The URL can be used to link to this page

EL-15-960Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-233120 Permit Number: EL -4-15-960 Scheduled Inspection Date: April 28, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: STUART, LAURA Work Classification: Repair Job Address: 66 NE 106 Street Miami Shores, FL 33138-2035 Phone Number (305)757-8880 Parcel Number 1121360060030 Project: <NONE> Contractor: DAW ELECTRIC, INC Building Department Comments REPAIR ELECTRICAL SERVICE RISER MAST AND Infractio Passed Comments REPLACE 2/0 CU SERVICE CONDUCTORS I INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. April 27, 2015 For Inspections please call: (305)762-4949 Page 16 of 29 yws, Miami Shores Village CCF 10050 N.E. 2nd Avenue NE DBPR Fee Miami Shores, FL 33138-0000 4 Phone: (305)795-2204 Pro)ect AGaress Parcel Number Applicant 66 NE 106 Street 1121360060030 LAURA STUART Miami Shores, FL 33138-2035 Block: Lot: Owner Information Address Phone Cell LAURA STUART 66 NE 106 Street (305)757-8880 MIAMI SHORES FL 33138-2035 Contractor(s) Phone Cell Phone DAW ELECTRIC, INC of Work: REPAIR ELECTRICAL SERVICE RISER MAS onal Info: ification: Residential ling: 3 Fees Due Amount CCF $0.60 DBPR Fee $2.25 DCA Fee $2.25 Education Surcharge $0.20 Permit Fee - AdditionstAlterations $150.00 Scanning Fee $9.00 Technology Fee $0.60 Total: $165.10 Valuation: $ 600.00 1 Total Sq Feet: 00 Pav Date Pav Tvoe Amt Paid Amt Due I Invoice # EL -4-15-55296 04/22/2015 Credit Card 04/27/2015 Credit Card $ 50.00 $ 115.10 $ 115.10 $ 0.00 Available Inspections: L Type:rical In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I cert" t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fu a ore, uthorize the ab ed contractor to do the work stated. April 27, 2015 Authorized Signa re: Nwner pplicant / Contractor / Agent Date Building Department Copy April 27, 2015 1 BUILDING PERMIT APPLICATION IVlldl l ll JI IUI CJ V111d6C 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 © ELECTRIC ❑ ROOFING APR 22 2015 FBC 20 Master Permit No. / / Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 66 Ne 106 Street City: Miami Shore County: Miami Dade zip: Follo/Parcelt�:11-2136-006-0030 Is the Building Historically Designated: Yes NO Occupancy Type: Res Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Laura R Stuart Phone#: 305-75748680 Address: 66 Ne 106 Street City:Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name :i�;;;: /�°.. �; [ Phone#: Address City: t State:/: Zip: / r° Qualifier Name: `"� �;�� .�.i.�� ' Phone#: State Certification or Registration #:,—/ Certificate of CornWency #: DESIGNER: Architect/Engineer: Phone#: Address City: State. Zip: Value of Work for this Permit: $ 600 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition Description of Work: Repair Electrical Service Riser mast and replace 2/0 Cu. Service conductors. Specify color of color thru tile: Submittal Fee $ S-0 Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ w Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE 5 �� l� Bonding 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. 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 certfied 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 �W� Signature..% OWNER or AGENT CONTRACTOR The foregoing instrument ss acknowledged before me this 2'Z, day of /ey'�6 20 /=—< by /J" 57140C who is personally known to me or who has produced -9, S6 3 6 ®-?4 "90�86s' Identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this %G day of 0-7, . 20 4!�5 by C10A 1t11y jX-- . who f personally kno to me or who has produced identification and who did take an oath. NOTARY PUBLIC: as Sign: XA, Print •° Seal: f S. I. ex ''r 3.2017 t � ,.urmca•�• a.�vuitere ses�e+sss�+ee:ssss� s��base �re��ss•s*ssss��e��aes�s Plans Examiner "—eli, Zoning Structural Review Clerk .4�o!eo CERTIFICATE OF LIABILITY INSURANCE 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, 0422/ 0 5YYY) 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(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 AP INTEGO INSURANCE GROUP LLC 333 WEST COMMERCIAL ST EAST ROCHESTER, NY 14445ADDRESS: CONTACT NAME: AICNNo Ext : 868 590.8965 FAX No): S88 733-5112 E-MAIL bwelerasel ollservl velers.com INSURER(S) AFFORDING COVERAGE NAIC # (866) 890-9965 INSURER A: TRAVELERS CASUALTY AND SURETY COMPANY INSURED D.A.W. ELECTRIC, INC. INSURER B: INSURER C: D LIGHTING MANAGEMENT & INSURER D: INSTALLATION, INC. 20200 NW 2ND AVENUE SUITE 301 MIAMI GARDENS, FL 33169 INSURER E: INSURER F COVERAGES CERTIFICOTF NIIMRFR• AA7rn7nnAAg1911 RFVISInN NIIMRFR- 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED o MED EXP (Any one rson $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: [—] PRO- JECT LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS MADE AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WA UB -3855T807-15 01/25/2015 01/25/2016 X I STATUTE ERH E.L.EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, desc riibe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) LICENSE #EC13005443 VJ -1.1111 wl 07;,111 -0 MIAMI SHORES BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ( %oIj� * • /_ — I.--��.i ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 66 Ne 10e Street Miami Shores, FL 33138 200A METER MAIN COMBO 1PH, 120/240 A 120/240V, 3W, 1PH 3-2/0 CU. IN r COND. "EXISTING SERVICE" VF 474237 3.2017 VIL #4 CU IN % COND. TO 2-5/8 X10 GROUND ROD & CWP. WMIN. ItLIM I KILAL Klbt:K DIAGRAM 0 w N P- Lul 0 9 Q t 120/240V, 3W, 1PH 3-2/0 CU. IN r COND. "EXISTING SERVICE" VF 474237 3.2017 VIL #4 CU IN % COND. TO 2-5/8 X10 GROUND ROD & CWP. WMIN. ItLIM I KILAL Klbt:K DIAGRAM