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ELC-06-1228 (2) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores FL yENTES tN 50 F�OR111)A Phone: (305)795-2204 Fax: (305)756-8972 nspection Number,1 -18287 `'` Permit Number. ELC-5-06-1228 Inspection Date: 05/25/2006 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: LLC, CAMP BISCAYNE AT THE GROVE Work Classification: Repair Job Address: 165 96 Street NE Miami Shores Village, FL 33138- Phone Number (786)290-8815 Parcel Number 1131010250130 Project: <NONE> Block: Lot: Contractor: OHMS ELECTRICAL CONTRACTOR Phone: (954)974-3840 Building Department Comments MAY 2 ® ENT'O /�J L Inspector Comments D Passed Failed Correction Needed a c Re-Inspection Fee ($75) a No Additional Inspections can be scheduled until re-inspection fee is paid. Wednesday, May 24, 2006 Page 1 of 2 Inspection History Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 ELC-5-06-1228 Electrical - Commercial Project: <NONE> Owner: CAMP BISCAYNE AT THE GROVE LLC Phone: (786)290-8815 Job Address: 165 96 Street NE Parcel: 1131010250130 Miami Shores Village, FL 33138- Block: Lot: Scheduled Insp# Inspection Type Inspection Status Inspector Date Completed 05/16/2006 INSP-17074 Final Denied/Re-Inspection Michael Devaney 5/16/2006 SEE INSPEC WORKSHEET AT JOBSITE FOR DETAILS 05/25/2006 INSP-18287 Final Pending Inspection Michael Devaney Not Complete Wednesday, May 24, 2006 Page 1 of 1 ORES Inspection Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL yENTE6 Myo F�ORIDp` Phone: (305)795-2204 Fax: (305)756-8972 z � s � ;5fr Inspection Date: 05/16/2006 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: LLC, CAMP BISCAYNE AT THE GROVE Work Classification: Repair Job Address: _ NE Miami Shores Village, FL 33138 Phone Number (786)290-8815 Parcel Number 1132060132510 Project: <NONE> Block: Lot: Contractor: OHMS ELECTRICAL CONTRACTOR Phone: (954)974-3840 Building Department Comments Inspector Comments f 7 F r -P Passed Failed ElV7-ei�.vGl�S tel? T� N6 � 2- Correction Correction i`N Needed pee g ?-.4/1/,--Lo Re-Inspection Fee spa' A p/2- ($75) Kq 17 ` Tin mx- - - 1��*'51" )'/-, No Additional Inspections can be scheduled until �7,Q re-inspection fee is paid. Monday, May 15, 2006 Page 1 of 2 02/12/2016 13:59 FAX 9549690372 OHMS ELECTRIC Z 002 OHMSE-1 OP Ip: MARZ DATE(MMIDOlYYYY) A`CORo" CERTWICATE OF LIABILITY INSURANCE 02/12/2016 THIS CERTIFICATE I,$ ISSUED AS A MATTER OF INFORMATION ONLY AND CONFER$ 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,tha policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and eonditivns of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rlghts to the certificate holder in I➢eu of such endorsements. NTACT PRODUCER NAN,,c; Javier A.FernAndez _ iSure Insurance Brokers PHONE 305.223-2533 � 8700 W.Flagler St.,Strloe 270 4,rIL� tSUreBrokersco o �{�Arc Nv) 305-220-0765 Miami FL 33174 ADELREss:Certificates Inl _ E-MlA G INSURER(S)AFFORDING COVERAGE Javier A.Fernandez E N-IC it _ INSURER A,Colony Insurance Co. _ �I INSURED OHMS Ef6trical Corp, INSURER s:Guarantee Insurance .lose Espaillat INSURER C;Progressive Express Ins. Co. 110193 1761 Banks Rd INSURER o.Torus National Insurance COm�_. Margate, FL 33063 - -- INSURER E; -- INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY"THAT THi POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION CF 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, INS _PO TYPE of 6URANCE IN POLICY NUMBER MM1DD MMIDD P LIMITS IIN A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADe OCCUR' 103GL0006S8201 70!01!2015 10/01120!6 PREml S cEa occREMIEu rBenoeI $ , 300,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,O0fl I POLICY X j T LOC 2,000,00C— PRODUCTS-COMP/CP AGG $ OTHER: SEM aNGL MIT AUTOMOOILE LIABIJIV ddft $ 1,000 00( C X ANY AUTO 01695473-3 10101/2015 10/0112016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accidont) $ AUTOS AUTOS PRO DAMAG HIRED AUTOS AUTOSWNED Per-xaldent) $.. UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ - 5,000,001 D X EXCESS LIAR CLAIMS-MADE 7724812150ALI 10/01/2015 10/01/2016 AGGREGATE $ 5,000,0DI DED RETENTION S - $ TH- WORKERS COMPENGATION XAND EMPLOYERS'LIA(31UTY sTATU ER B ANY PROPRIETOR/P{�tT?,IMEXECUTIVE YIN N WCP101266001 GIC 06/1012015 0611012016 E,L,EACH ACCIDENT $ 1,000,001 0FFI02R/MEM3ER EXCLUOED7 N/A •� — (Mandatory In NH) E.L.DISEASE•EA EMPLOYE $ 1,000,001 If yes,descrite under DESCRIPTION OF OPERATIONS bolow E-L DISEASE-POLICY LIMIT s 1,000,00' i DESCRIPTION OF OPgRA71ONS(LOCATIONS/VEHICLES (ACORD 101,Addltlonal Remarks Schedule,may he ettachvd If more space U required) ELECTRICAL WORK-WITHIN BUILDINGS CERTIFICATE HOLDER CANCELLATION MIAMIS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Building&zoning ACCORDANCE WITH THE POLICY PROVISIONS. Urbane Planning Department 10050 NE 2 Ave AUTHORIZED REPRESENTATIVE_ G Miami Shores Village, FL 33138 ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 02/12/2016 13:59 FAX 9549690372 OHMS ELECTRIC Z003 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 11.5 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301,1895 --954-831-4000 VALID'OCTOBER 1,20ILS THROUGH SEPTEMBER 30,203LG SBA. ceipt OHMS ELECTRICAL CORP 'ELECTR1CAL/ALARMS/C0N'TRACT Busiumm Name: Susine"Type,(;ELECTRICAL C6NTRACTOR) Owner Name:JOSE R ESPAILLAT Business Opened:13,/18/1997 9ruesDnwwLocatlon:1761 HANKS RD StabelCounly/CertlReg:EC 000109 MARGATE Exemption Code: IltUMV16W PhOn e: 954-97 4-39 4 0 Room% $"to �nrploys lilochlnp 1 P►oftsxlanalb For VKuMM;Suainsss OnFy Number of Wchinew VhMdkwfyNt: Tex Amount Transfer Fee NSF Fee Penalty Prior Years CoUectlon Cost Tckal Paid 27,40 0.0.0 0.00 9.00 0':OD 0.00 27.,00 i i I i THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS i TF91i,4 BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business vMhin Broward County and Is non-regulatory in nature, Yvu Must meet all County and/or Municipality planning LIMEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business Is sold, business name has changed or you have moved she business location.Thi®recelpt does not indicate that the business Is legal or that it 1s in compliance with State or local laves and regulations. 111 aliing Address: JOSE R .ESPAILLA'T Receipt, 1101A-14-0000804.6 i 1161 BANKS RD Paid 07/15/2015 27.0D MARGATE, FL 33063 1 2015 - 2016 I i . i r i i I RICK SCOTT, GOVERNOR DEPARTMENT pE STATE'OF KEN LAW-ON, SECRETARY LUSfNES ORl11A ELECTRfDAL AND PROFESSIONAL R©CENSING EI REGULATION ECo�1ss� C'tORS LICENSING BARD The ELECTRICAL 'Na e below IS CONTRAGTQR CEf2TIFIED : tcler tercvlt0rtsfChapter 4139 xpmatlon date: AUG 31,30116 ESPAILLAT .105E R OAI ASL OHMS ELECTRICAL CoppORATION 1761 BANKS RD MARGATE t:t � L 33063 t�1 ISSUED, 06%152014 � ` DISPLAY AS REQUIRED BYI-A f aEQ# 1.1406150001542