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EL-15-2160 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-250264 Permit Number: EL-8-15-2160 Scheduled Inspection Date: January 05,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: SANCHEZ,VAL Work Classification: Alteration Job Address: 101 NW 102 Street Miami Shores, FL 33150- Phone Number (305)962-9175 Parcel Number 1131010220050 Project: <NONE> Contractor: VAL SANCHEZ, LLC Phone: (305)962-9175 Building Department Comments RENEWAL OF EXPIRED PERMIT EL2003-352 Infractio Passed comments INSPECTOR COMMENTS False RELOCATE EXISITNG OVERHEAD SERVICE INSTALL NEW 200 AMP METER COMBO INSTALL NEW GROUNDING ROD Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid January 04,2016 For Inspections please call: (305)762-4949 Page 33 of 46 Pwr MW Miami Shores Village M g E tJT►##t T�8 >=+ �I-Resttential �,. 10050 N.E.2nd Avenue NW � to cCtasstttt Yon.,Altiration "'• Miami Shores,FL 33138-0000 Phone: (305)795-2204 P zpExpiration: 02/22/201 P! Project Address Parcel Number Applicant 101 NW 102 Street 1131010220050 Miami Shores, FL 33150- Block: Lot: VAL SANCHEZ, LLC Owner Information Address Phone Cell VAL SANCHEZ, LLC 3125 SW 80 Avenue (305)962-9175 MIAMI FL 33150- 3125 SW 80 Avenue MIAMI FL 33150- Contractor(s) Phone Cell Phone $ 1,200.00 Valuation: V I ELECTRICAL CONTRACTOR INC (786)229-6066 Total Sq Feet: 0 Type of Work: Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-8-15-56834 DBPR Fee $2.25 08/26/2015 Credit Card $ 116.70 $50.00 DCA Fee $2.25 Education Surcharge $0.40 08/24/2015 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $166.70 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAV I certify that all th oregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructsand zoni . Fut above-named contractor to do the work stated. August 26, 2015 uhorized Signature: r plicant / Contractor / Agent Date Building Department Copy August 26,2015 1 Miami Shores Village STV Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY. Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No.Z/ZJ —_22&0 ' PERMIT APPLICATION sub Permit No.�/2,_C9Z_ —�-5� ❑BUILDING P0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION A— "RENEWAL r-]PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFFEE: OWNER.Name(Fee Simple Titleholder): Phone#: r 7 (7'� Address: 3P S 51-0 jam City: -State: Zip. Tenant/Lessee Name: Phone#: Email: sem' CONTRACTOR:Company Name: 0 .1, PeXIC—q ® << �-, Phone#: Address: 771091 Wes,— 30 Lq i City: a State: Zip: 3 3 1 Qualifier Name: b.%- C� Phone#: *6— ZZ2—6 66 State Certification or Registration#: E C..13 0®-6 /Q 7, Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ / =2 t—j [1 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New n ❑ Repair/Replace Demolition Description of Wrk: `'O® ifYlO C e`�(� s / � IPA)C:'_7 - 70 d A- Se 'e AIL ALAo Specify color of color thru tile: rc_. Submittal Flee$ Permit Fee$ /'vP ��®� CC( $ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ ff TOTAL FEE NOW DUE$ 1 •�� (Revised02/24/2014) t ' 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 commen ement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issue a absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. f Signatur CIASignature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 by day of 20c . by 6W t�c./� � ,who is personally known to a who i ersonally known o me or who has produced F4 0/110-it 0 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: Sign: Print: Print: Seal: Seal: o``���pG'••., SELENYS VALDtS _'• My Comm.Expires Sep 28,2016 =?• °� Notary Public-State of Florida RVAPPROVE -/�EOF F�OQ Commission#FF 144263 plans Examiner My Comm.Expires Sep 28,2018 Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 �a 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CASTRO, VICTOR M V.I. ELECTRICAL CONTRACTOR, INC 7091 WEST 30TH LANE HIALEAH FL 33018 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 STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFEpR'�.NATEGULATION Every day we work to improve the way we do business in order to EC13005973 :." U `: 08/03/2014 serve you better. For information about our services,please log onto www.myfloridalleense.com. There you can find more information CERTIFIED EI d T t ,t CONTI�AG OR about our divisions and the regulations that impact you,subscribe GASTRO,VICI :z to department newsletters and learn more about the Departments initiatives. V.I.ELECTRICRIPI& ti Our mission at the Department is:License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, tS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new license! E)pkatiw"%:AUG31,2016 L1408o3o30 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC13005973 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 ® �.® r CASTRO,VICTOR M ■ V.I. ELECTRICAL CIONTRiihft, INC 7091 WEST 3QTH LANE HIALEAH C �4'. Y Ko '4 ISSUED: 08/03/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408030004238 )06eao Local Business Tax Receipt --"Miami-Dade County, State—of Florida -THIS IS NOTA BILL DO NOT PAY 7174881 LBT BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES V 1 ELECTRICAL CONTRACTOR INC RENEWAL SEPTEMBER 30, 2016 7091 W 30 LN 7454259 Must be displayed at place of business HIA M FL 33018 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS V I ELECTRICAL CONTRACTOR INC 196 SPEC ELECTRICAL CONTRACTOR PAYMENT RECEIVED EC13005973 By TAX COLLECTOR Worker(s) 1 $45.00 07/09/2015 CHECK21-15-086095 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit or a certification of the holders qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory lavas and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miam"ade Code See 8a-276. For more Information,visit wwrw.miamidads.9gy axcolleetor City of Hialeah Business Tax Receipt 2014-15 'y�aBFU9��E� Mayor Carlos Hernandez No: 238210-171 (OLD-1731-1144) Amount: $ 150.00 The person,firm or corp.listed here has paid the business tax required to engage in or operate the business specified subject to the regulations and restrictions of the City of Hialeah,Florida Owner: VICTOR CASTRO-V I ELECTRICAL CONTRACTOR INC Type of Business:Electrical Contractors and Other Wiring Installation Contractors V I ELECTRICAL CONTRACTOR INC 7091 W 30 IN Business Location: HIALEAH, FL 33018 7091 W 30 IN Validating No.: 0000 Expires September 30, 2015 THIS IS NOT A BILL RqxxtVievw pwiofI Valle OF Room I 1l 1$ iwmxlmavm f4t90Pm vxnm 9 Im 2W VJIU8DVWALCGUHVZMMC 7�t�9SIIA� HOLIM FL Me r ntaov�era �"mahr `� �¢�sc�er oe s m ��a� +a9� amroc�b adC�aaamee#aledien46�Pq��p�;1�arMIB `�,8°,'Ne�s �tamenarpa� eaaalb.a +� �� Irorwattls �� ei. �" weUs+ � 1reama�mw ��Ta� rar-t2 �ae+o�9 ^�w 1 1 DATE(MM/DD/YYYY) ,4�© CERTIFICATE OF LIABILITY INSURANCE 08/19/2015 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 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 lieu of such endorsement(s). PRODUCER NAME: ESTHER VIDAL MUTUAL INTEREST ASSURANCE Pn"rc°NN Ext):305 860 2003 �a/c No):305-860-0907 ESTHER VIDAL E-MAIL ADDRESS:MUTUALAS OL.COM 1295 CORAL WAY INSURER(S)AFFORDING COVERAGE NAIC# MIAMI, FL 33145 INSURERA:GRANADA INSURANCE CO. INSURED INSURER B: V.I. ELECTRICAL CONTRACTORS INC INSURER C: 7091 WEST 30 LANE INSURER D: HIALEAH, FL 33018 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR D POLICY NUMBER MM/DD/YYYY MM/DD A GENERAL LIABILITY GL—B-013-5344 07/19/2015 07/19/2016 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 X POLICY PE OT- LOC $ AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIREDAUTOS $ AUTOS Per accident UMBRELLALIAS OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WRY LAMIT OTR AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 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,H 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 CITY OF MIAMI SHORES VILLAGE ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE MIAMI SHORES, FL. 33138 AUTHORIZED REPRESENTATIVE a e ©1988-2010 ACORD CdqPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and loco are registered marks of ACORD ORE Miami shores V logo Building Department �lORi1DA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage fro ontractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU LEDG THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. ' Signature: Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of 20 By who is personally known to me o as produced —as identification. Notary: :+ r� -: MM WRWA _ MY COMMISSION#FF 100402 SEAL: �A>;,t°�� EXPIRES: Pub'cuedenftrs t - V. I . ELECTRICAL CONTRACTOR INC. AND FIRE ALARM CONTRACTOR 7091 West 30th Lane, Hialeah FL 33018 License # EC13005973 Phone: (786) 229-6066 Fax: (305) 819-4380 CSBE-DBE E-mail: vielectric@comcast.net DATE 08-23-15 TO: Miami Shores Miami Dade Florida ---------------------------------------------- , who being duly sworn, depose Before me this day personally appeared Ramon Ojito Who, Being duly sworn, deposes and say : he working in the property located abode . That he will be the only person working on the project located at: 101 NW 102 ST. Miami Shore . Sworn t and described before me this day of 0,20-J,sl By �'" ' ULANCO rsonal know-- - �' ' Notary Public-State of. Florida a„ .. My Comm.Expires Jul 6.2018 o Commission#FF 121678 -------------- — -- Stamp Name of notary If you have any question contact me at 786-229-6066 Thank You Victor Castro VA Electrical Contractor Inc. President 7091 W 30 LN V.I. Electrical Contractor Inc. Hialeah, FL 33018 Comments: CONFIDENTIALITY NOTICE:this fax, including attachments, is for the sole use of the Intended recipient (s) and may contain confidential and privileged information.Any unauthorized review, use,or disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender immediately and destroy all copies of the original message. ( F �� bATE / FECHA: 0167 r 5 ?,eo eel -e5 LLC CUSTOMER NAME (The name of the person or company who will be paying for the Invoice / El Nombre de la persona 'o empress que va a pagar la factura) CUSTOMER SS # / TAX ID # MAILING ADDRESS 3/0 5 s� Ave (Direction postal a donde seA ` � 3 � mandara la factura) /�t� M� JOB LOCATION : (La Direccion donde se va ha realizar el trabajo) "i,.H,* l 33/Sd CONTACT PHONE 3 a5 - J& (# de telefono) Fill out this portion, if applicable. Complete esta porcion si es aplicable. TEMP FOR CONSTRUCTION / "TEMPORARIO -PAAM CONSTRUCION CUSTOMER NAME : (Name of the customer who will be opening the account ' / Nombre de la ersona o em resa que abrira la cuenta FPL USE OK Y SERVICE PLANNER IO AMOUNT PROCESS CONNECT ORDER ? YES NO [cus# INV# !� ® It v �. ® X Q/ J. k LOT-9 LOT-10 LOT-II LOT-12 Q '. a BLOCK-1 BLOCK-1 BLOCK BLOCK-1 J J w o u uj FIP 1/2' 4' CHAIN LINK FIP 1/2 .;':; +• NO I.D. FENCE 85.23( &m) NO I.D. . 5.00 p08 m ? `� t,&,u dee�/,�� GSJ� '•:`' I THE WEST 1/2I ' r-10.5W Z LU W / / 9 / ' / / ' ..: 's i L U- Pi UJ SF _. V.6.. LOT-14 / / / ' / / / // o . �_. BLOCK-1 STE �/ / /r// / / / CD REMAINDER o '////',� / / /// '/ N / ,� PLANTER o.sr cL 0.4 FIP 1/2' FH _.•. —2r,.00---JPLANTER STE NO I.D. EAST 1/2 I ° R=25. I �L=39.4 _ Tan= .1.5 CONC. '• .�• 0=90.20'04' FIP . I WALK NO D. ° ?. FN I.D. .:5'fAAIC Sl➢ p.ACl4 �," ?j ' r 85 � s'- .4.. —FN FIP 1/2' CDNC NOI.D: NORTH RIGHT-0F-WAY LINE i RAMP 12'PARKWAY EDGE OF PAVEMENT !' N W A 02nd ST. 16'ASPHALT PAVEMENT 5V Pa&IC AIGHT44AY