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EL=15-2878 Inspection Worksheet �C 15— �r '�� Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-258222 Permit Number: EL-11-15-2878 Scheduled Inspection Date: May 11,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: , Work Classification: Alteration Job Address.280 NE 91 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060190410 Project <NONE> Contractor. ELECTRICAL MASTERS INC Phone: 305-265-7996 Building Department Comments INSTALL GFI'S TO NEW BATH KITCHEN AND LAUNDRY Infractlo Passed Comments ROOM INSPECTOR COMMENTS False Inspector Comments PassedEJ CREATED AS REINSPECTION FOR INSP-258085. CREATED AS REINSPECTION FOR INSP-257953.Add the following: Move 1 smoke detector and add 1 on the 2nd floor. Dryer receptacle to be 4 wire. 1 counter receptacle. Failed Add arc fault breakers and label panel. CANCELLED BY MELISSA Correction Needed Re-Inspection ❑ ��7/ / Fee No Additional Inspections can be scheduled until re-inspection fee is paid May 10,2016 For Inspections please call: (305)762-4949 Page 18 of 26 Miami Shores Village E� Building Department NOV 12 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY. Tel:(305)7952204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No.2 5- I�U� Permit Type:Electrical JOB ADDRESS: 9,Ako AOIF- st City: Miami Shores County. Miami Dade Zip: .3135 Folio/Parcel#: jl ` Z 09 O/ Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): /(/�}-f/oNAL vg�!;-4 L 6;/r �eG phone#:,?*.f-�Xo.3 33' Address: O Ale fl JY City: 44/0ay►i• %,CA#z --S State: Zip: 2. 131 Tenant/Lessee Name: AA' Phone#• Email: CONTRACTOR:Company Nttame: C-b , JPhone#: �t� " ill Q Z G- W S W City: 0 1 State: zip: 393 r Qualifier Name: USN/A t DE) `W y .1 Phone#: State Certification or Registration#:. CA 00/3 o.S7 Certificate of Competency# - QQW03 Contact Phone#• —7 FJ6 '3 NO 92 (0:3— Email Address.- DESIGNER: ddress:DESIGNER:Architect/Engineer: A _tS4el Phone#: ,2,f31;k-1 K3� dalue,Y'Wbtk f"orthis Permit:$ . JDA Square/Linear Footage of Work: ?•� Type f Wolk:''3Address DAlteration 5(New Wepair/Replace ODemolition Desc tla"i Wbrjfi '' �A/�;�7!LL �'1 7-0 Aja/ OAM dt�'►��x-,4�- Gt�rl��y Submittal Fee$ Permit Fee$ A CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$. Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ 0 TOTAL FEE NOW DUE$l ®I S Bonding Company's Name(if applicable) �J/A Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) N 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 IIVIPROVEMENTS 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 abs a of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acrtkn�owledged before me this 12- The foregoing' ent acknowledged ac - �before m this Jam' day of NJy ,2015,by (�l4Ct . -Q t0��£�N day of ��3 ,by cQ who is personally known to me or who has produced wh y known to me or who has produced (ADENSr As identification and who did take an oath. as identification and who did take an oath. NOTARY P LIC: NOTARY PUBLIC: Sign: ^� Sign: �00 Print: �1��(��UllPr �b Print: of Pu My Commission Expires: a Notary PuWic State of Floris My Commission P' •Commission N ff 121317 ;° Sindia Alvarez Bottled 7ft*Nam = My Commission FF 156750 ` or q Expires 09/03/2018 4nYtY9Hrir�rinPnYsklFaY�Y�h4rinkde�r4nlnTr4rintrt�nTeat it4tsSn4tktk�lnta4nie�Yintik&drdtdrokt4skinkitskfinArAr4t8rdedrdrdrsSednk�Sr+k*�k�R�Yek�Trdro�•de APPROVED BY �l /��c.ol//4! Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(RvAsed 07/10/07XRevised 06/10/2009)(Revised 3/15/09) • • 9 �r E �I FL 31 783 OWN to se log onto H u � •" I a i- - .-r r ,r r ¢i �� t rte: eN„ S t n semy= is } � :Z' ! � 5°A"•^f. DETACH HERE We VWT t Al .�,., a' ±I r �1 - .y L1RIV R L t 62- �� Local Business Tax Receipt - OSVALDO Miami—Dade County, State of Florida - IOK1NlOLt6E -THIS IS NOT A BILL-DO NOT PAY F; 8400 SW 14TH , MIAMI;FL 331 erste C1f-081fI4 L B Tj 3693075 t►fiir -sem & `` } r' BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES 6A ' ELECTRICAL MASTERS INC 2016 RENEWAL 8400 SW 14 ST SEPTEMBER 30, y r + '1flL.Cq #�• 44 k 3857902 MIAMI,FL 33144 Must be displayed at place of business Pursuant to County Code iJparur+rt»nv ri a.:o?�:1rsn�Y>iD1i a.irab`6`os P,`•l.�irk -.ate,eotutary ff19f �bn tam. Chapter 8A-Art.9&10 CTQB OWNER SEC.TYPE OF BUSINESS PAYMENT RECEtVEO ELECTRICAL MASTERS INC 196 ELECTRICAL BY TAX COLLECTOR Construction Trades t ualifying Board CONTRACTOR BUSINESS CERTIFICATE OF COMPETENCY Worker(s) 3 97E000003 75.00 09/30/2015 0235-15-006628 97 E000003 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holder's qualifications,to do business.Holder most comply with any governmental or nongovernmental regulatory laws and re*dm=M which apply to the business. ELECTRICAL MASTERS INC The RECEIPT N0.above mut be displayed on all commercial vehicles—Miami-Dade Code Sec Se-276. For more information.visit w ww t iRmi4 gpy xcollector D.B.A. ® i RODRIGUEZ OSVALDO Is certified under the provisions of Chapter 10 of Miami Dade County Am- vA0E) FOR dONTRACTIN Oft W_ Muni a pal Contractor's Tax Ilei pt lams DadeCounty, State of Florida QUALIFYING TRADE(S) THIS IS NOTA BILL-DO NOT PAY 0001 ELECTRICAL 0002 BURGLAR ALARM CC NO: 978D0Q003 M C 0004 FIRE ALARM SPECLT BUSINESS NAM E/LOCATION RECEIPT NO. HBMRM M*Mr>INC EXPIRES 8400SN14Sr SEPTEMBER 30, 2016 • MIAMI,R 33144 7473132 Mora K.Setas P.E M Pursuant to County Code secretary or are Board See 10-24 M9ami-Delle c retains ao s harem www." OWNER TYPE OF BUSINESS BIUMCf1LMAS EM INC 8-13MRIM ODNTPACTOR PAYMENT RECEIVED BY TAX COLLECTOR 200.00 09/30/2015 0235-15-006628 This receipt is not valid in the following Municipalities:Avenhxa,Doral.Hialeah,Key Biscayne, Miami Garderts.Miami takes.Palmetto aay.Pirmcrest.SUnny Isles Beach.Town of Qr11er Bay. MIAM For more informidion,visit www.rrion ELECT-1 OP ID:TC ' Ac"oRv� CERTIFICATE OF LIABILITY 11/10/20INSURANCE DATE(M0/20 5 15 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 policypes)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). iPROD InsBrokers cN�� Teresa R.Carmona, Agent 8700 W.Flagler St.,Suite 270 PHONNE0 E4:305-223-2533 I FAX (AM No):305-220-0765 Miami,FL 33174 E-MAIL Teresa R.Carmona, Agent ADDRESS:tcarmonaQisurebrokers.com INSURER AFFORDING COVERAGE NAIC# INSURER A:Atain Ins.Co. 17159 INSURED Electrical Masters Inc. INSURER B: 8400 SW 14TH Street Miami,FL 33144 INSURER C: 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. INSR ADDL SUOR POLICY EFF POLICY EXP LTR TYPE OF INSURANCEIMIL POLICY NUMBER D D LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS MADE OCCUR CIP24408 12/17/2014 12/17/2015 DAMAUE TO RENTED— PREMISES Ea occurrence $ 100,00 BLANKET ADDITIONAL INSURE MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY F—I JECT F LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AESULEDAUTOSUUTTOBODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accide $ UMBRELLA UA13 HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I IRETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITYY/N STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yyeeaa describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Addtllonal Remarks Schedule,may be attached If more space is required) Electrical Contractor CERTIFICATE HOLDER CANCELLATION VILLAMS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept 10050 NE 2 Ave. AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 rj�, f �J ©1988-2014 CACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE 11'1912015 Phr .eduter: Plymouth Insurance Agency This Certlflcabe Is hued as a matte of I Wormatlon only and oorrfers no 27.39 LI.S. Highway 19 N. rWft upon Vie Certifleetia Holder. This Certit4cate does not amend,extend Holiday, FL 34691 or alter the coverage afforded by the policies below. (727)938-5562 Insurers Affording Coverage MAIC# Insured: South East Personnel Leasing, Inc. 8t Subsidiaries insurer A' Don Insurance company 11075 2739 U.S. Highway 19 N. Insurer B: Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages The es rotelisted below have been Wsued to the Insured named above for the policy period Indicated. NOW#Wtwxftany requiremeM termor condition or any contractor other dommunt with reaped to which this caMcate may be last or may pertain,the Insurance afforded by the policies described herein is subject to all the terns,exclusions,and conditions of such policies. Aggregate limits shown may have been reduced by paid dainty INSR ADOL Policy Effective Policy Expiration omits LTR INSRD Type of Insurance Policy Number Date Date (MM/DD/YY) (MM/DD/YY GENERAL LIABILITY Each Occurrence Commercial General Liability Claims Made 13 Our occurrence) ntea premises(FA cc s Mod Exp eneral aggregate limit applies per. Personal Adv injury Policy Q Project O LOC General Aggregate Products-ComplOp Agg OMOBiLE LIABILITY Combined Single unit :y Auto (EA Accident) $ Ali Owned Bodily Injury Scheduled Autos (Per Person) Hired Autos fly Injury Non-Owned Autoe (Per Accident) Property Dome" (Per Accident) EXCESSAUMBRELLA LIABILITY Each Occurrence Occur 0 Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2015 01/01/2016 x wC Statu- OTH- Employers'Liability I tory Limits ER Any prcprialm/paMer/executive officer/member E.L.Each Accident $1.000.000 excluded? NO E.L.Disease-Ea Employee $1.0001000 If Yes,describe under special provisions below. E.L.Disease-Policy Limits $1,000,000 Other I Lion insurranoe Componrlf is A.M.Best Company rated A-(Excellent), AMB#12616 Descriptions of Operations/Locatlone/Vehicles/Exclusions added by Endorsement/Special Provisions: client ID• 91-68-228 Coverage only applies to active empkW*s)of South East Personnel Leasing,Inc.&Subsidiaries that are[eased to the following latent Company": Electrical Masters,Inc. Coverage only applies to bluries Incurred by South East personnel Leasing,IIx.&Subsidiaries active employee(sl,,while working in:R. Cove does not appy to statutory employee(s)or independent contractor(s)of the alent Company or any outer entity. A list of the active employee(s)leased to the aleft Company can be wined by faxing a request to(727)937-2138 or by calling(727)938-5562. Project Name: ISSUE 114)9-15(TLD) Begin Date CERTFICATE HOLDER 2 it 1S CANCELLATION VILLAGE OF MIAMI SHORES Should any of the above described polides be cancelled before the expiration date thereof,the issuing BUILDING DEPARTMENT insurer will endeavor to"req 30 days written notice to the certificate holder named m the left but failure to do so shall impose no obligation or liability of any Idd upon the Insurer,its agents or representatives. 10050 NE 2ND AVE MIAMI SHORES, FL 33138 � �