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EL-16-95 V � Inspection Worksheet Miami Shores Village ► ' 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-254393 Permit Number: EL-1-16-95 Scheduled Inspection Date: March 14,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: WHITEHEAD, MICHAEL Work Classification: Solar Job Address:150 NW 98 Street Miami Shores,FL 33138- Phone Number (305)889-2881 Parcel Number 1131010260050 Project: <NONE> Contractor: CORONADO CUSTOM HOMES INC Phone: (863)381-6083 Building Department Comments 9.6 KW ROOF TOP"PV"SOLAR ELECTRICAL SYSTEM. Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-250854. Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-Inspection fee is paid March 14,2016 For Inspections please call: (305)762-4949 Page 30 of 40 ��� � --_-_# �� � .���Vit, ``'Esq' i- }a "• �r Miami Shores Village 10050 N.E.2nd Avenue NW "'• Miami Shores,FL 331380000 I` 'mss Phone: (305)795-2204 , Expiration: 08/0712016 Project Address Parcel Number Applicant 150 NW 98 Street 1131010260050 MICHAEL WHITEHEAD Miami Shores, FL 33138- Block: Lot: Owner information Address Phone Cell MICHAEL WHITEHEAD 150 NW 98 Street (305)889-2881 MIAMI SHORES FL 33150- 150 NW 98 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone $ 22,000.00 Valuation: CORONADOyCUSTOM HOMES INC (863)381-6083 Total Sq Feet: 570 Type of Work:9.6 KW ROOF TOP"PV"SOLAR ELECTRIC Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:6 Review Electrical Review Electrical Review Planning Review Building Review Structural Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $13.20 Invoice# EL-1-16-58322 DBPR Fee $11.55 01/13/2016 CreditCard $50.00 $921.30 DCA Fee $11.55 Education Surcharge $4.40 02/09/2016 Credit Card $921.30 $0.00 Notary Fee $5.00 Permit Fee-Additions/Alterations $770.00 Pian Review Fee $120.00 Scanning Fee $18.00 Technology Fee $17.60 Total: $971.30 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the f r oIng information is accurate and that all work will be done in compliance with all applicable laws regulating constructio d zoning. Futhermore,I autho a above-named contractor to do the work stated. February 09,2016 A nature:Owner / Applicant / Contracto / Agent ate Building Department Copy February 09,2016 ol�7���� Miami Shores Villa e � ° °� g Building Department artment JAN � � ?o,s (� ' _ 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 �('�C��• Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 - !-t- ti FBC 20(q BUILDING Master Permit No. �-- I PERMIT APPLICATION Sub Permit No. ❑BUILDING M ELECTRIC ❑ ROOFING E] REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: O t7 rJ 6.1 Cl 7 t-, S I" City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 01, O 2 to -%)DSO Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: I Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):,�j� -, e l (A L.[4e L e-rA d Phone#:3 0 g--- % - 2?7I � �—� !C r��, Address: I � � � City: hNke�L'o"a State: / Zip: :3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 2) I h .SL�r.� ale ���, .L.cte+� Pone#: �$ �'� '3°� b flY3 Address: '3001 Gzd® -V%V, City:- G et w d L9 -State: r L- Zip: Qualifier Name: An i c YAe a Phone#: 2 State Certification or Registration#:� �, �'(, Q �1 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: StateZip: Value of Work for this Permit:$�� Square/Linear Footage of Work: 5-90 Type of Work: ❑ Addition ❑ Alteration ❑ New 1' ❑ Repair/Replace ❑ Demolition Description of Work: 9.o cs ��i') '� 1� S o e r sL Le.e e i Specify color of color thru tile: Submittal Fee$ ;0 « Permit Fee$ CCF$ CO/CC$ Scanning Fee$ CB Radon Fee$ DBPR$ f 1 . Notary$ Technology Fee$ 1 - Training/Education Fee$ (3 Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (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. Signature Signature fjD�� OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of U 20 16 ,by �_day of 20 ,by Mi p 1A Az(1� gR(- t Z ?Is personally known to 1��NN)S LTi 1� IM .who is personally known to me or who has produced FL`� N�V_ as me or who has produced 'c U 0M1M identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY BLIC: 4Sign: Sign• Print: S A Print: Q1 NR>(8 NU A ee� Seal: saw°y. Notary Public State of Florida Seal: " �^ Sindia Alvarez X40 V. Notary Public State of Florida "� c My Commission FF 156750 My Bare FF 156750 'Fofp�gt�� Expires 09/03/2018 �g Y t�pt Expires 09!03!2018 ******************************************** ***************************** d44VI APPROVED BY Plans Examiner Zoning Structural Review �-/�-�l •��� (Revised02/24/2014) t i�ljll .... oma Miami shores Village Building Department R 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION I NTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT COPY OF LIABILITY INSURANCE* a COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: C o no arc- BUSINESS ADDRESS: 3 O 01 <.'e-,r)orA ' ay-ir CITY"-1--STATE 0, ZIP �31FT BUSINESS PHONE: p( �'3 ) '3 �(��'� FAX NUMBER( _) Y S 'i-1-10 6 CELL PHONE QUALIFIER'S NAME: I ham►c �.�-- QUALIFIER'S LIC NUMBER: G �� 0 C1 STATE OF FLORIDA .2 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CVC56809 ISSUED: 06/08/2014 CERTIFIED SOLAR CONTRACTOR MEE, DENNIS KEITH CORONADO CWTOW HOMES INC IS CERTIFIED under the provisions of Ch.489 FS. Expiration date:AUG 31,2016 L1406080001651 01/12/2016 16:02 8634715438 CITY OF SEBRING PAGE 01/01 MEE, DENNIS CITY OF SESPING, FLORIDA (863)381-6083 LOCAL, BUSINESS TAX RECEIPT N° 4983 368 S. COMMERCE AVE, SEBRING, FL 33870 PERMIT YEAR OCT 1, 2015 THROUGH SEPT 30, 2016 License 26.26 Address: 3001 CEDORA TERRACE Penalty Transfer Activity: SOLAR CONTRACTOR CV056809 Fire Prev 5.00 Administr 6.00 Total Paid 36.25 Issued to: CORONADO CUSTOM HOMES INC. MEE, DENNIS 3001 CEDORA TERRACE SEBRING, FL 33870 MUST BE DXSPLAYED IN A CONSPXCUOUS PLACE 30) `'� ACORO® DATE(MM/DD/YYY1� `, ,,� CERTIFICATE OF LIABILITY INSURANCE 1/12/2016 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 CONT NAMA FrankCrum Insurance Agency, Inc. PHONE (727)412-7765 FAX .(727)608-1526 100 South Missouri Avenue .D L .FOIA@frankcrum.com INSURER AFFORDING COVERAGE MAIC @ Clearwater FL 33756 INSURER AAccident Insurance Company 11573 INSURED INSURER B Coronado Custom Homes, Inc. DBA Coronado Solar INSURER C: 3001 Cedora Terrace INSURER D: INSURER E: Sebring FL 33870 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. tLT R ADDTYPE OF INSURANCE L R POU NUMBS POLICY EFF POLICY EXP pplyrm LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE �OCCUR PR I E T RENTED $ 100,000 ES IE occurrence) CPP000991302 9/16/2015 9/16/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 $ POLICY❑JP& F]LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY C OMBIN IN LI 91= $ Eg a.cident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS AUNOSWNED Par accident) DAMAGE $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS IJAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION PE OTH- AND EMPLOYERS'UA131UTY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/IXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? F N/A @lIandeftrY In NH) E.L.DISEASE-EA EMPLOYE $ Bdescribe under DESCRIPTION OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT $ 1 1 1 ---[ I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached K more space Is required) Repairs & solar installation contractor and roofing with no hot work. CBC1253671 - Builder License / CCC1326519 - Roof License / CVC56809 - Solar License CERTIFICATE HOLDER CANCELLATION felicianoj@miamishoresvill SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE Miami Shores, FL 33138 AUTHORIZEDREPRESE14TATNE Matt Crum/RS ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 tgm4nii CERTIFICATE OF LIABILITY INSURANCE 1 2oD1 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 CONTACT NAME: PHONE WC,No : 1-800-277-1620 x4800 FAX AID No): 797-0704 FrankCrum Insurance Agency,Inc. E-MAIL ADDRESS: 100 South Missouri Avenue INSURERS AFFORDING COVERAGE NAICO Clearwater FL 33756 INSURER A: Frank Winston Crum Insurance Co. 11600 INSURED INSURER B: INSURER C: FrankCrum UC/F Coronado Custom Homes,Inc. INSURER D: 100 South Missouri Avenue INSURER E: Clearwater.FL 33756 INSURER F: COVERAGES CERTIFICATE NUMBER: 332571 REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME 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. am TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS WORD WOVD 001 fff" OMM/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL.LIABILITY DAMAGE TO RENTED PREMISES Wa omurrertce $ CLAIMS-MADE F—IOCCUR MED EXP(Nry are person) $ PERSONAL&ADV INJURY $ GENERAL.AGGREGATE $ GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ POLICY PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ecc dent ANY AUTO BODILY INJURY $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per aoddeN) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS $ UMBRELLA LIAR OCCUR EACH OCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND WC201600000 01/01/2016 01/01/2017 X WC STAMORY OR A EMPLOYERS'LIABILITY Y/N LIMITS ER ANY PROPRIETORPARTNEPAD EOUnVE OFT-ICERIMEABER EXCL UDED? Q N/A E.L.EACH ACCIDENT $1.000.000 ohndarory in NH) Iym,desaftrader E.L DISEASE-FA EMPLOYEE 1000000 DESCRIPTION OF OPERATIONS be ow E DISEASE-POLICY IT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,AdManai Remarks,Schedule,H more space Is requlreM Effective 09/26/2005,coverage is for 100%of the employees of FrankCrum leased to Coronado Custom Homes,Inc.(Client)for whom the client is reporting hours to FrankCrum.Coverage Is not extended to statutory employees. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village Bldg.Dept. AUTHORIZED REPAPENTATIVE 10050 NE 2nd Ave. -07 Miami Shores,FL 33138 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are.registered marks of ACORD