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DEMO-14-453 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-208667 Permit Number: DEMO-3-14-453 Scheduled Inspection Date: May 21, 2014 Permit Type: Demolition Inspector: Devaney, Michael Inspection Type: Final Owner: CAP REALTY LC,CAP REALTY LC Work Classification: Electric Job Address:2 NW 108 Street Miami Shores, FL 33168- Phone Number (305)773-3101 Parcel Number 1121360110090 Project: <NONE> Contractor: FRANKIE ELECTRIC CORP Phone: (305)332-7516 Building Department Comments DEMOLITION FOR ELECTRICAL Infractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed Failed �� Correction ® � Needed 10014 Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. May 20,2014 For Inspections please call: (305)762-4949 Page 7 of 30 Miami Shores Village Building p 7MMDe artment ��.r�� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 2% BUILDING Permit No.D_ ZMO 11-I--1153 PERMIT APPLICATION Master Permit No Permit Type: Electrical JOB ADDRESS:_gw �g__6t City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes N Flood Zone: OWNER:Name(Fee Simple Titleholder):_ C1e 6 -'q Phone#:1'z ' vd_ Address: j p City:.iAl it State: en Zip: Tenant/Lessee Name: _Phone#: Email: CONTRACTOR: Company Name. Phone#: ` oW'�Jrjl Address: 0j. City: State: Zip• VnA,VVVV-:A Qualifier Name: Phone# State Certification or Re istration#: Certificate of Competency#: Contact Phone#: se Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit:$ Square/Linear Footage of Work: �� Type of Work: ❑Address UlAlteration ❑New ❑Repair/Replace Demolition Description of Work: Submittal Fee$ Permit Fee$ OG' ',PO CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 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 ELECTRICAL WORK,PLUMBING, SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 rein ion fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this I day of�"6i/ll ,20 i�,by Ya VIIL C.C1261ifY,l i day of '-�C�-k,20 ILA,by Q7&1,(S,4 5 L O CZ— who is personally known to me or who has produced C /3 / who is personally known to me or who has produced i D 9s'-/163v60 As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Ca P • Nota Pubes Print: • Dann M Feliciano Commis esMY Commission FF 082753 My Commission Expires: >w; req Ot xi3ires 01/12r1018 0; ��11 aGol'�f APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) JEFF ATWATER c� CHIEF FINANCIAL OFFICER STATE OF FLORIDA • DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS-COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. =FFECTIVE DATE: 8/23/2013 EXPIRATION DATE: 8/23/2015 ERSON: PEREZ FEIN: 200894274 FRANCISCO BUSINESS NAME AND ADDRESS: FRANKIE ELECTRIC CORP 6943 NW 168TH STREET MIAMI FL 33015 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL ELECTRICAL WIRING CONTRACTOR WITHIN BUIL ELECTRIC LIGHT OR Pursuant to Chapter 440.05(14),F.s.,an officer of a co POWER LINE C not recover benefts or compensation r.Pursuant who elects exemption from this chapter by filing—acertificate of election under this section may of the business or trade listed on thenotice roff electtiont to be exempt Pursuant o Chapt r 440.05(13),certi'F.S.$Notices of election t be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the of election to be exempt apply only within the scope —• person named on the notice or A16 1 57 443 0 ®- a -® i -®• STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 19 ONN - LICENSE NBR SEQ#L1206080113f 06/08/2012 110412158 ER13013751 The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) PEREZ, FRANCISCO J FRANKIE ELECTRIC CORP. 6943 N.W. 168 STREET MIAMI FL 33015 RICK SCOTT GOVERNOR KEN LAWSON DISPLAY AS REQUIRED BY LAW SECRETARY 001816 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT ABILL-DO NOT PAY OT 5961538 �+ BUSINESS NAMEiLOCATION RECEIPT NO. EXPIRES RENEWAL 30—Sep-14 ELECTRIC CORP 6219117 6943 NW 168 ST Must be displayed at place of business Pursuant to County Code MIAMI FL 33015 Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED FRANKIE ELECTRIC CORP 196 SPEC ELECTRICAL CONTRACTOR BY TAX COLLECTOR 7.00E+50 $75 7/16/2013 Worker(s) 1 TXHS1-13-030426 This Local Business Tax Receipt only confirmspnjmnw of the Local Business Tax.The Receipt is not a license. permit,or a certification of the holders qualdictdllms.to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements vddch apply to the business. The RECEIPT NO.above must be displayed on all commercial vehicles-Miami-Dade Code Sec Ila-276. For more information,visit vv ws+miamidade aoyA@1collector Local Business Tax Receipt Miami—Dade County, State of Florid -THIS IS NOT A BILL-DO NOT PAY [L:BiTJ 5961538 EXPIRES BUSINESS NAME/LOCATION RECEIPT NO. FRANKIE ELECTRIC CORP RENEWAL SEPTEMBER 30, 201 FRANKIE IE 168 RI 6219117 Must be displayed at place of business MIAMI,FL 33015 Pursuant to County Code Chapter 8A-Art.9&10 SEC.TYPE OF BUSINESS PAYMENT RECEIVED OWNERSPEC ELECTRICAL BY TAX COLLECTOR FRANKIE ELECTRIC CORP 196 CONTRACTOR 75.00 07/16/2013 07E000050 TXHSI-13-030426 Worker(s) 1 confirms payment of the Local Business Tax.The Receipt is not a license, This Local Business Tax Receipt only I ,or a certification of the holder c qualifications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles V�YrMiami-DadeCode Sac 8a-276. lle for L,`'� For more information,visit MIAMFb4yt; � L`",�ol:e5 �` 001816 Local Business Tax Receipt Miami-Dade County,State-of FloridaLBT.1 THIS 1S NOT A BILL—DO NOT PAY 5961538 RECEIPT NO: EXPIRES BUSINESS NAME/LOCATION RENEWAL 30-Sep-14 FRANKIE ELECFRIC CORP 8219717 6943 NW 168 ST Must be displayed at place of business Pursuant to County Code MIAMI FL 33015" Chapter BA—Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED 796 SPEC ELECTRICAL CONTRACTOR By TAX COLLECTOR FRANKIE ELECTRIC CORP 7.00E+50 $75 7/16/2013 Worker(s) 1 TXHSI-13-030426 This Local Business enesTax Receipt duams t of the Local Business Tan The Receipt is Oct a license, permit,or a certification of the holder's gnal'ficdh°�t°a he busies comply vaitlt mry 8�ern�"�1 or nm{goveramental regulator)laws and requnemeats PPIY The RECEIPT N0.above must be displayed on all commercial vehicle-Mismi-Dade Code Sec Ba-27L For amore information.visit 'ate+ ovtAtcollector Municipal Contractor's Tax Receipt M iami—Dade County, State of Florida _THtS IS NOT A EN LL—DO NOT PAY M C] CC NO. 07E000050 BUS{NESS NAMEILOCATION RECEIPT NO. EXPIRES' FRA 1 ELECTRIccORP NEW BUSINESS SEPTEMBER 30 2014 6943 NVd 168 ST 7439828 Must be displayed at place ofbusiness (01A i1,FL 33015 Pursuant to County Code " Chapter 8A—Art.9&10 OWNER SPECIALTY OF BUSINESS PAYMENT'RECEIVED FRr1NK1E ELECTRIC CARP SPECIALTY ELECTRICAL CONTRACTOR BY TAX COLLECTOR 175.00 10/23/2013 0228-14.000534 For more information.visit www mianidade aoyjtaxcollector To: P-g9 3 of 3 20'I 4-03-07 a't:'19:Za(OMT) 18773680410 From: M®ry 114 ®1- 'A CERTIFICATE OF LIABILITY INSURANCE DATE(k&12/286!2013/2013 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 Ileu of such endorsement(s). PRODUCER RAS Mary Nelson ALL INSURANCE RESOURCES PHONE 305 200-1221 �— �No. 1-877-358-0410 5951 NW 151 ST.SUITE 213 APOR'MAIL mnelson@iinsureit all.com - - INSURER S1 AFFORDING COVERAGE �^ NAIC U MIAMI LAKES FL 33104 INSURER A: Ascendant Commercial Ins INSURED INSURER 6: __- Frankie Electric Corp INSURER C --.- 6943 NW 168 St INSURER o_ Hialeah,F133015 INSURERE:,...---. 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. — r . �u_—E.. POLICY ' LIMITSI i TPE OF INSURANCE INS OUMBER MID MMI _..... GENERALL14MTY EACH OCCURRENCE _ $ 1,000,000 �5A6AaCE7t5�€F1i — '— COMMERCIAL GENERAL LIABILITY I PREMISES lEa oaL100,000 nence $ -- CLAIMS-MAD OCCUR I �-MEDEXP(Arryonepersonl $ 5,000�� - - A _ _ GL391012 92/01/2093 12/01/2014 PERSONAL&ADVINJURY S 1,000,000 �..-. GENERAL AGGREGATE S 2,000,000 — GEWL AGGREGATE LIMIT APPLIES PER, i ` PRODUCTS_-COMPIOP AGG S 1,000,000 POLI jECTPRO- ICY! I I LOC s AUTOMOBILE LIABILITY j 1 M86J M $ (E acd I ANY AUTO ' f BODH.Y INJURY(Per person) !S — AALL UTOED SS A(C(JHHTEESULED i n/a �BODILYINJURY(PereastasIdent)i$n/a - -- I NON-0WNED i PRbPFJTY GE HIRED AUTOS AUTOS i(Per dent) $ UMBRELLA UABj OCCUR I i EACH OCCURRENCE .. j S IVa i sS DCC--ESS - i CLAIMS-MADE } r/8 I _AGGREGATE S -. .._ i I DED = RETENTION$ f $ !WORKERSCOMPENUTION t 7 TA - OTH- i AND EMPLOYERS'LIABILITY YIN 'ANY PROPRIETORtPARTNERS)MOUTIVEE.L.EACH ACCIDENT $ Na OFFICEMMEMSER EXCLUDED? D N 1 A n/a (MendOtDry In NFn :0yYea�ba0 E.L.DISEASE-EA EMPLOYE $ .Y — DESCnder RIPTION OF OPERATIONS bebw I E.L DISEASE-POLICY LIMIT $ EE I t I ; n/a n/a I I i 1 I ; I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remm-ke Schadute,If more space Is required) Electrical Contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS, Building Department 10050 NE 2 AVe AUTHORIZED REPRESENTATIVE Miami Shores,FI 33138 ni ACORD 25(2010105) ®1988-2010 ACORD CORPORATION.All rights reserved, The ACORD name and logo are registered marks of ACORD