EL-15-3112 (2) Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-264479 PermitNumber: EL-12-15-3112
Scheduled Inspection Date: August 01,2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: SOVEN,ALAN & KAREN Work Classification: Low Voltage
Job Address:1215 NE 95 Street
Miami Shores, FL 33138- Phone Number (305)297-9357
Parcel Number 1132060143980
Project: <NONE>
Contractor: MBM ELECTRIC INC
Building Department Comments
LOW VOLTAGE Infractio Passed Comments
RUN 10 LINES OF DATA OR CABLE TV FROM HOME INSPECTOR COMMENTS False
RUN TO MASTER BEDROOM AND LIVING ROOM.
OUTDDOR SPK X 2
Inspector Comments
Passed 1�
Failed
rze
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 29,2016 For Inspections please call: (305)762-4949 Page 39 of 43
I'eromtwo EL �2.1�� '112
3f
�sn°R s y, Miami Shores Village ic'8xl)t# 7"y Eft *� .j t ential
10050 N.E.2nd Avenue NE ( �&SStion Low Voltage
Miami Shores,FL 3313&0000
'pelm1 ct S:A ���
o Phone: (305)795-2204
Issue Date: 12 ITWI5 Expiration: 06814/2016
,x
Project Address Parcel Number Applicant
1215 NE 95 Street 1132060143980
Miami Shores, FL 33138- Block: Lot: ALAN&KAREN SOVEN
Owner Information Address Phone Cell
ALAN&KAREN SOVEN 1215 NE 95 Street (305)297-9357 (561)346-5533
MIAMI SHORES FL 33138-2549
Contractor(s) Phone Cell Phone Valuation: $ 680.00
MBM ELECTRIC INC
Total Sq Feet: 0
Type of Work:LOW VOLTAGE Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Review Electrical
Scanning:2
Fees Due AmountPay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# EL-12-15-58076
$2.25 12/17/2015 Credit Card $ 112.10 $50.00
DCA Fee $2.25
Education Surcharge $0.20 12/16/2015 Check#:6250 $50.00 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $6.00
Technology Fee $0.80
Total: $162.10
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 rate and that all work will be done in compliance with all applicable laws regulating
construction ad Ing. Futhermore,I author` _ize the above-named ontra to do the work stated.
r —4G_�/(/� December 17, 2015
Autfl-o-r1nd Signature:Owner licant / Contractor / Agent Date
Building Department Copy
December 17,2015 1
Miami Shores Village
Building Department DEC Nis
d 10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER-(305)7&2-4949
FBC 200
BUILDING Master Permit No. RC- 5- Is-I0g0
PERMIT APPLICATION Sub Permit No.i rz' ._ I S — 3 I { Z
❑BUILDING ;ErELECTRiC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: q�N Si
City Miami Shores County Miami Dade Zip: 33/3
Folio/Parcel#: Is the Building Historically Designated:Yes NO d
Occupancy Type: Load: Construction Type: Flood Zone: 8FE: FFE:
L �� soV�n1 �� r o •
OWNER:Name(Fee Simple Titleholder): APho . 7n
Address: 1216'
l p�- / 3-14City: MIAMI sSIV I S State: FL Zip: F3)
Tenant/Lessee Name: Phony#
Email:
CONTRACTOR:Company Name: 'eG r� L C Phone#: 01
��
Address: "
City: �� 19G .Q-s ate• .�,L-C�° Zip: 33 3.3
Qualifier Name: r ii' 0��f Y d9� Phone#: _3os G-- o
State Certification or Registration#: ? C 130 0 a VO V Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address City: state Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work;
Type of Work: ❑ Addition ❑ Alteration
]�J� ElNew Repair/Replace ❑ Demolition
"�
Description of Work. IAJ /0 L/WS or I)jqm 09 COW " 'n� fwm
L IV l*PJh 400 ff) . 0UTDoc)a J�—
Specify,colorof colorthruWe:
Submittal fee$��' Permit Fee$ �✓�®�Ey ® CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee'$ Training/Education fee'$ ruble Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 1171 . 10
(Revised02/24/2014)
r
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lenders 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 COA4MEN'CEMENT 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 , Signature
OWNER or AGENT CONT CTOR
The for oing instrumt was a knowledged before pe this The foregoing instrument was acknowledged before me this
y� d/ay of (J 20 1 S by `l day of G 20 is by
�V who is personally known to P _ f is personally known to
me or who has produced as m who has produced �1 as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBUC:
Sign: Sig (}
Print: �tD� t Q� �AC��/L� Print: �.►• S
Seal: C.8mrs V.
Seal: STEPHANIE PE CARDONA "UBWo MY COMMISSIOfI#R=84
STATE OF FLORIDA EXPIRES:APR13,X18
. Bonded Co m N FF111598 Uttou�1st State U
APPROVED By ���`-' 1- Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
rcn,nALV1 1,uAJVC%r4UR nM LPXVM V.bMAM1AKT
r
001-
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD -
�:; _ -
EC13002400 ,
The ELECTRICAL CONTRACTOR ==
Named below IS CERTIFIED >`7
Under the provisions of Chapter 481D FS.
Expiration date: AUG 31,2016
Wier
aMOREIRAS, BARBARO RAULMBNI ELECTRIC INC �i5460 SW 188 AVE
SOUTH WEST RANCHES FL 33332
■
tSSUM 07WrA14 DISPLAY AS REQUIRED BY LAW SEQ# L1407070001181
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S.Andrews Ave., Rm.A-100. Ft Lauderdale, FL 33301-1895—954-831-4=
VALE OCTOBER 1,2015 THROUGH SEPTENIBER 3o,2010
DBA: Kart ]=C'TR.IC INC Rss Type: ECTRIc RL/mss/WNTRAcroR
97
Busmess Nahma: Rosiness Tye:(MRSTER p*•ECT11/8UNG a FIRE
AiRK)
O*neti'Nanw BARBARO R NaRmsAs B1 RIM--OPOBe :01/21/1998
Bushmn Limon:5460 SW 188 AVE StBWC0UnV/Ce1`VReg:ea13002400
SOUTHWEST RANCHES Exemptlon Code:
Buchu s Phone:9S4-434-1067
Rooms Seats EmplOyet:s s Pry
7
FOr V B> o*
Tax Ani Trate Fee tom'Fee 7otel Pam
27.b0 0.00 '0.001 0.00 0.00 1 0.00 27.00
THIS RECEIPT PAW BE POSTED CONSM000SLY of YOUR PLACE OF BUSINESS
THE BECOMES A TAX RECIBPT. TtdB tax is bWed for the Privilege of doing budness wither Bmwend Courdy and Is
normegul■wy in nature.You must meht an County fmdf MAY Ptaf9
WHEN VAL.®ATEU and � TthL4 Tax Recut be when
the busies is sold, bhp h has dares or you, have moved the
Win.This does not tta�tte or that
it Is in compft=with State or local tae and mgubftm
E:LaMIng Address:
BARBARO R NORSIRAS Receipt #ICP-14-00018400
5460 SW 188 AVEMM Paid 07/27/2015 27.00
SOUTHWEST RANCHES, FL
33332
DATEsm� AITNSUNC121 6
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEIL 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(fes)must be endorsed. If SU8110GATION 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
certiflicate holder in Bela of such s).
PRODUCER 0ONrACT Karen Renfro
Travers Hartnett Insurance P ro E 561- ---- --- Faz- ---
1045 E Atlantic Ave#203 E-MAILL Elft
n- mfr 297-8549
E-MAIL idel versins.c om
Delray Beach,FL 33483 ----
-------------_{t I�ER(S)A"40RDMG COVERAGE j KNc a
IIVSURERA:AmTru3North Arnerlca
INSURED--------- ---- ---- a4auREitss4�at@dListrl�5—lTls� —
MBM Electric,Inc. :
Barbaro Raul Moreiras Lic#EC 13002400 INsuR>R D
5480 SW 188th Ave INsuRER E: - ----- r--
Southvrest Ranches FL 33332
119ISU9�i3 F-
COVERAGES CERTIFICATE N REV1Sl NUdtif3ER
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 REWROCENT,TERM OR COWDITM OF ANY CONTRACT OR OTHER DOCUMENT W!TH 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 SEEN REDUCED BY PAID CiAIAAS.
T%W OF 1{IE POLICY EFF POLECY E"_LTR LMM
GENERAL LIABILITY X i WPPI06332703 5/23/2015 5/23!2016 EACH oCc tRRErscE S 1,000,000
COMMERCIAL GENERAL LIABILITY I 'F__es_ss_i�oct�rencel $ 100,000
A CLAIMS4MDE 'X J OCCUR ! llT-Docd(n,y > s 6 000
I—i -- — --
1
l A l
PERSONAL a ADV INJURY s 1,000,000
_ cENER4A rAl-E $ 2,=,000
GEN'L AGGREGATE LiM APPLIES PER: I PRODUCTS-COMPICP irGG 'S
POLICY PRQ- LOG I I I$
AUTOMOBILE UA13UM ' I t SYGLE UVIT
'tfEa $
ANY AUTO I ; I BO ILD Y It+l)L92Y(Per PWsnn) I'$
ALL OWNED I'— SCHEDULED -
AUTOS AUTOS BDDILY(IU�URY f,Per acciC' sp 5
HIREDAUTOS AUTOS 1 PROPERTY DAMAGE i 5
!f {
I 1 I f is
UMBRELLA UAa '
OCCUR EACH OCCURRENCE 3
EXCESS LUlB I—JI CLAIM�� I I � I AGGREGATE S
I D D !�SFIeIaIY�'V3 i I $
AN O YINJ AWC1049563 5/23120151 5123!2016 OR LIMIT aTK --
ANYPROPRIETORIPARTNERIEXECUTIVE I i I EL FACHACCIDENT is 100 Q00
ME
B OFFICERUSEREXCLUDED? ` �� ---- --'--
( r to NH) ' I i EL DISEASE-EA tMtLOYFI S100,000
K d8srdifo uDF Onder
i DESCRIPTION PERATIONS 11. i EL DISEASE-POLICY LIMIT:S Soo om
I i
1
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEICCL.ES(Attain ACORD 101.Adder Remuft She,0 more space is requi-M
Certificate Holder is named additional insured on General Liability Policy.
CERTIFICATE HOLDER CJUWCELLATION
Miami Shores Village SWWLD ANY OF THE ABOVE DESCRWRI,POLICIES BE CANCELLED BEFORE
Building 8 Zara Department THE Ex�IIZMTI�I DATE THEREOF, N TICS WILL BE DELIVERED IN
Zoning Departm ACCORDANCE WITH THE POLICY PROVIS".
10050 NW 2nd Ave
Miami Shores FL 33138 RIEPRESENTAT/VE
17?,
0'I9S8-2070 A COR ORATION. Ail - reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD