EL-14-2510 S L�®
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-223463 Permit Number: EL-11-14-2510
Scheduled Inspection Date: November 18,2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type:
Owner: TURK,JAMES AND JANINE Work Classification: Temp for Cons ruction
Job Address:1275 NE 94 Street
Miami Shores, FL 33138-2946 Phone Number
Parcel Number 1132050100090
Project: <NONE>
Contractor: CARLY ELECTRICAL SERVICE Phone: 305-970-6345
Building Department Comments
Infractio Passed Comments
TEMP FOR CONSTRUCTION INSPECTOR COMMENTS
False
Inspector Comments X V P, <J1t&
Passed 4�� ��c
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 17,2014 For Inspections please call: (305)762-4949 Page 35 of 45
Miami Shores Village Iy�� n- D
Building Department NOV 1 2014
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 BY:
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No. kc_ N Cr$q
PERMIT APPLICATION Sub Permit No.P/f y♦��V
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
"5" Cp CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: —`/ Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 1—o1� Phone#:
Address: 12 �5' A F_ t
City: �11� �X.��i�t[lG� State: ` Zip:
Tenant/Lessee Name: Phone#:
Email:
hone#: r'
CONTRACTOR:Company Name:: �— �-( jam.( ,cc ICAC _SUA -C.P �`1��3Address• C@�uWGAW I�C>�LV
City: jUl/k/yk f State• M Zip:
Qualifier Name: CAl_C LU 5 96 k o AAb E z Phone#:
State Certification or Registration#: 6C 'l_3®® 5_—t `'I 2 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 8�b� Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration XNew ❑ Repair/Replace ❑ Demolition
Descriptio
SpecifyMur at wfflv�
.
Submittal Fee$ Permit Fee$ /041,04P CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ 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 appro ed and inspection fee will be charged.
Signature Signature
0/NE or AGENT CONTRACTOR
The foregoing instru et�t wa ackno/wle"dg�ed before me this The foregoing instrument was knowledged before me this
'--�day of /� ®I/ ��I",20 by day of 20 _,by
who is personally known to who iersonally know
me or who has produced C �/�l/'�G— • 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-
public Sta �•!�pRY LB�i�
Int: P NotatY F& _ 3 Print' `�': Notary PU�IIC-State of Florida
Seal a IS
MY 1C eg 00111212018 Seal?a �sd Cot "11188 n#►EE 81889
Flt oe�o� ExP �'».,4,`,;:•O� Bonded Through National Notary Assn.
APPROVED BY /Xa'd Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
STAVE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELETRIGAL CONTRACTORS LICENSING BOARD (850} ���- 395
G
� 1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
HERNANDEZ,CARLOS ALBERTO
CARLY ELECTRICAL SERVICE, INC.
680 FLAGAMI BOULEVARD
MIAMI FL 33144
Congratulations[ With this license you become one of the clearly ---
one rniNion Floridians licensed by the Department of Business and a= „m
Professional Regulation. Our pro�sionals and businesses range STATE OF FLORIDA
from aC+Chlt M to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND
and they keep Florida's economy strong. PROFESSIONAL REGULATION
-Every day we work to improve the way we do business In order to EC13006942
ISSUED: 08/03/2014 °
serve you better. For information about our services.please log onto CERTIFIED ELECTRICAL CONTRACTOR
www,ntyf cddaticem*.com. There you can find more infomtatron
about our divisions and the regulations that Impact you,subscribe HERNANDEZ,CARLOS ALBERTO
to department newsletters an learn more about the Department's CARLY ELECTRICAL SERVICE,INC.
Initiatives.
Our mission at the Department is:License Efficiently,Regulate Fairly.
We Con�s#itve to serve you better so that you can serve your is CERTIFIED ander the provisions of Ch.488 FS.
a omars. k you for doing business in Florida. m�:AUG 31.2070 �t�7
and congratulations on your new license{ e
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPART MENT OF BUSINESS AND PROFESSIONAL REGULAT ION
ELECTRICAL CONTRACTORS LICENSING BOARD
Ec�3o�saaa . . ;; : ... •
The ELECTRICAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31,2016
HERNANDEZ,CARLOS ALBERTO �6 -CARLY ELECTRICAL SERVICE, INC.680 FLAGAMI BOULEVARD E
MIAMI FL 33144
0
tssUED. 08=2014 DISPLAY AS REQUIRED BY LAVH SGCIA LUM300MG7
DATE
Acs CERTIFICATE OF LIABILITY INSURANCE 09/24/14
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 pollcypes)must be endorsed. N 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).
CONTACT
PRODUCER NAME.
MAIRO INSURANCE INC PHONE Em. (305)267-0565 ac No:(305)266-3515
2138 SIR 67 Ave ADD ss:maikoiaauraace41att.not
Miami, FL 33155
sISIME") AFROIe11Nti cwrasaoe N=s
INSURER A:ATLANTIC CASUALTY INS CO
INSURED CARLY ELECTRICAL SERVICE INC INSURER 8:FLORIDA WOPYJM COMPMSATION JUA
680 FLAGAMI BLVD INSURER C:
MIAMI FL 33144 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.
LTR TYPE OF INSURANCE POLICY NUMBERM&W Lam
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
2, COMMERCIAL.GENERAL LIABILITY PREMISES Me ocrxmerx» $ 50,000
CLAIMS-MADE ®OCCUR MED EXP(ArW one person) $ 1,000
A L 07000892-2 9/27/149/27/15 PERSONAL BADV INJURY $ 1,000,000
GENERAL. AGGREGATE $ 1,000,000
GEML AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGG $ INCL
POLICY PRO LOC $
AUTOMOBILE LIABILITY Ea acddent $
ANYAUTO BODILY INJURY(Per person) $
ALL SOEDULED BODILY INJURY(Per acddeM) $
NON-OWNED $
HIRED AUTOS AUTOS Pet amt
$
UMBRELLA LIABOCCUR EACH OCCURRENCE $
EXCESS UAB HCLAIMS-MADE AGGREGATE $
F1 DED RETENTION$ $
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY 10/10/14 10/10/15 R T I T F
B " NIA 57428048-1 E.LEACHACCIDENT $ 100,000
Lpme�ray in NH) E.L.DISEASE-EA EMPLOY $ 100,000
ESdescrbe D
Ww
DCROFF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remeft Schedule.H more space is raquired)
ELECTRICAL SERVICES
CERTIFICATE HOLDER CANCELLATION
MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
BLDG DEPT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS.
MIAMI SHORES FL 33138 _
0 1988-20CORD CORPORATION. All rights reserved.
ACORD25(2010105) The ACORD name and logo are registered marks of ACORD
. t Local Business Tax Receipt
Miami—Dade County, State of Florida
-TM IS NOT A BILL-00 NOT PAY [LBT
5040781
BUSINESS NAMBILOCATION RECEIPT NO. EXPIRES
CARLY ELECTRICAL SERVICE RENEWAL SEPTEMBER 30, 2015
INC 4356795 Must be ftkW at place of business
680 FLAGAMI BLVD Pursuant to County Code
MIAMI,FL 33144 Chapter 8A—Art.s&10
OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED
CARLY ELECTRICAL SERVICE INC 196 ELECTRICAL BY TAX COLLECTOR
CONTRACTOR 45.00 08t08t2014
woriter(s) 2 EC13005942 0230-14-009240
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