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ELC-15-255 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-239637 Permit Number: ELC-2-15-255 Scheduled Inspection Date: July 24, 2015 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: LEONI, TODD Work Classification: Addition/Alteration Job Address:9636 NE 2 Avenue Miami Shores, FL 33138- Phone Number Parcel Number 1132060132500 Project: <NONE> Contractor: CRESS LLC Phone: (407)476-9473 Building Department Comments ADD 10 NEW ELECTRICAL OUTLETS TO Infractio Passed Comments ACCOMMODATE NEW BANKING EQUIPMENT INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-233884. CREATED AS REINSPECTION FOR INSP-233755. CANCELLED BY MARCO 954-305-1435 Failed Correction Needed Ll j Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 23, 2015 For Inspections please call: (305)762-4949 Page 23 of 39 21� �2O1S Miami Shores Village L Building Department FEB 0!V015(`J' _ g p E 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax: (305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2010 BUILDING Master Permit No.'F— l— S-Z S75 PERMIT APPLICATION Sub Permit No. ❑BUILDING ® ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ^1CONTRACTOR DRAWINGS JOB ADDRESS: �%3 6 r" E C2»9 AV en 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: � � 1 ti OWNER: Name(Fee Simple Titleholder): t Gz la a Z c) o Y) 1 LL(:_- Phone#: Address: ,^71 U' 0 S F-f,i SC /Ay 05-- � I11`D, frE 2.0.1, City: 1"' L a m ' �p State:l (�'L Zip/: 3 3 1 Tenant/Lessee Name: 'J �lr(a Iy C V� t Y? Phone#: �-1D 7' 2 f 37 h Z Email: '4��)Y-0 Gl , K-N V1 SAY C ti'1Gc SG • L-Dyvl �3 CONTRACTOR:Company Name: � � Phone#: 4 ` ` ' / 73 Address: 7 c?-E o x -7 City: P V l �/�� `� _/��S,t1ate: Zip: ?Tz /o 7 /�� 2 Qualifier Name: C� a Y\1 T l l - I ►'` Phone#: �)tTl ' `7 7fD ' ` �J State Certification or Registration#: /�� �1� 5 Certificate of Competency#: DESIGNER: rchitect/Engineer: � ' Pho e#: � 1jbjl u9(:::) 3City: , L r Zip:Address: ( � Value of Work for this Permit:$ a 1G0 Square/LineaarFootage • �F����' � of Work: Type of Work: ❑ Addition ® Alteration ❑ New ❑ Repair/Replace ❑ Demolition �A,,,�� Description of Work: A 0 p n f-1�) C' �� Ly 1 C--a n ,J T bf'_ ±D- aso 1/�►,pAll� Vti e W 0-)o 141' vt Spe i color of color thru tile: Submittal Fee$ Permit ke$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1 ( � ' 3C) (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address i 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 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 bJaroved and a reinspection fee will be charged. / ���� z Signature ��� J�signature OWNER or AGENT �71C dNTRA AR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 4 day of br��� 20 j by day of ?" e-�Y�kY 20 1 J by (,rfJ 1 who i personall known �� is personally known t me r who has produced as ze or o has oduced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: WZ J Sign: Sign: Print: qrl vi J&ea, Print: Seal: ANDREW VOGEL Seal: "y P" ARIEL GUZMAN MY COMMISSION Y EE130930 ;�� �4'� Notary Public State of FlOrbi EXPIRES:Novanbtr25,2015 .• My Comm.Expires Jul 25,2017 Fl.Now Di _ i eoo u+or�Rr rr /Woa Co Commission #FF 039882 ` pApS Ng Assn. APPROVED BYAQ- gam - Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) f SNC.1% y 7 Real Milli" Miami Shores Village Building Department OR 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A$30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION(EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE(CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE(EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: BUSINESS ADDRESS: AN'v 7 CITY C 0G1i c�y- STATE F � ZIP CODE J Z -7e BUSINESS PHONE:(4 01 )1 ) 0 4• �Li 73 FAX NUMBER(21 D 7 -�'- 7 l CELLPHONE(LIISLl S JALIFIER'S NAME: QUALIFIER'S LIC NUMBER: P D 0 ) 5 -8 L E-MAIL ADDRESS(IF APPLICABLE): C 6W ''1 ""� yr 5S &m- -/-t -V " L-o zx--� Created on 3119109 BY MLDV I RV 3126109 MLDV I Scott Randolph, ' Goliector LOEa Bius n ss Tax -eceiR wrange Loun�X :r�ior�u� Thin klcaii woe".3 Inaddt1{or1 td acid no,- IOU of•arry Orlrier t�rcegedred by laworfiw pa!orctinaf e.Bush sses era sUtljea to.reg or za+in9:health and oih tawtut aulharilies Tide rec�ipt_is4retJkt froit+f)dp0er 1 S{trpt�Sep> be3tFofwNEs added October 9 2014 1.602_ C6tT ELECTRICAL CON ' X30;00 1. EMfFLOY .' BU_BWESS OFFIE€ $34 Q0 1 fMPIfi�YEE TOTAL TAX —W.00; {CHT GARY PREVIOUSLY PA1D • TOTAL DUE •l � RESS -. . (• Qy HAIGHT GARY R N. d P '1* !' O7at764 7 T IL7- RLANDO FL32 &78176 0RLANDO 8$ 4 PAID $60OQ •0098- .621631 7/6/2094''. This receipt is official when validated by the Tau Collector. C6h§-Wttila-Hd isl-Ndh this-license yo[rbecortte-one-ofthe-rlearty one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, F BUSINESS ' and the k y g DEPARTMENT• AND i y keep Florida's economy strong. PROF��S IOC 4LR,-EGULATION Every day we work to improve the way we do business in order to EC0001584 90.ARJ '08/14/2014 Ifo oration about cur services,please log onto ;�,r� om. There you can find more information . CERT.IFJED E OR 3 _ 'impact you,subscribe .Pore about the Department's FfiA1GHT,GAf� iniFianves• CRESS I LC t;�, :« u !><_ I Cusiu€cers. i nanK you for doing ousiness in r-ionaa, and congratulations on your new license! I ExpVe*m date.:AUG 31.2016 V F L14081400O2164 DETACH u� RICK SCOTT GOVERNOR ..... ........ _. . .............. . KENL.AINSON,SECRETARY ...... . STATE OF FLORIDA _. a ,•�^ - - -- cc re"40%PROFESSIONAL REGULATION QRS _ICENSING BOARD t .. ... - .. 3� h"pl= F l_32878 CRESS-1 OP ID:SP CERTIFICATE OF LIABILITY INSURANCE DATE 01/26/15) 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: M 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 Phone:407-898-8891 CONTACT Corkhill Insurance Agency,LLC NAME: PHO20 South Bumby Avenue y, Fax:407-898-8813 (AIC No Ext): ac No): Orlando,FL 32803 E-MAIL Scott Corkhill,AAI #A054965 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Southern Owners Ins Company 10190 INSURED Cress,LLC INSURERS:Bridgefield Employers Ins.Co. 10701 Commercial Real Estate Service P.O.Box 781764 INSURER C:Owners Insurance Company 32700 Orlando,FL 32878 INSURER D: INSURER E: 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. ILTR TYPE OF INSURANCE POLICY NUMBER MMUEFF(MM/DD POLICY EXP RLIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 72725471 11/06/14 11/06/15 PREMGE TO RENTED ISES Ea occurrence $ 300,00 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO jECTLOC $ AUTOMOBILE LIABILITY COEa accidMBINEDentSINGLE LIMIT $ 1,000,00 C X ANY AUTO 4821685700 11116/14 11/16/15 BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,00 A EXCESS UAB CLAIMS-MADE 48-216857-01 11/06/14 11/06/15 AGGREGATE $ DED X RETENTION$ 5000 $ WORKERS COMPENSATIONX WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER B ANY PROPRIETORIPARTNERIEXECUTIVE830-43463 11/06/14 11/06/15 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,00 If yes,describe under 500,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) LICENSE #EC0001584 CERTIFICATE HOLDER CANCELLATION CITYMI3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Ave Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. 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