Loading...
EL-15-2331 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL / Phone: (305)795-2204 Fax: (305)756-8972 1. rJ —�✓ Inspection Number: INSP-266419 Permit Number: EL-9-15-2331 Scheduled Inspection Date: September 22,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: , Work Classification: Addition/Alteration Job Address:88 NW 111 Street Miami Shores, FL 33138- Phone Number (954)465-3753 Project: <NONE> Parcel Number 1121360030400 Contractor: SKY ELECTRIC, INC. Phone: 305-542-0060 Building Department Comments NEW ELECTRICAL&TEMP METER Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-243408. Need the following: Ea 30 dat temp. for test Permit plans. Adders on residence. Failed Correction ❑ � Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid September 21,2016 For Inspections please call: (305)762-4949 Page 6 of 23 s>ss31, MM'. E(do t Miami Shores Village 10050 N.E.2nd Avenue NW `Ork Cf �c Ili diti term •• Miami Shores,FL 33138-0000 ` Phone: (305)795-2204 2io8► a� � PI aoRmp' fl Expiration: /26/2016 Project Address Parcel Number Applicant 88 NW 111 Street 1121360030400 Miami Shores, FL 33138- Block: Lot: Trifecta Capital LLC Owner Information Address Phone Cell Trifecta Capital LLC 1504 BAY Road (954)465-3753 MIAMI BEACH FL 33139- 1504 BAY Road MIAMI BEACH FL 33139- Contractor(s) Phone Cell Phone Valuation: $ 9,000.00 SKY ELECTRIC, INC. 305-542-0060 Total Sq Feet: 0 Type of Work:NEW ELECTRICAL&TEMP METER Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:3 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W.W. Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $5.40 Invoice# EL-9-15-57074 DBPR Fee $4'73 09/28/2015 Check#:1051 $297.86 $50.00 DCA Fee $4.73 Education Surcharge $1.80 09/14/2015 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $315.00 Scanning Fee $9.00 Technology Fee $7.20 Total: $347.86 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 DOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all oregoing informati is cc and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore au ize the n ed co tract to do the work stated. September 28, 2015 Authorized Signature:Owner pplicant / Contractor / Agent Date Building Department Copy September 28,2015 1 ti Miami Shores Village Building Department SEP 14 015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972Ly INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 BUILDING Master Permit No. 12iC` 3 PERMIT APPLICATION sub Permit No. 45W19M ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:] CANCELLATION ❑ SHOP S8 CONTRACTOR DRAWINGS 10B ADDRESS: OS N� 1[14,51' City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): _Tn �Pe6 & C'C&_J �I-A( . LLC Phone#: l 5y- 4 4 5- 3+,53 Address:__156� 6PIf Rd X 12'0 y City:1111 X61 6 R_'kak State: r L, Zip: 3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: y Phone#: e Address:-W ?.,v City: ltllAlm 11 Stater Zip: Qualifier Name: C_-0-1^-z / �° �✓it. Phone#: State Certification or Registration#: ���✓�ae',i 7 C-Z- Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: Q City: State: Zip: Value of Work for this Permit:$ 1 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New 1 ❑ Repair/Replace El Demolition Description of Work: + F^�� me Specify color of color thru tile: Submittal Fee$ Permit Fee$ � CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) . t 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 absence of such posted notice, the inspection will nnapprd a reinspect n fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The forgoing instrument Meas ackn Iedged before mthis _day of .20 / S ,by day of 11 20�`` .by who is personally kn n to wh wn to me or who has produced as me or who has s identification and who did take an oath. identification an w o i a e a ath. NOTARY PUBLIC: NOTARY PUBL to of Florida " Oggph Sign: Sign: 62 Print: Li w� ELIANA PAF Dari r Seal: r13AV r Pubr�, Seal: u12491 S.Exp• ` ?018 APPROVED BYP�''��/✓� Plans Examiner Zoning Structural Review Clerk (ReVised02/24/2014) STATE OF FLORIDA v DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 w 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 WAY, RICHARD JR SKY ELECTRIC INC 90 NW 156 ST MIAMI GARDENS FL 33169 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses rangeF`Via.-xSTATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. 10 ' PROFESSIONAL:REGULATION Every day we work to improve the way we do business in order to EC13002762 .ISSUED: _.09/04/2014 serve you better. For information about our services,please log onto www.myfloridalicense.com. There you can find more Information CERTIFIED ELECTRICAL CONTRACTOR about our divisions and the regulations that Impact you,subscribe WAY, RICHARD JR " to department newsletters and learn more about the Department's SKY ELECTRIC'INC initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new license! Expiration date:AUG 31,2016 L1409040002736 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC13002762 The ELECTRICAL CONTRACTOR ' Named below IS CERTIFIED we Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 0 WAY, RICHARD JR .. SKY ELECTRIC INC •ti 90 NW 156.ST . MIAMI GARDENS FL 33169 ME ❑ ' ry • ncmAmnle nisPI AY AS REQUIRED BY LAW SEQ# L1409040002736 Local Business Tax Receipt R Miami—Dade County, State of Florida THIS IS NOT A BILL-DO NOT PAY 5568721 LBTJ BUSINESS NAMEMOCATION RECEIPT NO. EXPIRES SKY ELECTRIC INC RENEWAL 90 NW 156 SSEPTEMBER 30, 2015 T 5806671 Must be displayed at place of business MIAMI,FL '33169 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS SKY ELECTRIC INC 196 ELECTRICAL BY rAX COLLECTOR CONTRACTOR 75.00 09/30/2014 Worker($) 2 EC13002762 CREDITCARD-14-042653 This Local Business Tax Recelpt only contirns payment of the local Busineas Tax.The Receipt is nota license, permit,or a certification of the holder's qualifications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed an all commercial vehicles—Miami—Dade Code Sec 8a-276. MnIAMMK For more information,visit wwnv.miamidede. Wglixogif or a CERTIFICATE OF LIABILITY INSURANCE 0812DATE(M 412015MIDD 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 1S WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement an this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). RODUCER NTA T IBET SERRANO 'EEL INSURANCE AGENCY PHONE 954 956-0006 FAX Nal, 954)956.0555 11BW COVER ALL INSURANCE E-MAIL rool58OO@yahoo.com 800 W.ATLANTIC BLVD. INSURERS AFFORDING gokWE NAIC# IARGATE FL.33063 INSURER : UNITED SPECIALTY INSURANCE COMPANY 12537 ISURED INSURERS:COMMERCE&INDUSTRY INSURANCE COMPANY 19410 -KY ELECTRIC,INC. INSURjR • FRANK WINSTON CRUM INSURANCE COMPANY 11600 0 NW 156 STREET INSURER 0, IMI FL 33169 INSURER E: INJURER : :OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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. SR TYPE OF INSURANCE ADDL SUER iffia POLICY NUMBER POLICY EFF POLICY EXPHL LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100,000 CLAIMS-MADE Q OCCUR DCGO1937.00 0712612015 0712612016 MED EXP(Any one arson $5,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,DOO,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP OP AGG s2,000,000 POLICY Z PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEpULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS (Par accident) X UMBRELLA L.IABOCCUR EACH OCCURRENCE $1,000,000 X EXCESS LIA6 CLAIMS-MADE EBU057721467 0712612015 0712$12016 AGGREGATE $1,000,000 E $ WORKERS COMPENSATION X WC S7A7U- OTH- AND EMPLOYERS'LIABILITY YIN OFFICERIMEM ER EXCLUDEANY D? Y NIA FAFL151481 712612015 712612016 E.L.EACH ACCIDENT $100 000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100 000 If yes describe under ES6RIPTION 0 E.L.DISEASE-POLICY LIMB $500,000 ELECTRICIAN ESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule.H more space Is required) LECTRICAL WORK :ERTIFICATE HOLDER CANCELLATION CITY OF MIAMI SHORES BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBEV POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,g NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVENUE ACCORDANCE WITH THE POLICY PROM IO1 MIAMI SHORES FL 33138 --'"• .�-' "diLs9R AUTHORIZED REPRESENTATIVE RSKI250 MSN.COM ©1988-2010 ACORD CORPORATION. All rights reserved. .CORD 26(2010105) The ACORD name and logo are registered marks of ACORD Repots Viewer Page 1 of 1 i 180 n� JEFF ATWAM STATE��FLOt�1F3A a Fn Icw.oFFrt DEPART MSNT OF FINANCIAL.SERVICES DIVISION OF WORKERS'COMP sNSATIGN t►C.ERTIFICA E of ELECTION To BE EXEMPT FROM FLORIDA WORKERS'COMPENSAT ION LAW.. CONSTRUCTION INDUSTRY MEOW-,ION This cwWas that ft ineWdual fisted below has elected to be exempt from Florida tPlorkers'CompensaCwe law. IsFFECTIVE DATE: 6/1612014 MVIKATION DATE: 6!1512016 1M80111: WAY RICHARD JR PON: 650759183 BUSINESS NAME AND AD13RE t SKY ELECTRIC INC 90 MW 156 STREET MIAMI Fl 33169 SCOPES OF BUSINNS OR i4i r: CONTRADCTORC r p� Cnkaa ot2a�2eta.vY�'3 a cart:w:a d atecan tx�arv>a IIe=�'aR asY pwm.�amat7nn.u-+sd2•+It1}•CS..sn et.eards��m C�CMA2tii1-W3 ei accucna b:o.ompt_apsY r.�.2W'�'+t22�` txt '�=°`Wsa.�Rm- P '�G ,y0.b41tg,F 5.,ttWcss alCkc7arolm et¢ttx c�M� d Ih9tiW'�f9t9e98 Uro9tmda ne�c2 U 2�mCe BsBR(S �ysy q cf the x�i4s0f49M R2't•�nfaffi1'3t 912 e9:�B awes s.emmt aamtte osbSad ee.rem62v Y uarw lig erterttce>4vv0+r m:rrcJ:c am �vs�a2te9a te2+2��2 �9�a srsa�'+�,�R-�������s.aekeocmvne-texas taerwr�d9.e p2nm2r ea t22cersx':xe= • Ot1=5rIQN57 i8501d'13-1809 aas-Rz-MVC.=CaxnFx A-M of sr_Ecn0H ToEg EXOMIs sEnsso 0-1.12 nnmlrrrr�nnrlitiP.Wer/TcnortVjcNvc-.asp%?data=kdvpcinc9D7Q3g146TER6... 6/17/2014 Std Rs soon Miami shores V Building Department L0R1DA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers'compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers' compensation msur coverage fro contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW,YOU CKNO LEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of '20 . By Ei' who is personally known to me or has produced ification. Florida nde Joseph My CommMion EE I pF F)ires 01102/2016 SEAL: SKY ELECTRIC INC. 90 NW 156"ST Miami, FL 33169 305-542-0060 EC13002762 State of: Florida County of: Miami Dade Before me personally appeared Richard Way Jr.who being duly sworn,deposes and says: That he will be the only person working on the property located at 88 NW 111th ST Miami Shores, FL 33168 Sworn to(and affirmed) and subscribed before me to this 8th of September,2015 By Richard Way Jr. Personally Known by Eliana Medaglia, Licensed notary. ''''•., ELIANA MEDAGLIA s Notary Public-State of FIorM8 ' Commission#F FF 132491 o�: IMy Comm.Expires Jun 15,201d �Lti41U� �?//('D/rviLl/9• � �, ��