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DEMO-14-2476 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-223211 Permit Number: DEMO-11-14-2476 Scheduled Inspection Date: April 07, 2015 Permit Type: Demolition Inspector: Devaney, Michael Inspection Type: Final Owner: STEAD, MARC GREGORY Work Classification: Electric Job Address:93 NW 93 Street Miami Shores, FL 33150-2232 Phone Number Parcel Number 1131010340240 Project: <NONE> Contractor: EVOLUTION ELECTRICAL CONTRACTOR GROUP LLC Phone: (305)986-8537 Building Department Comments REMOVAL OF SINK REFRIGERATOR AND DISHWASHER Infractio Passed Comments RELOCATE ELECTRICAL SWITCH INSPECTOR COMMENTS False Inspector Comments Passed E�r_ Failed i Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. April 06,2015 For Inspections please call: (305)762-4949 Page 8 of 63 Miami Shores Village Building Department Lvov J�� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 0 2014 Tel:(305)795-2204 Fax:(305)756-8972 3 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 _-- BUILDING Master Permit No.):)eaz 423 59 PERMIT APPLICATION Sub Permit NOQ /xd 602?ti, ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: � 3 W q3 � _ City: Miami Shores County: Miami Dade Zip: .73 tS Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: }Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Phone#: '296 aa—7ef a d Address: A- ' 3 7V ) 1 City: �°`c Ant , ! lO z `S State: Z Zip: Tenant/Lessee Name: Phone#: Email: 1 CONTRACTOR:Company Name: ��t �'�4��C7 �/Z ' �� G4b"�Phone#: �uS qS-�P Address: c. / {� r City: State: Zip: Qualifier Name: 0-/+*-L Qlnj Z,,rL e Z Phone#: State Certification or Registration#: �L 13 d rS l Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: A1-1 d re s: City: State: Zip: Va a of WQrla;forvthisPermit:$ �G Square/Linear Footage of Work: Ty aifa�tRork�� ,fI. J� Addition ation ❑ New �] Repair/Replace ❑ Demolition ee I r-b 0 y lV/1 o�p t h c-,,911 cv'c ; Specify color of color thru tile: Submittal Fee$_ 0 Permit Fee$ l'� ''®� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ , TOTAL FEE NOW DUE$ (Revised02/24/2014) s 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 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 Signature , �OWNEA or AGENT,P CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 �� by 3 day of NOy M h-c2 ,20 /�( ' by who is personally known to tZlm iZ. GaN2ALE2,who i ersonally known o me or who has produced ® \ as me or who has produced as identification and who did take an oath. identification and w �� O Pti►�Y"Ve o DAWD N RAIIIELO NOTARY PUBLIC: ,os0��/'°• �� NOTARY PUBLIC: '' • c s paw PW _State /�s�� '. = My Comm.Expires Ave 12,> 17 Sign: Z/ ® ign Print: '. /�.�idx3 �� Print: Seal: u Seal: APPROVED BY � /Z/g'�� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range g ' a STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, , DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFESSIONAL REGULATION Every day we work to improve the way we do business in order to EC13005989 ISSUED: 08/2412014 serve you better. For information about our services,please log onto `CONTRACTOR www.myfloridalicanse.com. There you can find more information CERTIFIED ELECTRICAL R about our divisions and the regulations that impact you, subscribe GONZALEZ, to department newsletters and learn more about the Department's EVOLUTION ELECTRICAL CONTRACTOR GR initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your IS CERTIFIED under the provisions of Ch.489 FS. customers. Thank you for doing business in Florida, ExpUaE date:AUG n er ��a.489 FS. and congratulations on your new license! 04474 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION �11-' `s ELECTRICAL CONTRACTORS LICENSING BOARD FSM ` 7 EC13005989 ADDITIONAL BUSINESS QUALIFICATION � x The ELECTRICAL CONTRACTOR v . Named below IS CERTIFIED ```�'. .t.g Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 0 0 GONZALEZ, CARLOS R �. CTOR GROUP LLC EVOLUTION ELECTRICAL CONTRA 81 SW 91STAVENUE#107 PLANTATION FL 33324 a s ISSUED: 08/24/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408240004474 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895— 954-831.4000 VALID OCTOBER 1,2014 THROUGH SIEPTEMBER 30,2015 DBA: Receipt#:181-26145 $f�ISlnelsS IIRI11et:EVOLUTION ELECTRICAL CONTRACTOR EIRIA CbGROUP LLC Business Type: NZaCIOR(ELECTRICAL) Owner NaMO: CARLOS R GONZALEZ /QUAL Business Opened:04/03/2014 Buslne+s>e Location: 8131 NW 11 CT State/County/C®rt/Reg:EC13005989 j PEMBROKE PINES Busineels Phone: 305-986-8253 Exemption Code: Y 7k RoameSeats Employees rMachines Professionals Wank F� For Vending Business Only Number of Machines: V®riding Types j Tax Amount Transfer Fee NSF Fee Penalty Prior Years Coll'Coo"Cost Total Patd 27.0,0 3.00 0.00 0,00 ` O._ 0 10.00 µ2 .00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLAOE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax Is levied for the privilege of doing business within Broward County and � ty is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business Is sold, business name has changed or you have moved the business location, This receipt does not Indicate that the business Is legal or that It Is In compliance with State or local laws and regulations. Mailing Address: CARLOS R GONZALEZ /QUAL 8131 NW 11. CT Receipt #30A-13-00013045 PEMBROKE PINES, FL 33024 Paid 09/23/2014 30.00 11/10/2014 MON 10: 20 FAX 636 779 0080 CUSTOMER SERVICE 2001/001 DATE(MMIDDFANY) CERTIFICATE OF LIABILITY INSURANCE 11/05/14 F_ 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. . _ _...— SSSS. -... ._...__SSSS---_._ IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pol)cy(les)must be endorsed. If SUBROGATION IS WANED,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). —-.....-•-- ------SSSS---.__.—._... .---._. PRODUCER CONTACT ANGELA DEHART GOMEZ NAME: Morgan Insurance Group Inc PHONE E> (305)222-9001— No)__ (305)222-9006 13155 SW 42nd St#107 'MAtI an ela mor anin com _AnD _9._CBI._.9__.g9�p-..SSSS--SSSS SSSS - Miami,FL 33175 INSURER(S)AFFORDING COVERAGE_ NAIC d Phone (305)(305)222-9001Fax (305)222-9006 _-- INSURER A: SCOTTSDALE INSURANCE COMPANY —..... INSURED INSURERB: EVOLUTION ELECTRICAL CONTRACTOR GROUP LLC iNSURERC: ' 8131 NW11TH CT INSURER D. -RETAILFIRSTINSURANCECOMPANY PEMBROKE PINES,FL 33024 305 INSURER E: --- - INSURER F ----._. __. _._ ... _.. . COVERAGES CERTIFICATE NUMBER: _ __ ___ REVISION NUMBER: _ 1 _ SSSS---SSSS-- 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ._.-..... .. --- ADDLSUBR! SSSS— --.... r_LTR- -__-_-_TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS --. _----__JALSB.i_WYR: .._..._. —__. IMd91DDlYYYYJIMMJDDIYYYY);_ GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000,00 DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occyrrerru�--._$_100,000.00 CLAIMS-MADE 1/' OCCURMED EXP(AnLone parson) $ 5,000.00 A — N CPS2106217 .10/16/2014'10/16/2015 SSSS - - PERSONAL&ADV INJURY $ 1,000,000:00 -- -GENERALAGGREGATE : $ 2,000,000.00 _ - -----SSSS-- -- _. ...--- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG j $ 2,000,000.00 ...-..._.SSSS----'� LOC $ AUTOMOBILE LIABILITY COMBINF�SINGLE LIMB _ ANYAUTO BODILY INJURY(Per person); $ I - ALL OWNED SCHEDULED BODILY INJURY(Per accident] $ NON-OWNED PROPERTY AMAGE T - -- ---- AUTOS HIRED AUTOS AUTOS (Paredent�. _. $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UABi -------------_.. ,.._-.. _._--- — CLAIMS-MADE AGGREGATE $ DED RETENTION$ -- $ WORKERS COMPENSATION - WC STATU- —0TH- AND EMPLOYERS'LUWIUTY YIN ___._TORYLIMITS _.._:ER ANY PROPRIETORIPARTNERIEXECUTIVE 52047417 E.L.EACH ACCIDENT $_500,000.00 D OFFICERIMEMBEREXCLUDED? - NIA - 04/09/2014:04/09/2015----------------- - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE$ 500,000.00 DESdRIPaTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT i $ 500,000.00 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) ELECTRICAL CONTRACTORS .............._........ i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF MIAMI SHORES THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL 33138 } AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)OF The ACORD name and logo are registered marks of ACORD 1� f*tr- i14 b - Z71-1-1 F