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EL-15-2175 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-251686 Permit Number: EL-8-15-2175 Scheduled Inspection Date:July 18, 2016 Inspector. Devaney,Michael Permit Type: Electrical- Residential Inspection Type: Final Owner: GAIQUI, MARITZA Work Classification: Alteration Job Address:1450 NE 101 Street Miami Shores, FL Phone Number Project: <NONE> Parcel Number 1132050240040 Contractor. METRO ELECTRIC SERVICE, INC Phone: (305)945-1991 Building Department Comments REPLACING EXISTING ELECTRICAL.OUTLETS AND Intractlo Passed Comments FIXTURES WITH NEW INSPECTOR COAAMENTS False Inspector Comments Passed El ROUGH 2ND BATHROOM Failed El Correction a Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid July 15,2016 For Inspections please call: (305)7624949 Page 7 of 44 9'd 00000 elggea dtC:9096 9L Inf Pef it NO'. EL-8-15-2175 Miami Shores Village X16'' 3# :E) :-, 3s) ttt ) 10050 N.E.2nd Avenue NE a.» Werk Glassifiaafton Alteration Miami Shores,FL 33138-0000 � �'; , Paimit Status.APPROVED f � Phone: (305)795-2204 issue Data;91,10101 Expiration: 3/Oil/201 Project Address Parcel Number Applicant 1450 NE 101 Street 1132050240040 __.._._.�_�.._... ... Miami Shores, FL Block: Lot: NATASHA GAIQUI&MARITZA G Owner Information Address Phone Cell NATASHA GAIQUI&MARITZA GAIQUI& FIRST UNION PO BOX 40062/C MOORE --- - -- - JACKSONVILLE FL 32231-0062 Contractor(s) Phone Cell Phone METRO ELECTRIC SERVICE, INC Valuation: $ 4,000.00 Total Sq Feet: 00 a Type of Work:REPLACING EXISTING ELECTRICAL OUTLE Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 DBPR Fee Invoice# EL-8-15-56854 $3.38 08/25/2015 Credit Card $50.00 $422.16 DCA Fee $3.38 Education Surcharge $0.80 09/10/2015 Credit Card $422.16 $0.00 Permit Fee-Additions/Alterations $225.00 Scanning Fee $9.00 Technology Fee $3.20 Work without Permit Fee $225.00 Total: $472.16 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing info is a curate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-n mej co r ctor to do the work stated. September 10, 2015 Authorized Signature:Owner / Applicant Conf or / Agent Date Building Department Copy September 10,2015 1 Miami Shores Village Nus 25 201 Building Department 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 ��� BUILDING Master Permit No.D-r 15 7/7 PERMIT APPLICATION Sub Permit No. t5 d 1.� 2. ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ; 1�y I 1 S� s3f- City: Miami Shores County: Miami l Miami Dade Zip: Folio/Parcel#: ` J � � NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: --FF�E: 3 p, OWNER:Name(Fee Simple Titleholder): f�)Q L1 -�—C` l' Cl. AZA f. Phone#: Address qCC\J� ) -t ` City:-l� WA/-t State: Zip: f� Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:—rV1 til Phonene#: Address: City: NkCi614 i State: Zip: l Qualifier Name: nA ccv- Phone#: State Certification or Registration#: ®3 2J,6 Certificate of Competency# DESIGNER:Architect/Engineer: Phono#: Address: City: Sate: Zip: Value of Work for this Permit:$. L4j o(X),ec Square/Linear Footage of Work: Type of Work: ❑ Addition [ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee$ Permit Fee$ a�S r ®!� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ �-�`Go Structural Reviews$ Bond$_ TOTAL FEE NOW DUE (Revised02/24/2014) e � 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. 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this in day of 20�by day by MMI fZ9, CWL!"�At ,who is personally known to is personall=knownto me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI PUBLIC- Si Sign- Pr ign: Print: u_t_o�'P, s Print: o H' UU3ch, PIERRE ivatary Public-State of Florida Seal: NOTARYPUBLIC,S7;T^OFFLORM& Seal: �,° MY Comm.Expires Apr 30, zpir e•°�"''•o Lars Madison r Commission# C, - � EE 19 '196 E Commission#EE12840$ r+ed Throu r, 9 Natiorai R-,, '•n...,.••`'Expir EP.08,2015 **��x****** •�a�*�*t.t��wa�Ef,'Ni�t�**x�**x��x***�****�x�+�********>k**�***>k*>x*���*�**�x�**�*******x�***�x**x�*******� APPROVED BY ill Zrl'..i'I&� /mss Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL-CONTRACTORS LICENSING BOARD (850}487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 HERNANDEZ, OMAR R METRO ELECTRIC SERVICE,INC. 3314 SW 123 AVE MIAMI FL 33175 Congratulationsj with this kine you baCme one of the n one million Floriclians — Professiona RewWon. our Pft of Busirtes8 amrofessla from arch tefs to yacht brokers,from l wom to barbe,que re�au } STATE OF FLORIDA and#Wkeep Fk7fida's er, stroryg• DEPARTM W-OF BUSINESS AND Every day we work to improve the �, PROFESS! GULATION y we do busa�e�in order to ::. , °: ' a serve you better. For infom�on about our services lease onto .( EC13405325. v_ 408/25/2014 warty rny#Ioridali con. about our divisions There y°;'ern tinct more in�nrntetion _ a�._� and the mpulaftm that impact you,sr,Waibe �; CERTIFIED dR Ito dap rbnent newsletters an �more about the Department's . .,HI=RfilRtdD87_ `j a: I' Es. MI ELEC Our mission at the erg is:license Effipe lJye, strive to ssrve �:Regulate Fairly. , , custotrters. you tetter sa that you can serve your sttd You for doing business in Honda, ?i;' FS.Csazrrr reD undariin�' 'wz} �aionaanYom now licenseh �, r1 101%of,Q,h,489 F$. • ' adxte r AI1fl$t.BQtS Lt•4QgZ}t 4+a' i`.I�. ar.._oimi,?1•+-5.��L.,t��'iw._.*�w+;—_.;=•^�,^.Jtt..::_+..... ._._�.o....... ..v.... DETACH HERE MTART— STiATEOFhLOItDA DEPARTMENtOF'I3UiWE8ii AND PROFESSIONAL REGULATION i' ELECTRICAL 2 CTORS,LICIMING BOARD s EC13Q05326 =ONAf _BUSIRIUs lZt L EA7 OAITfte ELPCTPICAL• CTOR . . .. Namdbelow'ISCER11FIEU ;�- Uhdiar°the ,� ,►� r F s Of Chrapter449.FS. , Expir6tiob date AUG3.1,2015 i ypr. 81R f 1�d50 N� IC'SE I, QT7I:q}CEN � , s •:.,� i +i I LocalBus" es i pt Miami—Dade County, State of Florida `THIS 18 NOTA BILL -• DO NOT PAY n 173963 tB: T] SUGINESS NAMEILoCATION WTRO ELECTRIC SERVICE INC aecElPrivo. EXPIRES , 15050 NE 20 AVE RENEWAL, SEPTEMBER 30, 2095 NORTI-I MIAMI FL 33181 173963 Must bs displayed at place of business Pursuant to County Code Chapter 8A—An.9&10 OWNER METRO ELECTRIC SERVICE INC SEC.TYPE OF allSINESS Worker198 ELECTRICAL CONTRACTOR PAYMENT RECEIVED �s) 10 EC13005326 8Y TAX COLLECTOR $45.00 09/12/2014 LocaTh1s it,or ostnoss Tax liouoipt only coaflmts peymunt of pto i.00nl Rusinass Tax.17to ftopgl is nota Ih:gnso, porntit,or o ouriilieatlon 011ie holder's gaalfileailons,to do Ruldprlq{Tat aQmpfu.t:Lii6 naq poin�ngaso,d omen8oventotontal ra8ulatory laws eat,requiromoms whioh apply to ihn'Lnsiaus,>, Tito IIEC@IPT N0,nlrovO umat boilisployod an all Ooaunnrslo,trohfCt>ra-ir�tn+ui••pntia.Cada Sor,3ti�r3(y}'�'+ far more intonnnlioo,vistfy�RdRm111itlls!.pQ�+{gt4jy.' J 7 DATE(MM/DD/YYYY) ACORU CERTIFICATE OF LIABILITY INSURANCE 8/10/2015 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 NAMEACT Patty Carlton Ext 306 BB Insurance Marketing Inc PHONE 954-452-4900 FAx .954-452-0450 10167 W Sunrise Blvd,3rd Floor EMAIL Plantation FL 33322 .Patty@bbimi.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Florida Citrus&Industries Fund INSURED METRO-2 INSURERB:Essex Insurance Company 39020 Metro Electric Service, Inc. INSURER C: 15050 NE 20TH Ave North Miami FL 33181 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:818184832 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY B X COMMERCIAL GENERAL LIABILITY 3DV2170 8/9/2014 9/7/2015 EACH OCCURRENCE $1,000,000 DAMAGE TO CLAIMS-MADE ❑X OCCUR PREMISES EaEoccurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY❑PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $1,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION10651441 2/2/2015 2/2/2016 PER OTH- AND EMPLOYERS'LIABILITY Y/N x STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) Electrical Contractor located at 15050 NE 20 Avenue, North Miami, FL 33181. License number(EC13005326)and Qualifier(Omar Hernandez) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE WITH THE POLICY P OVISIONS. 10050 NE 2nd Avenue Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AC�® DATE(MM/DDIYYYY) �. CERTIFICATE OF LIABILITY INSURANCE 9/10/2015 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(ies)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). NT PRODUCER NAMEACT Pa Carlton Ext 306 BB Insurance Marketing Inc PHONE 954-452-4900 FAQ o•954-452-0450 10167 W Sunrise Blvd, 3rd Floor E-MAIL .Pa Plantation FL 33322 tty@bbi INSURERS AFFORDING COVERAGE NAIC# INSURER A:Florida Cltrus&lndustrles Fund INSURED METRO-2 INSURERB:Nautilus Insurance Company 17370 Metro Electric Service, Inc. INSURERC: 15050 NE 20TH Ave INSURERD: North Miami FL 33181 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1261702143 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. INSREUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD LIMITS B X COMMERCIAL GENERAL LIABILITY NN581981 9/7/2015 9/7/2016 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ❑X OCCUR DAMAGE (RENTED PREMISESS Ea occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL BADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 XPOLICY 11PRO JECT 71 LOC PRODUCTS-COMP/OP AGG $2,000N ,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY ppAUTO BODILY INJURY(Per person) $ AUTOSNED AUTOSULED BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 10651441 2/2/2015 2/2/2016PER OTH- AND EMPLOYERS'LIABILITY Y/N X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEd$1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Addhlonal Remarks Schedule,may be attached If more space is required) Electrical Contractor located at 15050 NE 20 Avenue, North Miami, FL 33181. Re: License#EC13005326 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 N.E.2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 4M @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD