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EL-16-32 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-251200 Permit Number: EL-1-16-32 Scheduled Inspection Date: January 21,2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: h Owner: IRAHETA, MARIO AND TIFFANY Work Classification: A eration Job Address:501 NE 94 Street Miami Shores, FL 33138- Phone Number (305)754-3003 Parcel Number 1132060140850 Project: <NONE> Contractor: LANGER ELECTRIC COMPANY Phone: (786)251-8585 Building Department Comments REPLACE ELECTRICAL PANEL Infractio Passed Comments INSPECTOR COMMENTS False �C Inspector Comments Passed r CREATED AS REINSPECTION FOR INSP-251027. No one home at 4:00 E5- P. M.. Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid January 20,2016 For Inspections please call: (305)762-4949 Page 23 of 32 Permit No EL4,- Miami Shores Village Pefi l t y :Elec�cal R S ( 10050 N.E.2nd Avenue NE S11itrk 6 ss adorn Alteration. Miami Shores,FL 33138-0000 Perm,, 1, 0rmit Stator'APPROVED x ° Phone: (305)795-2204 issue 1 131211 8, Expiration: 07/112016 Project Address Parcel Number Applicant 501 NE 94 Street 1132060140850 MARIO AND TIFFANY IRAHETA Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell MARIO AND TIFFANY IRAHETA 501 NE 94 ST (305)754-3003 (786)229-7011 MIAMI SHORES FL 33138-2847 Contractor(s) Phone Cell Phone Valuation: $ 1,150.00 LANGER ELECTRIC COMPANY (786)251-8585 (305)759-5777 __.. . Total Sq Feet: 0 Type of Work:REPLACE SERVICE(150 AMPS) Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:2 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee Invoke# EL-1-16-58251 $2.00 01/07/2016 Check* 1518 $50.00 $63.20 DCA Fee $2.00 Education Surcharge $0.40 01/13/2016 Check#:1519 $63.20 $0.00 Permit Fee-Additions/Alterations $100.00 Scanning Fee $6.00 Technology Fee $1.60 Total: $113.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In acceptirig this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are requiredfor ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVZignature: Veo at I the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and authorize the above-named contractor to do the work stated. January 13, 2016 hori dwner / 61>611cant / Contractor / Agent Date Building Department Copy January 13,2016 1 Miami Shores Village - �: Building Department JAN 07 2015 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 201 y � BUILDING Master Permit No. EL?..H-2- PERMIT APPLICATION Sub Permit No. Eu(,o —32 ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION �ENEWAL F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Sd/ /16— �� inga!tT t3 City: Miami Shores County: Miami Dade Zip: �3/ 3 C� Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 10 d(� C) Phone#: Address: 5'u ( t 9 y S�- City: State: -4e Zip: Tenant/Lessee Name: Phone#: Email: / /��/ q CONTRACTOR:Company Name: L.a N6Ie9 L/eC�/� 6/r/�� Phone#: % —1� gM I Address: 66W NAS/ a / ALK AL06— . .SUt 7E- 04 City:rek i Lo u dew c/o le State: 2 t A( Zip: Qualifier Name: /-0 N n< Phone#: 9 g pl e( G q State Certification or Registration#: z(2 0000.99 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: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: P C P le C g -eeC c- 'ec / cr tit Specify colors of color thru tile: Submittal Fee$ Permit Fee$ �®�'"�'� CCF$ ( ° 2�O CO/CC$ Scanning Fee$ M Radon Fee$ CID DBPR$ Notary$ Technology Fee$ ) 0"') Training/Education Fee$ ® Double Fee$ 0 Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 6 eV� (Revised02/24/2014) N 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. s� ww"�,Iw Signature Signature OWNER or AGENT CONfRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �T day of -Tck rs is r ,20 by day of ZQ nUC 20 k k-e by t eozk4i\zt ZQrlI+eTck,who is personally known to who is personally known to me or who has produced FL-R b L_ 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: [ Signv Print: �i"r�o ri I (q Print: Seal: Seal: - - amu► Im 40 Fly SM .~ '- MY COMMISSION 4 FF24304 MY COMMISSION p FF2435N EXPIRES iww s .aom Nor)99&ot53 3GMW.0= APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION V.4 ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET (850) 487-1395 TALLAHASSEE FL 32399-0783 Q LANGER, ROGER E q, LANGER ELECTRIC COMPANY 6500 NW21ST AVENUE SUITE I FORT LAUDERDALE FL 33309 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 O from architects to yacht brokers,from boxers to barbeque restaurants. STATE F FLORIDA and they keep Florida's economy strong. DEPARTMENT OF BUSINESS AND Every day we work to improve the way we do business in order to PROFESSIONAL.REGULATION serve you better. For information about our services,please log onto ECOOOOO99 08/26/2014 www.myfloridalicense.com. There you can find more Information about our divisions and the regulations that impact you,subscribe CERTIFIED ELECTRICAL CONTRACTOR to department newsletters and learn more about the Department's LANGER,ROGER.'E: ' initiatives. LANGER ELECTRZ.-CbMp ,,ANY. Our mission at the Department is.License Efficiently, Regulate Fairly. We constant) strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the PrOVISiOnS Of Ch,489 FS and congratulations on your new license! Exnlrabnndnt(� A(IG31 7M6 L14082&=225-, DETACH HERE RICK SC-077. GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31. 2016 LANGER, ROGER E LANGER ELECTRIC COMPANY." 6500 NW 21ST AVENUE SUITE I FORT LAUDERDALE FL 33309 ISSUED 08/26/2014 DISPLAY AS REOIJIRFr) RY I I AW Rprift 1 iAn$I1)r-nAM13,5A.7 1 LANGE-2 OP ID: F4 A164 �_ " CERTIFICATE OF LIABILITY INSURANCE7IT2/17/201 5 E(MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS :RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES _OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED PRESENTATIVE 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. NAME: PHONE 1201 W Cypress Creek Rd#130 A/c No Ext:954-776-2222 FAX No; 954-776-4446 P.O.BOX 5727 E-MAIL Ft.Lauderdale,FL 33310-5727 ADDRESS: Andrew Noye,CIC,CRIS INSURERS AFFORDING COVERAGE NAIC# INSURER A:FOCI Insurance Company 10178 INSURED Langer Electric Company#1 INSURER B:National Trust Insurance Co. 20141 6500 NW 21st Ave,Suite# Langer Electric Service INSURER C:FFVA Mutual Insurance Co. 10385 Fort Lauderdale,FL 33309 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. IN D BR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I—XI OCCUR GL0016519 03/10/2015 03/10/2016 Eff- PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[X]JECT LOC f PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X Ea accident $ 1,000,000 ANY AUTO CA0026498 03/10/2015 03/10/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED DAMAGE AUTOS Per acr ident $ X UMBRELLA LIARJXTOLCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB AIMS-MADE UMB0018524 03/10/2015 03/10/2016 AGGREGATE $ 5,000,00 DED X , RETENTION$ 0 WORKERS COMPENSATION AND EMPLOYERS,LIABILITY X STATUTE ER H C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WC84000300132016 01/01/2016 01/01/2017 OFFICER/MEMBER EXCLUDED? El N/A E.L.EACHACCIDENT $ 500,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500 000 Ii es,describe under , DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Equipment Floater CM0008069 03/10/2015 03/10/2016 Leased& Rented 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) License#EC0000099 CERTIFICATE HOLDER CANCELLATION MIAMIA r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I{ Miami Shores Building&Zoning THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores, FL 33128 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 000118 T_ Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS .NOTA BILL - DONOT PAY L I B 253781 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES LANGER ELECTRIC COMPANY RENEWAL SEPTEMBER 30, 2016 DOING BUS IN DADE CO 253781 Must be displayed at place of business MIAMI FL 33000 Pursuant to County Code Chapter 8A-Art 9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED LANGER ELECTRIC COMPANY 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR Worker(s) 10 EC0000099 $75.00 08/26/2015 CREDITCARD-15-042571 This Local Business Tax Receipt only confines payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holder's qualifications,to do business.Holdermust comply with any governmental or nongovernmental regulatory laws and requirements which apply to the busing. The RECEIPT N0.above must he displayed on all commercial vehicles-Miami4ade Code Sec 8a-276. For more information,visit www.miamidade.gov/bexcolloctor