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EL-15-687 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-252993 Permit Number: EL-3-15-687 Scheduled Inspection Date: February 29,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: MARKUS, DAVID Work Classification: Alteration Job Address:1190 NE 92 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132050270460 Project <NONE> Contractor. FRONT LINE ELECTRIC LLC Phone: (561)777-8835 Building Department Comments REMODEL KITCHEN APPLIANCE NEW GFI'S SMALL tnfractlo Passed Comments APPLIANCES LIGHTING&SWITCHES PER FINAL INSPECTOR COMMENTS False DESIGN PLANS Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-252678. CREATED AS 19 REINSPECTION FOR INSP-252544. No access at 3:10 p m. 16 feb. 16 Need arc fault breakers and repair connection to G. F. I. breaker. Failed Correction ❑ �� Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid February 26,2016 For Inspections please call: (305)762-4949 Page 29 of 60 Miami Shores Village ; 10050 N.E.2nd Avenue NE , . Miami Shores,FL 33138-0000 Phone: (305)795-22043 nu ... _ m. •Tr Expiration: 11J0812015 Project Address Parcel Number Applicant 1190 NE 92 Street 1132050270460 DAVID MARKUS Miami Shores, FL 33138- Block: Lot: Owner information Address Phone Cell DAVID MARKUS 1190 NE 92 Street MIAMI SHORES FL 33138-2935 Contractor(s) Phone Cell Phone $4,780.00 FRONT LINE ELECTRIC LLC (561)777-8835 Valuation: Total Sq Feet: 00 Type of Work:REMODEL KITCHEN APPLIANCE NEW GFI'S Available Inspections: Additional Info: Classification:Residential inspection Type: Review Electrical Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 invoice# EL-3-15-54952 DBPR Fee $2.51 05/12/2015 Check#:3105 $ 139.32 $50.00 DCA Fee $2.51 Education Surcharge $1.00 03/28/2015 Credit Card $50.00 $0.00 Permit Fee-Addidons/Afterations $167.30 Scanning Fee $9.00 Technology Fee $4.00 Total: $189.32 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 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 zo g. F ore,I authorize the above-named cont r r to do the work stated. May 12,2015 Autho Slgnatu Owner / Applicant / Contractor / Agent Date Building Department Copy May 12,2015 1 r Miami Shores Village MAS 26 2015 Building Department L� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC/20 10 BUILDING Master Permit No.�c / .5_- ,- t- PERMIT APPLICATION Sub Permit No.cj /C— ❑BUILDING dELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑MECHANICAL [:]PUBLICWORKS [] CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I (iQ A16- !qa ,97— City: Miami Shores County Miami Dade Zip• f 2f Folio/Parcel#:_ i9woD Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Tltleholder): 1 Ib S, Phone#: 5 AddressS '` City: � OkIA� !2tu, State: F7-L- Zip: 3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 19461 l./ t 8 &:d -o Phone#:�� Address: tJ City: 6NAOZ24 State: Zip: 13 Qualifier Name: iLI=v - Phone#: State Certification or Registration#: EV1 1301 q95:3� Certificate of Competency#: DESIGNER:Architect/Engineer: T tdAk Phone#: yn-s�, Address: X35 C, C'4glIt5(fIZ..636AM.r -Wq City:46141 �'7iyr-5EMtate: _Zip:"&330Y/ Value of Work for this Permit:$ 1 /�O eq-�- Square/Unear Footage of Work: f DQ S&. tc-r— Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 62EW1>f:_=L_ (C{' { 'Ist�1C° tt� A .C!4f4Gf ftei wAAKe-m i J_16*PriA sial RELO MAL �0516n1 PLANS Specify color of color thru We Submittal Fee$ Permit Fee$ /AZ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ T-OTAtDUE� (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 flrst inspection which occurs seven(7) days after the building permit Is issued. In the absence of suc posted notice, the Inspection will not be appy a and a r In ection fee will be charged. )c Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2 7 day of- 4 (Ilia 20�by _��day of --�U �� 20 i S'' by [_� ' 'Y�t21�(i5 who is personally known to LQ5 L--r who is personally known to me or who has produced L— 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: ptll Sign: Sign: Print: t S Ls p�L'Yi Print: l� L S L L Seal: LO131EPPER ��::,; � LOIS1EPPER * * IN COMMISSION#FF 045244 Seal: * * MY COMMISSION#FF 045244 e EXPIRES:Segember 9,2017 EXPIRES:September 9,2017 `O 8=W Thru aprt� Budg�NotaryBervkes BmMThruBudgditryBervim ####ffi####ffiffi###ffi###ffiffi#ffiffiffiffi#####ffi###ffi####ffi#ffi###ffiffiffi###ffiffi##ffiffi###ffi##ffi####ffi###ffi##ffi##ffi##ffi#########ffi##ffiffi##ffi#ffi###ffi#ffiffi AAPPROVED BY 174</ i/a Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 11/14/2014 09:48M 561777.8873 K:ELECTRIC PAGE 02/04 T - r . � R, +Mf iVA� f;ii7 ELECTAIdA.CONTRACYORS UCENSING-'WMO {850}457.1395 1940 NORTH MONROE STREET TALLAHASSEE FL 323990783 FggW� NETHt3JR RONT LINE ELECTRIC,LLC 5072 PINNACLE PASS WAY KWNTON BEACH FL 33473 a#ne m F �oara bVVIM y' from ercf►16sRgrs tram m' r8Y'AYE AF LG13! 1 • fie. � � , � �IN�ESSro 0 and t W kM Fto<Pale's economy stnuo. . wmrO r-a Wpm oft •fie way we#ob besa to oto 8s9i 43. X90'14 itu�\ ,'t WIC pqon .q ■obw our wvw".own�y� rMtcqntnd d tI.V ttdd you, TO ,.. to dwwb—,Wt rmvwsom ow ma ebb*."Depwknows Our at Ow Q Anent I Uoena� y,Rsph is Ia" V%oQ ddw toavowb9ft sio ttdA you can sante Baur rB. yya�,�r buNneas In R6tds, f q _ i ,p�ovt�roiie/r i oa#f'fuzand conwakdWord DETACH HERE RICK SCOTT,t90YERNt?R _ _ « 04 LAWSON,UCR,E1'ARY •8.1'A'1�:01'�.ft' A � N. •�.��.�'�y..�w�,.r'••raF+• 1•'4 a•' T �,�• 1-. ;�.,.'•� tib•',' '4 �•S ,,ate V 't r. s Client#:25021 FRONTLIN �,rAC1DATE(MMlDDIYYYI� ORD- CERTIFICATE OF LIABILITY INSURANCE 1/26/2015 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 policy(les)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). PRODUCER W.cT Joyce Simpson Cypress Insurance Group PAIL No ;954 771-0300 MAIC,No): 954 772 8424 PO Box 9328 ""'L o Fort Lauderdale,FL 33310-9328 Awe JyceS @CYpresslnsurance.Com 954 771-0300INSURERS)AFFORDING COVERAGE NAIL 0 INSURER A:Old Dominion Insurance Company 40231 INSURED Front Line Electric LLC INSURER B:Bridgefleld Casualty Ins Co 10335 8072 Pinnacle Pass Way INSURER c Boynton Beach,FL 33473 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 CONTRACTOR 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. IN LTV TYPE OF INSURANCE INSH WVD POLICY NUMBER gagwr LIMITS A GENS LIABILITY MPG4355D 6/03/2014 06/03/201 a EACHOCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea om D nce $500,000 CLAIMS-MADE a OCCUR MED EXP(Arty one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PROT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per acddent UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION 19631594 0610312014 06/03/201 aX WC STAT% 0TH- AND EMPLOYERS'LIABILITY 9 Y/N ANY PROPRIETOR/PARTNER/EXECUTNE E.L.EACH ACCIDENT $500,000 OFFICERIMEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Electrical Contractor Workers Compensation applies Florida operations and Florida employees only. CERTIFICATE HOLDER_ CANCELLATION _ C of Miami Shores SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami,FL 33138 AUTHORUM REPRESENTATIVE Awn* ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S191813/M178741 - - CC y CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 14EOOOO71 FRONT LINE ELECTRIC LLC D.B.A.: BERT KENNETH GEORGE Is certified under the provisions of Chapter 10 of Miami-Dade County 11/14/2014 09:48AM 5617778873. F '44"ELECTRIC. 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