, Inc.
INSURER D:
933 NW 134 Place
INSURER E:
MIAMI, FL 33182-
INSURER F'
COVERAGES CERTIFICATE NUMBER: 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.
INgR
Li
TYPE OF gdSURANCE
I
APDL
UBR
POLICY NUMBER
POLICY EFF
(IMAM
POLICY EXP
D
LIMIT&
GENERAL LIABILITY
EACH OCCURRENCE S 1,000,000.00
PDAGSE TO RENTED $ 100,000.()0
O COMMERCIAL. GENERAL LIABILITY
A
❑ ❑ CLAIMS -MADE R5 OGCUA
F7y
0185FLOOD40472
11/10/2014
11/10/2D15
M® Ew [ one $ 5,000.00
PERSONAL&ADV INJURY S 1,000,000.00
G€NERALAGOREGATE $ 1,000.000.00
❑
PRODUCTS • COMP/OP AGG $
GEN'L AGGREGATE LIMIT APPLIES PER.
S
O POLICY ❑ PAW ❑ LOC
AUTOMOBILE LIABILrrY
CE M2BINED(SINGLE LIMIT
❑ ANY AUTO
BODILY INJURY {Per person) S
BODILY INJURY (Per accident) S
B
❑ AALL
UTOS OWNED ❑ SCHEDULED
NOINED
❑ HIRED AUTOS ❑ AUTOS
PROpEM-Y DAMAGE $
Per ace
❑ UMBRELLA LEAH ❑ oOD,R
EACH OCCURRENCE S
AGGREGATE $
❑ EXCESS LIAB ❑ CLAIMS.MADE
❑ DED ❑ RETENTIONS
$
B
WORKERS COMPENSATION
AND EMPLOYEAW LIABILnY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMREREXCLUDED?
(Mandatory In Nle Y❑
N/A
TWC3436484
11/04/2014
11/04/2015
WC STATU._ �- 01-
G.L. EACH ACCIDENT S 1,000,000.00
6.L DISEASE- FA EMPLOYE • $ 1,000,000.00
E.L. DISEASE •POLICY LIMIT $ 1,000,000.00
If yyeep� d�Ber�bs under
DE3G�RSPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS J LOCATIONS / VEHICLES (Attach ACORO tog, Additional Remarks Schedule, If more space Is required)
Electrical Contractor
Alarm Installation
Subject to forms, conditions, endorsements, timiteons and exclusions,
Uc#ECO002727
CERTIFICATE HOLDER CANCELLATION
✓ VAS -2010 ACORO C RPORATION. All rights reserved.
ACORD 25 (2010/05) OF Th ACORD name and I o are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miami Shores Village
Building Department
THE EXPIRATION DATE THEREOFOTIGE WILL BED ELIVERED IN
ACCORD WITH TME POLI PROVISIONS.
10050 NE 2nd Ave
AUTii7EPRESE ATr1/E
Miami Shores Village, FL 3313e
Fax -305756-8972
✓ VAS -2010 ACORO C RPORATION. All rights reserved.
ACORD 25 (2010/05) OF Th ACORD name and I o are registered marks of ACORD