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EL-14-2303 1H t Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-232032 Permit Number: EL-10-14-2303 Scheduled Inspection Date: April 10, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GONZALEZ, MARIO Work Classification: Alteration Job Address:9811 NW 1 Avenue Miami Shores, FL 33150- Phone Number (786)236-0135 Parcel Number 1131010330080 Project: <NONE> Contractor: MESA BROTHERS INC Phone: (305)345-1974 Building Department Comments ELECTRICAL WORK FOR INTERIOR REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed EJ Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. April 09,2015 For Inspections please call: (305)762-4949 Page 31 of 41 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 FBC 2010 BUILDING Master Permit No. Rc= �\-f' 9 915 PERMIT APPLICATION Sub Permit No-E, ` I+ 2a03 ❑BUILDING P"ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING r-] MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION [] SHOP CONTRACTOR DRAWINGS JOB ADDRESS: '?9// 41 kV J 4k(?— City: Miami Shores County: Miami Dade Zip: 35/5 0 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: /Construction Type: Flood Zone: BFE: FFE: ��/ � 02f/// �e�Phone#: � `� OWNER:Name(Fee Simple^Titleholder): � C�� e� r � Address: City: tri ��` �c�`� f� State: i � Zip: /. Tenant/Lessee Name: Phone#: Email: V e_ /1 CONTRACTOR:Company Name: �!- l f`' ' " Phone#: Address: City: �`". ��""�� State: r�,/C'` � Zip: Qualifier Name: �� f �� ` . Phone#:•�' T y `"�� State Certification or Registration#: e�� °w Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ l Square/Linear Footage of Work: Type of Work: ❑ Addition % Alteration ❑ New —❑ Repair/Replace ❑ Demolition Description of Work: /C- 70 pb)ei-°ati h°. .G 7-yin «••;:`y,a,,:. gtQS sa La ,�,rar�,o�PaA�,.94 Specify co r of for tll/ iffle:_�. r Submittal Fees TIMMeZG��ice® CCF$ B CO/CC$ Scanning Fee$ ` Radon Fee$ DBPR$ > Notary$ t 03 Technology Fee$ �L 7��Training/Education Fee$ 1-to Double Fee$ MA Structural Reviews$ Bond$ pp TOTAL FEE NOW DUE$ U (Revised02/24/2014) i 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OW R or AGENT CONTRACTOR The foregoing instrument �was -�acknowledged before me this The foregoing instrument was acknowledged before me this e day of I`�Y 20 by day.oof (J/CfllbPl' 20 ly by who is per onally k wn to � aylil�'rSctr ,who i ersonally kno to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: y� NOTARY PUBLIC: signs - � _��i .� Gyfit/✓CJ Print: Print: _ P�1►pr��B SPL publ-$;0f FlorMs Seal: Seal: R° • My Comm.E Dec 14,2017 Comminlon i FF W774 BoideA NNbpl NMN APPROVED BY /n/, ' l 9/t l S�G�'G1' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) RICK_ SCOTT, GOVERNOR T ~� KEN LAWSON, SECRETARY _..- STATE-OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION I ELECTRICAL CC!QRACTORS LICENSING BOARD fEroms�.0::.. I .T - LEC'ffl Ad; OfVTFiACT`C7I �" Ud r1e ovJlca �w... pr c9t,G ter'4S9 FS. ' plrr3ldri & .A If s�•1�ft,/[1..,.' �.. ,. .ems. -..`""'ti. � \��^\1�\` `l� v\ , + ' Gr ail/rlfV/1J1AI - :FL 3. - }�„ "` �. •, ;�`.. Y�''�'/'"err•' J^ ;�.y..lY '"�, �i , yup yl a I� `� \�,., \ `�,,`,`r, ■ , • .z:. .e!".�•^."...�.......C".:. M � •a . -^'�^�:...��..�.�^�,',��"`o- rc �\�," ,ty`y�' •x �\r5 rV•\♦ ❑• • � ISSUED; 06/10/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1406100001578 —._........__ _ —-- - -------- 000136 — — • <,tt ;> >'sr 1^��is"'r H�li��,�'� 1� r 1 VA z. � 7P ;t5 #�1�•�.Ia�q�4��11,P�t Yn'}+,f,'�z�j t t 's1.��t t��+� •^1?.a a i ¢ , �� ; pe�1't7`r nt•,'� \ a i+ �.`r"i�,11 r f p �„'e$t{?u /t.p "^ ��'� r`rl � 1 7�,�,� i�Yk a�\� rJ y�{��,t'a �t r` t�4`•�}� Y`tk't �� K �a• ��+Y,� ,t�l`r ��}\' ��6, z r gAadf¢��F�� k�{J rdr t 1 t.�.;r s ry, r r tv� 9 ,v�P 'Y ,,.,.i�1R•s;,yy,y., a ;OWN "{. m•, c`z t:: raAg¢lt+� iSA 'f,2 MESA ERS INC sec. r °eusRrvess�}'t1" m"+0, Arf' .1196 ELE L Ct T♦�A��sir�3 PAYMEt1%R@CEI 10 , C13001 �t t n� t �r Tax LLecr - 75 000. n.,. HECK2fi-14--053106 Thls uslnes cerpt o rr> Irma pa nt of th " '� 2' „w Eli Pa cettlllc the hol elificati s to do buW61 a Holder Tex.The Re s not a '� omenta to ', 1'' p ry la equlrem0 is which apply to the bu kir r nY 8ove CEIPT bove m played o atvehic4 a Sac 6a!, d rt>, For, ation. r MESAB-1 OP ID: MY .a�oRo- CERTIFICATE OF LIABILITY INSURANCE D 10/10/2014Y) 10/10/2014 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(ies) 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 CONTACT BROWN&BROWN OF FLORIDA INC Phone:305-364-7800 NAME;- 14900 NW 79th Court Sulte#200 Fax:305-714-4401 PHONE FAX Miami Lakes, FL 33016-5869 MAILS Ext)[ (A/C,No): Ramon A Rodriguez ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:FCCI Insurance Company 10178 INSURED Mesa Brothers Inc. INSURER B: 5215 SW 103rd Avenue(Rear) Miami,FL 33165 INSURER C: 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. INSR -- - -- - -- ADDL SVBR - POLICY EFF POLICY EXP -- LTR TYPE OF INSURANCEINSR wyn POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY GL00147262 01/01/2014 01/01/2015 DAMAGE SPREMESTO RENTED occurrence) $ 100,00 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,00 - - -- ---- ----- PERSONAL&ADV INJURY $ 1,000,00 -- -- ---- ---- - - GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY PROJEC• LOC - $ -- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ AOSCHEDULED AUUTOSS AUTOS BODILY INJURY(Per accident) $ _ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LtAB I OCCURH OCCURRENCE- $ - EXCESS LIAR —� i '-EACH --- - -- U_CLAIMS-MADEI, AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 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 no. EC130001870 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami,FL 33138 AUTHORIZED REPRESENTATIVE � o ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD .�►c ►� CERTIFICATE OF LIABILITY INSURANCE ,"""� 1D119Pt014 THIS CERTIRCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO FIGHTS UPON THE CERTIFICATE HOLDER.TM CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATIVELY AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED'BYTHE POLICIES BELOW.TIES CERTIMATE OF INSURANCE DOES NOT CONSTITLfrE A CONTRACT BETWEENTHE ISSLgNG INSURER(Sb AUTHORZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE ffiffiURN W;¢ rWWate hakfor is an ADDITIONAL INSURED... pal y(les)must be endorsed, 0 SUBROGATION 15 WAIVED,8ubjact to tarots LtondiHona o!the policy,certain).!kiss ray require prt endorseme the m. A statement on this ceAiticses trot Cartier rights to the cart ewe holder In Ow at SUO en_ dorsernen�s)` PSR i1l•_i1-925-x+33 F:xl.208:14 5=W1eh@nom H1Sta8P�E SQfu -.�. : NAS:. A.O.BDk 3442 �t1.561.746-5077 FAX ,eqWVA FL 33469 �. OQYERA4E - NAICtt __.._____ _._.__—_.�.�� ._ tt•18tazER A:Te _ktsute:tice Corr keC. P09Mwh F- Ade t Co.wo and ail its WMatwwKlsubsk%rias i fl a S•:0?PtitkiBfeQ Dr R{8lHIEA C:_ _. - Swasata,FL 34243 r rrlstlNER D �uetep F COVERAGES CERTIFICATE Nt=ER.WA7S54' REVISION NUtABER: THIS IS TO CERTIFY THAT THE POLICIES o�RM ANCE LISTED BELOW VE BEEN ISSM TO THE INSLIRED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANO NG ANY REOLAREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE�E AFFORgED BY THE POLICIES DESCRIBED HERE W IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND COM—T ONS OF SUCH POLICES.UMtTB SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - "-T .TYPEaF�tIRA _EPP - -E%P- 719DC'�OiBti _-'-- -- _ :dam.LtAal4.tTY F Lam EACH OCCURJENCE S COMMEROM GEPiERA1 LIAINUTV DAU- M-E TO RENTID PgEMSES IEA W.-mmoa'st $ CLANwS-td46E Q OCCiNa u'e;?EXP��r,�,t8�r90�; g. _.------ _.. KRSONRL 8 A3ti PQ4jRY S _......_..._..__... ..__.... .._.__ GEMRALAGGRECaATE S 8Ek-L At RELuaTEiUIM7 APPMS PEA. PRODUCTS,CDA'RW AQU S FOucv Fl� Loc i 1 6 AUTO1msnELrMMM erat g ' ANY AUTO :E9DIlY 1R4NRYfPatyaro0n1 '.$ ALLY DS AUTOS - �8CU4YINtt1En'(Pei 'N3�S NAED AUTO6 < -----'- S 1Hd8Etq l,A YA9OCCUR =,.•;n^H YTC.CSiflA> ICE & EJtl SS lIA6 CL4NSAfADE' AGuAEttATE 5 RETEt•TrrtON- _ ... waalCaFtsc�c�sATtort _ $ _ 10i01.2Uf5 ANY PADPRE�ryg YlF! OFt10ER7i—um E3m3AA)EO4 •N f A EL.EACH A=GENT S i4tarkaWtY iA tOQ _. __.. _ R Et-O%SEtiSE-EABCPLOYEE $ 1,tw.00-D t E.L.DISEASE•Pacy tJAST S f•ODD.d�`i i 5 S 00$CRIPYION OFOPegAlTlMlgtLaCAT101Va tV6iICLeg(AttaepA�r01.AtOtRlRngt 1.. BCMdute.B�apace c0 j. Coverap is,s:Aendeo m CO amployses but not s Actors of Mesa BrovorS ktc Llcensa UEC13001870 CERTIFICATE HOLDER CANCE6LATK?N n SHOULD ANY OF THE ABOVE DESCRIBED POLXM BE CANCEIAED BEFgp¢ THE E)CPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCEWITHTHE POUCY FROVL4MW n Tauri Snorers VtBage TAflvB 100501OAve we t11iarul FL 33138 ! + I i Page t oP; 1988-2010-ACORD CORPORATION. AR rights-reserved. ACORD 25(2010105) The ACORD natne and togQ are registered marks D1 ACORD r