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EL-14-1038 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-244216 Permit Number: EL-5-14-1038 Scheduled Inspection Date: October 02, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: MARTINEZ, RAFAEL Work Classification: Alteration Job Address:511 NE 101 Street Miami Shores, FL 33138- Phone Number (305)458-2502 Parcel Number 1132060171090 Project: <NONE> Contractor: ARO ELECTRICAL CONTRACTOR Phone: (786)873-3555 Building Department Comments UPDATE ELECTRICAL UPDATE GFI'S AND ADD SMOKE Infractio Passed comments DETECTORS INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-243390. CREATED AS Ef REINSPECTION FOR INSP-243230. Add the following: inter system bonding bar. 120 volt receptacle at the end of counter. 120 volt receptacle next to ACCU. Failed ❑ 120 volt receptacle next to panel. Dryer receptacle to be 4 wire. Clothes washer receptacle to be 20 amp. Garage receptacles to be G.F. I. protected. Correction ❑ Support conduit for AHU and ACCU and T stat cable. Needed Replace DM receptacle cover.Seal hole in the bottom of panel. Add arc fault breakers. 24 sep. 15 Re-Inspection ❑ Add arc fault breakers. Fee, Have all breakers on and circuits tested, Kitchen counter receptacle. Front porch G F I not tripping and in use cover No Additional Inspections can be scheduled until re-inspection fee is paid. C s mc-/ "� October 01,2015 For Inspections please call: (305)762-4949 Page 20 of 37 r , Miami Shores VillagecF,IvED Building Department MAY 20 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY' Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No.WA%— LO 3-4- PERMIT APPLICATION Sub Permit No.E/�f — ❑BUILDING ><ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: p /01 5-t City: Miami Shores County: Miami Dade Zip: -S3/3(? Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): VOI&pJI/ MQ✓ 1hez. Phone#:dos Address: A��® 41/ lJC: =it 113 City: 1 r iQ�j State: f.l Zip: 3-3/.33 Tenant/Lessee Name: n Phone#: Email: ,f A fAe `P)l o m"4j4j 7- CONTRACTOR:Company Name: AQO CCeor<GGL( CoJra�kr , (✓iG Phone#: .'7�9 Address: I A .�-L4o S W �1 S City: a l'L (^State: EL Zip: '33 (9 Qualifier Name: V, Ll/<er Phone#: 7K-2S�-5731 State Certification or Registration#: "c (3 oo q )-G 4f Certificate of Competency#: o DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition iteratiion ElNew ❑ Repair/Replace ElDemolition Description of Work:_ 116.1144'a ,tel{ u h do-1,4 s • Specify color of Color ffiru tile: Submittal Fee$ Permit°Fee$ ?�,� 3� CF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ L110 ° (Revised02/24/2014) f � 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 n 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature .� Sig 7� nature I C �,,�' OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this ' ' day of M Pv" ,20J ,by -7 �� day of V"►JIA� 120 ,by Cl-'-- (bpm Ik64who is personally known to OkAVk'wk Z_who is personally known to me or who has produced CA . 11-D as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: �� '% .�.�� • •,.. ••• . Sign: Print: Print: �� Mal =C> e rn;ED Seal: s Q. ,� ti a•'�\ Seal: MYCOMMOE14011110 "Ofteh��k��***�**�*+rix****�***�x��+��w*�*�k`9� *EXPIRES:F 24,2018 "Oft APPROVED BY ,20 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) . . ...SC©.. .G.. . .R . : KEN iAWSON,SECREI"ARY . ... . . . . . . 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ECK27 ;:7 4T.O To 3:9569 sl9af.8asit�aas.> e'(l6R.ei tai ewifirBrs N. .. ..:..:. .peY6Ae►rtoilheLo©al Business Tax. lhe:Ri isRofaadtl :f: :%'::f:ic': p�xq_J�;9f:�ceR�cdMA.AY11tbe troll ��Uat�flcatiCiNs;io.do business.'Fioltlar•awsc;g44?.hf:ti?'� V »: arneoaaYCrnnterrialreauiamrviaw�$cndT oufy��y��Yo�yy(�}..� w..,•.t-a6. y.�.xir��,. .p...........�!Y90 en?m!catal; :::<> .' ..: �.' .:..:.....::.�..I�'+!N.•AN.'VYJ{NJvB.V..4�YhY6a.JAS+:??�gRroN1%:.:JIYi'u.J.•iWlse.:..YJ..r./.:YJ'il::.'::.:.:::.::..:.:.:.'.•. ... .. . r ' CERTIFICATE OF LIABILITY INSURANCEDATEiMM/DD/YYYY) -- 10/15/14 THIS CERTIFICATE IS ISSUED ASA 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. TH13 CERTIFICATE OFiN3URANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN-THE 13OUING IN3URER(3),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policyges)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 -NAE: Tamara Mourino Great Florida Insurance-Pinecrest PHONE (305)256-0616 FAQ No): (786)522-1889 11205 S Dbde Highway 101 E-MAIL-Annpr s: tamara@greatNorida.com Miami,FL 33156 INSURERS AFFORDING COVERAGE NAIC Phone (305)256-0616 Fax (786)522-1889 INSURERA: Mount Vernon Fire Insurance Company 10233 INSURED INSURER B: Ascendant Insurance Company Aro Electrical Contractor Inc INSURER C: 16540 SW 97 St. INSURER D: Miami,FL 33196 EC13004264 INSURER E: COVERAGES CERTIFICATE NUMBER: INSURERF: 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. ILTR TYPE OF INSURANCE ADD WVO UB POLICY NUMBER POLICYEXP LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000,000.00 0 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000.00 CLAIMS MADE Q OCCUR A F-103/17/2014 03/172015 CL2637402A MED EXP(Any one person $ 5,000.00 PERSONAL&ADV INJURY $ 1,000,000.00 El GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000.00 21 POLICY ❑ PRO- ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ❑ ANYAUTO BODILY INJURY(Per person) $ ❑ OWNED SCHEDULED AUTOS ❑ AUTOS BODILY INJURY(Per accident $ ❑ HIRED AUTOS ❑ OWNED ATOS PROPERTY DAMAGE $ Per accident ❑ UMBRELLA LIAB [:]OCCUR EACH OCCURRENCE $ EXCESS LIAR ❑CLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N LIMITS ANY PROPRIFTOR/PAPTNIRWEXECUTIVE WG63376-3 R ER B OFFICER/MEMBER EXCLUDED? NIA 08/16/2014 08/16/2015 E.L.EACH ACCIDENT s 100,000.00 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 100,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Electrician CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2 Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village FL 33138 AUTHORIZED REPRESENTATIVE ""' m 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)QF The ACORD name and logo are registered marks of ACORD