The URL can be used to link to this page

EL-15-451 2c ILI — ZI 0/ Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-248464 Permit Number: EL-3-15-451 Scheduled Inspection Date: November 30,2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael YP Inspection Type: Final P Owner: WALLACE,JOHN Work Classification: Addition Job Address:518 NE 106 Street Miami Shores, FL 33138-2046 Phone Number Parcel Number 1122310140211 Project: <NONE> Contractor: ATLANTIS ELECTRICAL CORP Phone: (305)551-4043 Building Department Comments Electrical work as per plans FOR NEW ADDITION. Infractio Passed Comments INCLUDE 2 SMOKE DETECTORS,2 INTERIOR LIGHTS,3 INSPECTOR COMMENTS False EXTERIOR LIGHTS 28 INTERIOR SWITCHES AND OUTLETS,3 EXT OUTLETS AND NEW UNDERGROUND SERVICE. Inspector Comments Passed E� Failed v lip is Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid November 25,2015 For Inspections please call: (305)762-4949 Page 26 of 36 Miami Shores Village Building Department De t MS 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 . Tel:(305)795-2204 Fax:(305)756-8972 7MAR INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20(CS r?0 BUILDING Master Permit No. '"' 1_1' s: Jl PERMIT APPLICATION sub Permit No. (z ❑BUILDING ELECTRIC ❑ ROOFING \_\❑ REVISION ❑ EXTENSION ❑RENEWAL LUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: o Folio/Parcel#: I[-ZZ3 j` o1q , Is the Building Historically Designated:Yes NO CI Occupancy Type: Load: Construction Type: Flood Zone:_ j O BFE: FFE: OWNER: Name(Fee Simple Titleholder): �o\'kv 04-L�(�d Phone#.-ZO3 Address: �l 01125 10(0 51T_ �j v City: �-\ ( l State: G c— Zip: �0 •Tenant/Lessee Name: I Phone#: Email: CONTRACTOR:Company Name: ��Sl.L��{ Phone#: Address: I S$ City: g lam i State: L Zip: 3S(_q5 Qualifier Name: D>;anwi`�G� �P«2 Phone#: State Certification or Registration#: &C Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: Square/Linear Footage of Work: Type of Work: P Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 15 � f4UW_ At Pfd P[-WC 2 N(!jJ ) A9P1 g70Aj -M Ifyc-&up(K fAD � � LJ_G (s) rWM;arCyL t_1fit'+f'S Specify color of color thru tile: Submittal Fee$ Permit Fee$ ,g t41®V� CCF$ CO/CC$ Ocanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$.a-'43. 2,3 (Revised02/24/2014) 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. SignatureAJ• GL_ Signature fp OWNER or AGENT CONTRACTOR The forego g instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _day of PC awe 20 by Z day of NkP42-(- 20 �.� by who is personally known to C! who is personally known to me or who has produced, 4LfS' '4n as me or who has produced 15, as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: int-.Vol.- Notary Public State of Florida Print: Joanna a My Commission FF 082753�,� Seal: ''"'"'. �� Exp�re8 011121201 s �REBECA M.PASTRANA nF s. MY COMMISSION H EES72624 EXPIRES:February 07.2017 av Meffi**�kxexeakakak*****�k*�k�k*4�k*�k�k�ksk�k�k�kffi****+F�k�k+kik+F4�k�k�k�k�k�k�kt�*�k�k*Kc�k�k+k�k4*�k�k*�k%��k�k*�k*�kN��k*Me*�kak�k�k�kak+k+kik**+k+k�t��k�k*�k�k�k�k&******N�Ke APPROVED BY ��®lL,�w Pians Examiner Zoning Structural Review Clerk (Revised02/24/2014) rr ATLEL-1 OP ID:MA ACORD� DATE(MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 02/27/2015 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 pollcy(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 CONTACT MARIANA GONZALEZ BUTLER,BUCKLEY,DEETS INC. PHONE 786-216-1778 FAXNo:B05-262-0187 6161 BLUE LAGOON DR.,STE 420 AIC No Ext MIAMI,FL 33126 E-MAIL MARIANA BBDINS.COM Mariana Gonzalez ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERAMESCO INSURANCE COMPANY INSURED ATLANTIS ELECTRICAL CORP. INSURER B: 12803 SW 20TH TERRACE MIAMI,FL 33175 INSURER C: INSURER D: 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. INSR TYPE OF INSURANCE DDL R POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MM/DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY WPP1138623 01 02/10/2015 02/10/2016 PREMISES Ea occurrence $ 100,000 CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY JECTPRO LOC $ AUTOMOBILE LIABILITY Ee COMBINED.IdnSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOOr AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS PER ACCIDENT UMBRELLA LI18 HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMI ER ANY PROPRIETOR/PARTNER/EXECUTIVEE. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ L N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,K more space is required) ELECTRICAL CONTRACTOR CERTIFICATE HOLDER CANCELLATION MIASHVI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VILLAGE OF MIAMI SHORES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING$ZONING ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N E 2 AVE. MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE ed ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD