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EL-14-2163 a ' Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-240757 Permit Number: EL-10-14-2163 Scheduled Inspection Date: September 01, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: IOANNA KONIDARI,WILLIAM F HULME Work Classification: Alteration m Job Address:196 NE 105 Street Miami Shores, FL 33138- Phone Number Parcel Number 1121360130630 Project: <NONE> Contractor: SHINE ELECTRICAL ENGINEERING Phone: (305)688-2000 Building Department Comments ELECTRICAL FOR INTERIOR HOME RENOVATION Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-240686. Released work with to F P L so residence electric can be checked. Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 31,2015 For Inspections please call: (305)762-4949 Page 18 of 37 r Miami Shores Village Building Department ®Cr )T',10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 By: INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 l� BUILDING Master Permit No.?1C PERMIT APPLICATION Sub Permit No. ❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 196 NE 105 Street Com: Miami Shores County: Miami Dade Zip: 33/33 Folio/Parcel#: 11-2136-013-0630 Is the Building Historically Designated:Yes NO X Occupancy Type: SFR Load: Construction Type: CBS Flood Zone: X BFE: FFE: OWNER:Name(Fee simple Titleholder):William F. Hulme III & loanna Konidari Phone#:305-510-7342 Address: 196 NE 105 Street City: Miami Shores state: FL Zip: 33138 Tenant/Lessee Name: Not Applicable Phone#: Email: CONTRACTOR:Company Name: Shine Electrical Engineering Phone#: 305-688-2000 Address: 3876 NW 125 Street City: Opa Locka State: FL Zip: 33054 Qualifier Name: Francisco Santos Phone#: 305-688-2000 State Certification or Registration#: EC0001514 Certificate of Competency#: DESIGNER:Architect/Engineer: Alejandro Santamaria Phone#: 305-785-8296 Address: 10251 SW 72 Street, Suite 104 City. Miami state: FL Zip: 33173 Value of Work for this Permit:$8,500.00 Square/Linear Footage of Work: Type of Work: ❑ Addition X Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Interior Home Renovation Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ S � 0 CO/CC$ Scanning Fee$ 9 Q0 Radon Fee$ - G DBPR$ '4, 4(o Notary$ Technology Fee$ Training/Education Fee$ 1 9Z-1) Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) r � o 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 OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged beforemethis I� day of 6�� ,20 � by S� day of 0� CAO of ,20 1 "'1 , by IA��-�'aAt�1 NI1.1�'� ,who i ersonally know o iTQ 'SC0 C. san ho is personally know�o 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: NOTARY PUBLIC: Sign• i Print: ! �� Print: .5�� LkVD Seal: NELSONINEDNA"lR, Seal:,.°�!!r° '°o Anis y Kim NOTARY Plow COMMISSION#EE 194256 $TATE OF FLORIDA 9�' �� IBES:JUN.24,2016 • Como#FF103142 °a, ,„o` www AARmNOTArtuam 06 2tv/� APPROVED BY Z 0—e-7'- Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) � v -4 DD CERTIFICATE OF LIABILITY INSURANCE DATE 09/2314IM PRODUCER All Motors Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 11934 SW 8th Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Miami,FL 33184 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (305)559-8818 Fax (305)227-0977 INSURERS AFFORDING COVERAGE NAIC# INSURED SHINE MAINTNANCE ELECTRICAL CONTRCTR CORP INSURER A: SCOTTSDALE INS. CO. INSURER B: ASCENDANT COMMERCIAL INS.CO. D/B/A SHINE ELECTRICAL ENGINEERING INSURER C: 3876 NW 125 STREET- INSURER D: PROGRESSIVE INSURANCE CO. OPALOCKA, FL 33054 INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMBS LTR INSRD DATE MM/DD DATE MIDD GENERAL LIABILITY EACH OCCURRENCE 1,000,000 To(ERENTED 7 COMMERCIAL GENERAL LIABILITY JOSTO-L 07/27/14 07/27/15 PREM SES Ea occurence 50,000 ❑❑ CLAIMS MADE 0 OCCUR MED EXP(Any one person) 5,000 A ❑ ❑ PERSONAL 8 ADV INJURY 1,000,000 ❑ GENERAL AGGREGATE 3,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 1,000,000 ❑ POLICY 0 PROJECT ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea accident) ❑ ALL OWNED AUTOS URY C ❑ SCHEDULED AUTOS BODILY rperson) d❑ HIRED AUTOS d❑ BODILY INJURY NON OWNED AUTOS (Per accident) ❑ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ❑ ❑ ANY AUTO OTHER THAN EA ACC ❑ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND ❑ WC STATU- 0 OTH- EMPLOYERS'LIABILITY WC-66006-0 09/23/14 09/23/15 TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT 500,000 OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE 500,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ELECTRICAL CONTRACTOR INCLUDING FIRE&SECURITY SYSTEM, PHONE LINES, ELECTRICAL ENGINEERING CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL F76a1O6)tlOM MAIL VILLAGE OF MIAMI SHORES 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 NE 2 AVE THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY MIAMI SHORES, FL 33138 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ` ACORD 25(2001/08)QF ©ACORD CORPORATION 1988 6caI 'Bosine s Ta Recetp Miami-Dada County, State Of Florida THIS IS NOTA BILL — DONOTPAY 4841491 � 13tJ5tIUESSN�119LS/LOCAttSafY �,R�Ce1t�T�nlo� �':° SNIIVE,ELECTRI�LENGINEERING °RN9INwt SEPTEMBER 3�4 X075 3�s LVW t25 Sr 603 o Muse be��s1ala>red ar place of pu hese C1PALO urs uAfL 33454 I? u,antto CliunYy+Cbde C1lapter8A—Ari a&Tb OWNER SEC.TXFyS OF BUSINESS P.B.YMEN't'RECEIVED SHINE I� liTENANCE El FC CPNTR 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR CtSRI' EC0001514 $45.00 `07/25/2014 Worker(s) 7 CREDITCAARD-14-029910 This local Business Tai Receipt ably ceafirms payment of the local Business Tai.The Receipt is not a liconse panni!ora certification of the botder srqnalificadapqss,,to do business. Holder,must canply witfi awry govorn- al or goggoveromental Kegylatory lauvs eltd requiremohts vrhiRh apply to We business rhe'IIECEIPT Ntr:above mf t rl splayed ori dlC.aammarcial vebi4e§`=111110 _fpads Cgdo Sec ll.476. For more Information,disituit m7amidada.anyJfexcollecta'