EL-16-1231 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-259956 Permit Number: EL-5-16-1231
Scheduled Inspection Date: June 01,2016 Permit Type: Electrical- Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: DESPAIGNE,CECILIA Work Classification: Service Change
Job Address:105 NE 95 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060132720
Project: <NONE>
Contractor: LANGER ELECTRIC COMPANY Phone:(786)251-8585
Building Department Comments
NEED WORK TO OPEN LOCK ON MTER TO Infractio Passed Comments
REMOVE/REPLACE INTERIOR SQD 150 AMP MAIN/SUB INSPECTOR COMMENTS False
PANEL.
Inspector Comments
Passed 21
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
May 31,2016 For Inspections please call: (305)7624949 Page 34 of 45
r, Miami Shores Village `
10050 N.E.2nd Avenue NES '{ a
Miami Shores,FL 33138-0000
Phone: (305)795-2204
Expiration: 11/05/2016
Project Address Parcel Number Applicant
105 NE 95 Street 1132060132720
Miami Shores, FL 33138- stock: Lot: CECILIA DESPAIGNE
Owner Information Address Phone Cell
CECILIA DESPAIGNE 105 NE 95 Street
MIAMI SHORES FL 33138-2708
Contractor(s) Phone Cell Phone Valuation: $ 1,000.00
1-8585
LANGER ELECTRIC COMPANY (786)25 (305)759-5777
Total Sq Feet: 0
Type of Work:NEED WORK TO OPEN LOCK ON MTER TO R Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Review Electrical
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# EL-5-16-59696
$2.25 05/09/2016 Check#:7426 $ 115.10 $50.00
DCA Fee $2,25
Education Surcharge $0.20 05/06/2016 Check#:7484 $50.00 $0.00
Permit Fee-Additions/Aiterations $150.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $165.10
In considirbtion 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 tPis permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required forELECTRICAL,PLUMBING,MECHA L,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that a rmation is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermor t ori the above amed contractor to do the work stated.
May 09,2016
Authorized Sign or �Jcan�mtractor / Agent Date
Building Depairtr
May 09,2016 1
M Y d 6 2016 .
Miami Shores Village
. .
Buliding Department
r��
1WS0 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fac(305)7S6-8972 •�`l
INSPECTION UNE PHONE NUMBER:(305)762-W9
FBC 2CW-t
BUILDING atwW Permit No. 12
PERMIT APPLICATION Sub Permit No.
(BUILDING M ELECTRIC ❑ ROOFING REVISION ❑EXTENSION ❑RENEWAL
[]PLUMBING 0 MECHANICAL OPUBLIC WORKS [] CHANGE OF 0 CANCELLATION M SHOP
4E-5 CONTRACTOR DRAWINGS
,OBADDRESS: 105 W> 95 Street
city., Miami Shores County Miami Dade 2io•
Foft/parceM:11-3206-013-2720 is the BuNdbig Historkaft :Yes NO
Occupancy Type: Load: Construction Type: Electric Float Zone: SFE: FFE:
OWNER:Name(Fee Simple*rfdehoider):Cecilia M Despaigne phot 786-238-6362
Address:105 NE 95 Stmt
Cid Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Same Phone#:
Email:.cdmpigne@gmall.com
CONTRACTOR.Company Name: Langer EleGtk Company Phone#: 954-984$489
Address: 6500 NW 21 Avenue,#1
Fort Lauderdale Ste: Florida AP: 33309
Qualifier Name: Roger Langer Phone#: 954'984'$489
State Certification or Registration#: EC0000099 Certificate of Competency M.
DESIGNER:Architect/Engineer. Phone#:
Address: City: State: Zip:
value of Work fw thb Pennlli:$ 1, 600 -01d sgwweAbww Footage of Work
Type of Work ❑ Addition ❑ Alteration ❑ New M Repair/Replace ❑ Demolition
Description of Wim: reed work with with to open lock on meter to remove/replace interior SOD 150amp
main/sub panel.
Specify color of color thru tile:
Submittal Fee 9 .M PenmR In$ /,3�®.�b CCF$ C) 60 co/CC$
Scanty ft Fee$ - CD Radon Fee$ Q• ZIS DBPR$ -92. P� Notary$, _
Tedmolow fee$ ' w Traim ft In$ o Dwble Fn$
Structural RevWws$ Bowl$
TOTAL FEE NOW DU-E-�
$
(Rewbedo2/24/2014)
a
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. 1 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 Applkant: As a condition to the Issuance of a building permit with an estimated value exceeding$25W,the applicant must
promise In good faith that a copy of the natke 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,f'i'rst Inspection which occurs seven 17) days after the building permit is , n the absence of such posted notice, the
Inspection will not be approved and a reinspection fee will be charged
Signatu 'M Signature
OWNER or AGENT C CTOR
The foregoing instrument was edged before me this The foregoing instrument was acknowledged before me this
2'9 day of 20 /(Q ,by _day of WA4 �20 ,by
Cec i& M DrA" v,�who is personally known to OC���r1 "x:: ,who is personally knom to
_ U"'
me or who has produced FL. 'b Z i 2- 13-157-4lr-0 as me or who has produced as
Identification and who did take an oath, identification and who did take an oath.
NOTARY PUBUC: NOTARY PUBLIC:
Sign:
Print: L Print: C
Seal: Seal ` ,
FUNWI.I.A 81Nt
�aAY poo RW Milds¢ -': .: Mil COMMiSSKOi#FF243534
a esNoWyEXPIRES June 23,2M9
(��p assotas
i�RFiilIiititiitiitttttiittitttiitittttittt
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COMMMM FF 9M
APPROVED BY No. Plans Examiner Zoning
Structural Review Clerk
(RwbeM2/24/2014)
• ''�'�1 LANCE-2 01'ID:F4
CERTIFICATE OF LIABILITY INSURANCE 031�'4n�ll
THIS COMFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THit
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 osrtNicate 1101der is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies my require an sndorsernent A statement on this certificate doss not confer rights to the
cortlfieste holder In lieu of such endorseme s
PRMCER
tM W Cypress rown Creeok Rd 0130 gal'.154778.2222 IA& 954-7784446
P.O.Box 5727 -�
Ft Lauderdale,FL 33.310-7727 N---E
Andrew Noye,CIC,CRIS WMERM"Po"NOCCARMAN NMI
wsurseRA:Amerlsum Mutual Ins.Co. 23396
�+►� Langer Electric Comluany w6uma:North River Insurance Company 21105
Langer Electric Service Co uTIupin c,FFVA Mutual Insurance On 10385
6500 NW 21st Ave,Suitt:#1
Fort Lauderdale,FL 33309 wwrm o:
IN e:
wSILMIE f F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMB
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 REQUIREMIENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDE;O BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TTP@ OF PMRANCH POLICY NUMM as P LaltTe
A 0010 INCIAL ONGWAL LIA3DJTY BACH O00UPAENCE s 1,000,0
CLAfr**ADE 0 OCCUR GL210036400 03/1012016 03!1012017 $ 100.0
MED EV VkkW ax, ; 5,004
_ PIABCNAL A ADV INJURY at 1,000,
OeRL AGREOATE LIMIT APPLIES PM ON AOMOATE S 7.000,
i�OLicv 0PRO- ID� L00 PRODUcrs.COMPMP AGO s 2,000,
an am. $ 11000,
AUTOMOS E UANUTY 9 1,000,
A X ANY A JTo CA210036200 03M 012M16 0311012017 3001LY INJURY(Per I ) 5
ALL LIMED SCHE0111 E0
AUrCe {u/T� 1I=LY INJURY(Per eeddeat) I
X HIRED AUTOS X4VNP d R — 6
S
)( uMar>Et u1 LUiB X OCCUR E?AGH 00CURRENCE s 5,000.0
B a SstaAe
CLAIMS-NAM 11065146 03M0 W$ 03/10!2017 AQWK0ATr, s 8,000,0
dED X I RESENTM s 0 m<
woraueas coaPensaTroN
AND 11IRPLOYEW LL4eLrTY X FATUM
C ANYPROPRETORIPARTNEkd3x /:IVE YIN 32915 01M11Z016 01/01/2017 EL.fACHACCaQENT 3 500.0
CFFlt2> NBM EXCLUDfiD7 ®N!A
Ig1l datoy M N LL,tHS6ASB•EA EMPWM 5 500.
RATRM bNew E.L.DISEASE.POLI ♦ 500,0
A Equipment Floater IM210030600 03110f2016 03MWM7 Leased&
Rented 100,9
DE.RCRJPNW OF OPERATI M 1 LOCATtONB I VBMCt9(ACCRa7101.Add!ICMKI R=Wks 60Mf.I*.MY a»etteebed If mac MM Ie ntaA*d)
License#EC0000099
CERTIFICATE HOLDER CANCE=LLATYON
MIAMi-1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 136 CANCELLED BEFORE
Miami Shores Building$►Zonis THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
g 9 ACCORDANCE WITH THE POLICY PROVISION5.
10050 NE 2nd Ave
Miami Shores,FL 33125 AUTN+MMftW*B$wl'rA"V0
®1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo am registered marks of ACORD
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