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EL-15-2594 Y C Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-251459 Permit Number: EL-10-15-2594 Scheduled Inspection Date:January 26,2016 Permit Type: Electrical- Residential Inspector: Devaney,Michael Inspection Type: Final Owner: HASSAN, BENJELLOUN Work Classification: Addition Job Address:230 NE 107 Street Miami Shores, FL 33161- Phone Number Parcel Number 1122310130670 Project: <NONE> Contractor. PINAR ELECTRIC MD INC Phone: (786)256-0812 Building Department Comments ADDITION OF GARAGE Infractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-251311. CREATED AS 12� REINSPECTION FOR INSP-251192. NO one home at 2:45 p. m.. Failed Correction Needed `f Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid January 25,2016 For Inspections please call:(305)762-4949 Page 28 of 41 12128/2015 10:31 :FL, 2S,9 1 4:PaQWP.0011001 �� CERTIFICATE OF LIABILI INSUNCE __ oA�2i2s�`ioiD_ �- _ PRODUCER Exoetlenoe Insurance Ageney THIS CERTIFICATE 19 ISSUED AS A NATTER OF INFORMATION 3901 SW 147 Avenue ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Mlaml,FL 33165 ALTER THE COVERAGE AFFORDED BY THE PPLICI ES BELOW. Phone (305)228-3900 Fax (305)126.3997 INSURERS AFFORDING COVERAGE MAIC# INSURED Pinar Electrio,MD INC I S RERA. Granada Insurance Company 00334 4910 NW 102 Ave #102 INSURER e: Normandy Insurance Company 13870 Doral,FL 33178- INSURER C: INSURER D• INSURER E COVERAGES INSURER F: THE POLICIES OF INSURANCsE LISTED 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.T"S INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLOES.AGGREGATE LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EPPEe:WA POLICY EXPIRATION LTR *=aTYPE OF INSURANCE POLICY NUMBER ATE DATE LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,()00,000 ENTED ®COMMERCIAL GENERAL LIAaury 0185FL00001837-0 08=115 08/09/16 mmmoomnnftl 100,000 ❑❑ CLAm MADE ® OCCUR MED EXP(Aryorm person) 5.000 A r-1 PERSONAL&ADV INJURY 1,000,000 ❑ GENERAL AGGREGATE 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG 2,000,000 YJ POLICY I-1 PRoJEcT [ LOC - - $5Q0 Ded Prop.DamaQ6 _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO XEaqd#dqg ALL OWNED AUTOS 9 ❑ ❑ BODILY INJURY SCHEDULED AUTOS ❑ HIRED AUTOS Per E3 NON OWNED AUTOS BODILY LY INJURY (Per eraident) ❑ PROPERTY DAMWE Per swiderg GARAGE LIABILITY AUTO ONLY•EA ACCIDENT ❑ ❑ ANY AUTO OTHER THAW EA ACC ❑ _...»_. . AUTO ONLY: AGO EXCESSIUMSRELLA LIABILITY EACH OCCURRENCE ❑ ❑ OCCUR ❑ CAMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION 8 WORKERS C01111PENSATION AND ® _•' ❑ --- EMPI.OYEW LIABILITY NHFLOW242016 11/15/15 11/15/16 _ B ANY PROPRIETOR!PARTNERI EXEC OFFICER I MEMBER EXCLUDED? UTIVE EL EACH ACCIDENT 1,000,000 If yes.describe under E.L.DISEASE-FA EMPLOYEE 110001000 SPECIAL PROVISIONS belowTHER E.L.EDISEASE*-POLICY LIMIT -- 1,()00,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS License#EC 13005412 CERTIFICATE HOLDER CANCELLATION -� - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 13B CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INOUNER WILL ENDEAVOR TO MAIL Miami Shores Village 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED To 10050 NE 2nd-Avenue TWE LEFT.BUT FAILURE TO DO 80 SHALL IMPOSE NO OMAGAT10N OR LIABILITY Miami Shores,Florida 33138.0000 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE . �Fax 30F>^758-8972 �,� �::s��•� __ Y ACORD it(2001%08)(W ®ACORD CORPORATION 1980 - 3 Miami Shores Village ' ' 10050 N.E.2nd Avenue NEE �� z "� Miami Shores,FL 33138-0000 ` Phone: (305)795-2204 �e F�si z t'It Expiration: 0412012016 I Project Address Parcel Number Applicant 230 NE 107 Street 1122310130670 BENJELLOUN HASSAN Miami Shores, FL 33161- Block: Lot: Owner Information Address Phone Cell BENJELLOUN HASSAN (305)207-0606 Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 PINAR ELECTRIC MD INC (786)256-0812 Total Sq Feet: 00 Type of Work:ADDITION OF GARAGE 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-10-15-57407 DBPR Fee $3.38 10/23/2015 Credit Card $243.96 $0.00 DCA Fee $3.38 Education Surcharge $0.40 Permit Fee-Additions/Alterations $225.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $243.96 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 AF T: I ce ' that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction I zonin . ore,I authorize the above-named contractor to do the work stated. October 23,2015 AuthoNzed Sign ,ure:Owner / pplicant / Contractor / Agent Mare Build' epartment Copy October 23,2015 1 ED Miami Shores Village cF-ly g BuildingDepartment OCT 14 p 2015 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/L. BUILDING Master Permit No,gC/S- )e% PERMIT APPLICATION Sub Permit No�//_�-- ❑BUILDING Q ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 230 N E 107 ST City: Miami Shores County: Miami Dade Zia: Folio/Parcel#c 11.2231.013.0670 Is the Building Historically Designated:Yes NO N Occupancy Type: R-1 Load: Construction Type: V-B Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):HASSAM BEJENLLOUN Phone#:786-251-0138 Address:230 NE 107 ST City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: hassanb0me.com CONTRACTOR:Company Name: PINAR ELECTRIC MD INC. Phone#• 786-256-0812 Address: 4910 NW 102 AVE#102 City: DORAL State: FL zip: 33178 Qualifier Name: ANDRES ORTA Phone#: 305-994-7957 State Certification or Registration#: EC 13005412 Certificate of Competency#: DESIGNER:Architect/Engineer: CESAR M. CANO Phone#: 305-740-7929 Address:4906 CAMPO SANO CT. City: CORAL GABLES State: FL Zip_ 33146 Value of Work for this Permit:$1.500.00 Square/Unear Footage of Work: Type of Work: M Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ADDITION OF GARAGE Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$0 (RevMMZ/24/2014) • r 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the fast inspection which occurs seven (7) days after the building permit is issued. M the absence of such posted notice, the Inspection will not be approved and a reinspection fee will be charged. n Signature Signature ER or AGENT CONTR7nowledged The fore in ' rument was acknowledged before me this The foregoing instrument was a before me this (V*M day of ®4-Mh& tom,20 15 ',by eTr"' day ofOGTmr=">�'".-- ,20 L 5 • ,by +AWJC-O#-k '�• ��&4Nho is personally known to +e► .Ol04MZb who is personally known to- me or who has produced as me or who has produced as identification and who did take an oat11111ip °°° identification and who did take an oath. SIC °i°°iii NOTARY PUBLIC: ��Q`l S�CHF� NOTARY PUBLIC: N�' SSS fYP i \SS�ON Exoi i � 4,.�O�Qti,2Q��•.• Sign: = o ®® a.•: = Sign: -srAw Prin o`• o Print. Seal: ��1°�sj° /'U81 CtStP o� Seal: A*c�SS, ��°�� 11111►Illt{1�� fill ssassssss�ssssstrssassstest►srsassssssssteteteteassssssssssssssss*ssssssssss$sssssasssssssssssssssssssssssssssssstrte o` 7 APPROVED BY � -�� Z!!X ' Plans Examiner Zoning Structural Review Clerk (Revisedo2/24/2014) RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY -STATE OF FLORIDA DEPARMNT;OF NUSIl CESS AN®PROFS SIQN�IL REGUlA�'ION i p ELSGi 1�Iki 6 � TARS NSING BARD lificloPi of n � 'MLNV1t� M.2Ih" s - -�_ ria-w +�' � - - 4e �•p�RJ�' •�� Z A� sL v 1` _. '� .. ... �-'m+.�` .. — 4 „- '.� �v tea.. aSu, Y"�q y'�,, �'Oy 4 4e• '0 ��¢ � �.�•et,,,,,,, a- ``;.��Y � ° ��"�4`^•�.;. + �° �• • X06 'k � 1�... ■ 1 � ', ,� °�''T'..•r� 4-. iia ��`�� ^Y�4.3�1 k9SUED: 06r2 M14 DISPLAY AS REQUIRED BY LAW SEO# L1406280001050 1L'o ani B silr ass' Reetw a - a - - % 0 L Miamik bade Count,�Sfia�e of��'lori�, , 4litlSlFB'NOTAM4-00NQT'PAY '•, i 51�25802� ' I BusmnaSsaantvte t ► , neC r wo expliUs PI{alAl�„'ELECTRIC_MD 1lNC RENEWAL 49ao NW ,oa n ,- X02 SBPTMB€R X,2 016 b354774: 00RAL 'FL 331.78' AA 'basPlaysd ae plana of'kualjtess' pursuant to"I Cede Chapter$A Art:.9 1o, OWNER SEC.TYPE OF;sus" k" PAYNEEIIT REC8IVED PINAR ELECTRIC MO INC 116 ELECIIRIM' BY TAX COUACTOW CONTRACTOR 70.00 X01$ Workers ) 2 EC13005412 0223-15.006839 "Ittis Looalitl Tax,t oaq p tlf-tke Locai�6nS Tax.7kat lut a oaeada @erm%orateof9iehome's �Eo Notderauestoa ty+aitbBoil or. nryeaad; +wfirot�i,v , Tba1�1�PT�. ;mueth0oaape�mralatr�I�: I�m1-�aleGo�e8ea8a,Z1B� Farmore Wsk ' .4a 20 f CERTIFICATE OF LIABILITY INSURANCE DA 0/ 1 5 PRODUCER, Excellence insurance Agency THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 3801 SW 107 Avenue ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Miami,FL 33165 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone(305)226-39W Fax (305)226-3997 _ INSURERS AFFORDING COVERAGE NAIC# INSURED Pinar Electric,MD INC INSURER A: Granada Insurance Company — - 00334 4910 NW 102 Ave #102 INSURER B: Technology Insurance INSURER Q Doral,FL 33178- INSURER D: —^ --_ INSURER E. —^— _COVERAGES �—__.._�.------ INSURER F: ----- -- ---------- THE POLICIES OF INSURANCE LISTED 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAW. JIM AOWL AMAXUM TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE p EXPIRATION LIMITS ATE DRAMWM GENERAL LIABILITY EACH OCCURRENCE 11000,000 ®COMMERCIAL GENERAL LIABILITY 0185FL00001837-0 08/09/15 08/09/16 PREMISES 100,000 ❑❑ CLAVAS MADE W OCCUR MED EXP(Any one person) 5,000 A ® ❑ PERSONAL&ADV INJURY! 1,000,000 ❑ --� GENERAL AGGREGATE 2,000,000 GEN1.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 2,00_0,000_ ® POLICY ❑PROJECT ❑ Loc _— $500 Ded Prop.Damage_ _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB ❑ ANY AUTO ((E wxkfenQ ---_.----- T^--- ❑ ALL OWNED AUTOS B [] F] SCHEDULEDAUTOS (perBODILY DlL ❑ HIRED AUTOS BODILY INJURY ❑ NON OWNED AUTOS (Per accident) ❑ --- , PROPERTY DAMAGE PeracddeM) — 1 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ❑ i❑ ANY AUTO OTHER THAN EA ACC ❑ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE — ❑ DEDUCTIBLE -- — ❑ RETENTION $ _ --�— WORKERS COMPENSATION AND ® ATU Q-�R- EMPLOYERS•LIABILITY WCC 0043627 00 11/15/14 11/15/15 B OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT 1,000,00_0 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE 1,000,000 B yes,describe under SPECIAL PROVISIONS below— — -- E.L.DISEASE-POLICY LIMIT 1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL.PROVISIONS Number 12219 Contract MCC 7040 Plan,MCC 7360 Pian EC 13005412 CERTIFICATE HOLDER CANCELLATION _ — T SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Miami Shores Village 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO Building Department THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 10050 NorthEast 2nd Ave OF ANY KIND UPON TR INSURER,ITS AGENTS OR REPRESENTATIVES. 7M=r Miami Shores Florida 33138 + A ATIVE Fax 305-756-8972 ACORD 25(2001/08)QF ---� ! — --- 0 ACORD CORPORATION 1988