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EL-16-2334 (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-265896 Permit Number: EL-8-16-2334 Scheduled Inspection Date: August 23,2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: gh Owner: CORTINAS, LAUREN &ALBERTO Work Classification: AI ration Job Address:186 NW 106 Street Miami Shores, FL 33150- Phone Number Parcel Number 1121360080080 Project: <NONE> Contractor: JP ELECTRIC SERVICES CORP Phone: (786)399-5871 Building Department Comments INSTALL FEEDER ROLLING GATE 120 VOLTS 20 AMPS infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed - Failed Correction �✓ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 22,2016 For Inspections please call: (305)762-4949 Page 32 of 36 VSs i g04 S �MI'� M1° 3 3 s I sKO1 y� Miami Shores Village € � — t 01 X ) 1t1t ) t� 10050 N.E.2nd Avenue NW Miami Shores,FL 33138-0000 Phone: (305)795-2204 Cyt % � �CORIU�' �, x3 �f 8 0 Expiration: 1 2017 3N""] t ' ;«. ,. Project Address Parcel Number Applicant 186 NW 106 Street 1121360080080 LAUREN&ALBERTO CORTINA: Miami Shores, FL 33150- Block: Lot: Owner Information Address Phone Cell LAUREN&ALBERTO CORTINAS 186 NW 106 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 1,100.00 JP ELECTRIC SERVICES CORP (786)399-5871 Total Sq Feet: 0 Type of Work:INSTALL FEEDER ROLLING GATE 120 VOL Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-8-16-61041 DBPR Fee $2.25 08/18/2016 Check#:3688 $50.00 $110.70 DCA Fee $2.25 Education Surcharge $0.40 08/19/2016 Check#:3689 $ 110.70 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 In consideration of the issuance to me of this perry It, 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 n zoni g. utherm I authorize the above-named contractor to do the work stated. August 19, 2016 Authorized Signature:O er / Applicant / Contractor / Agent Date Building Department Copy August 19, 2016 1 Miami Shores Village ' = Building Department F7A 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 -- ---__ Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949p FBC 2013' BUILDING Master Permit No. FELI PERMIT APPLICATION Sub Permit No. ❑BUILDING Fo� ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ORENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 186 NW 106 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:1121360080080 Is the Building Historically Designated:Yes NO X Occupancy Type: Residential Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): Lauren &Albeto Cortinas Phone#: Address. 186 NW 106 ST City. Miami Shores State: FL Zip: 33150 Tenant/Lessee Name: Phone#: 786-624-0715 Email: acortinas@tesiamotors.com CONTRACTOR:Company Name: JP Electric Services Corp Phone#: 786-399-5871 Address. 4636 SW 32 DR City. WestPark State: FI Zip: 33023 Qualifier Name: Jose M PaeZ Phone#: 786-399-5871 State Certification or Registration#: EC13007362 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$1100.00 Square/Linear Footage of Work. 0 Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Install Feeder Rolling Gate 120 Volt- Permit to Replace Permit EL-12-15-3082 Specify color of color thru tile: Submittal Fee$s0 '0.0 Permit Fee$ CCF$ l ' ?,0 CO/CC$ Scanning Fee$ Radon Fee$ DBPR/$ 2 . O� Notary$ ® d Technology Fee$( ' Training/Education Fee$ " 1"d Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (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 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. ��tJ� a77��' 7, %fi Signatur Signature OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this / day of Av `�i s} ,20 by f day of 20 1 G by � e N e�- who is personally known to ra r-Y� �� i r��S o is personally known to ��Se �• �1 m�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 PUBLIC: Sign: 41Sign: �" IMJ," Print: r C- �` f Print: �`C'rt'�' ��C>\�a"'J % IUALAf�LGAR * * MY COMMISSION#FF 067554 * MY COMMISSION#FF 067554 Seal: EXPIRES:October 31,2017 Seal: EXPIRES:October31,2017 �pp BW&dTluv Budget N0WyWft �q occ�d°��c Bonded Thru BudgetNOhuy Servkee APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) amen ,.,nom Miami hores illage Building Department ��D'1tlAp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 CONTRACTORS' REGISTRATION, IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33136 Certificate must specify the description of operations or contractor license number. ■■eweeereaeerre•errarrrrrrerswre1errerrrrerrrrerwerwwrrrrw®®•rerreererewerrrrrrweereeeeewar BUSINESS NAME: P I G�F-,� �� l , c C,2 r BUSINESS ADDRESS: y G 3 L 5LA-) 32- Dir CITY ��T�STATE T(- ZIP 3'3 v z 3 BUSINESS PHONE: (_ f.- ) '� �_FAX NUMBER t 14 ) _51 3 - S-6 0 L CELL PHONE(g L 3 —� 1 QUALIFIER'S NAME: d -s e- e a� QUALIFIER'S LIC NUMBER: E C 3 C Z ACC> CERTIFICATE OF LIABILITY INSURANCE 708'1MMIDDNM�,,i 17/2016 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 CONTACT NAME: MARIA ALMOLDA Blanco Insurance Assoc.,Inc. PHCN o ; (305)888-0524 FAX,No): 7862720044 1462 E 4 Ave E-MAIL DD RESS : maria@blancoinsurance.com Hialeah,FL 33010 INSURERS AFFORDING COVERAGE NAIC# INSURER A: SCOTTSDALE INSURANCE CO. INSURED INSURER B: JP ELECTRIC SERVICES CORP. INSURER C: 4636 sw 32 Dr INSURER D: INSURER E: West Park,FL 33023 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 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR 1 S POLICY NUMBER MM/DD MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 X COMMERCIAL GENERAL LIABRE LIABILITY PMI ES Ea occurrence $3 100,000.00 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000.00 A N N CPS2508363 07/18/2016 07/18/2017 PERSONAL&ADV INJURY $ 1,000,000.00_ GENERALAGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000.00 X POLICY PRO--JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ X EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TRY LIMIT ER _ ANY PROPRIETOR/PARTNER/EXECUTNE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 7N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Electric work withibng buldings. 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 BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E 2ND AVE AUTHORIZED REPRESENTATIVE MIAMI SHORES FL 33138 ACORD 25(2010/05) @ 1988-2010 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD ® DATE(MM/DD/YYYY) A�!eQ CERTIFICATE OF LIABILITY INSURANCE 08/18!2016 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 CONTACT NAME: Automatic Data Processing Insurance Agency,Inc. PHONE FAX AIC No Ext): A/C,No 1 Adp Boulevard ADDRESS: Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: CastlePoint Florida Insurance Company 13599 INSURED INSURER B: JP ELECTRIC SERVICES CORP INSURER C: 4636 Sw 32nd Dr West Park,FL 33023 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 277961 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 INSURANCEADDLISUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD MWCD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE 7OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JE Q POLICY❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS $ NON-OWNED PerOP.ER ntDAMAGE HIRED AUTOS AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ER TH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECU I— YIN N E.L.EACH ACCIDENT $ 1+��+�� A OFFICER/MEMBER EXCLUDED? ❑N N/A N WCP761114602 05/30/2014 05/30/2015 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 1000000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ + + DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached U more space Is required) Electric Work Within Buildings. 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. 10050 N.E.2nd Avenue Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE A@ 1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD nivrot.v i,vvvcnwvn KtN LAVVSUN,StL:Kt IAKY STATE OF FLORIDA g DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION , { ELECTRICAL CONTRACTORS LICENSING BOARD � EC1300?362 The ELECTRICAL'CONTRACTOR Named tielaw,LS CERT{FLED 4 ' ;. Under the,prov!ptgrv$of Chapter'489 FS. Explra#!on date: AUO 31,2018' PAz, ,ltJSE MANUEL , JP„ELECTRIC SERVICESi 4636 SW-32Nt 10RlVE . MY 'Xl Py9 K y. STT,-.P�4RK EL 323-' y Q `1 v e ISSUED: 06/22/2016 - D{SKAYAS REQUIRED SYLAW Std# L1606220001286 4 e ; F t atoaao ' - Local Business Tax*Becei t Miami—Dade County,State of Florida rL � T -THIS IS NOT A BILL-DO NOT PAY 6337661 BUSINESS NAMElLOCATION RECEIPT NO. EXPIRES: 1P ELECTRIC SERVICES CORP RENEWAL DOING.SLISINESS IN DADE COUNTY660474I9 SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A-Art 8&10 OWNER SEC.TYPE OF BUSINESS JP ELECTRIC SERVICES CORP 196 ELECTRICAL CONTRACTOR PavanENr RECEIVED JOSE M PAEZ,QUALIFIER EC13007362 BY TAX COLLECTOR' Worker(s) 3 $75.00 07/08/2016 ` CREDITCARD-16-037083 This Local Business Tax Recelpt only mmorms payment of the local Business Tax.The Receipt Is not a license, permk or a certification of the holder squalilications,to do business,Holder must comply with any governmental.' or nongovernmental regulatory laws a requirements which apply to the business The RECEIPT NO.above must be displayed on all commercial vehicles.Mlsmi-Dada trade Sec ea-276, For more Information,visit vrue+v�r!lamidade non Y fiect�� 7; i` ♦,t�oRF, Li � ,► Miami shores Village Building Department res ORIDA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. I�-- IS- )01?2 Owner's Name (Fee Simple Title Holder): A l b,Ao ,A rx,..c Phone#: -"4 c - G Owner's Address: 19L O Q liu b S-V City: s 5L-O e s State : Zip Code: -' I J--b Job Address (Of where work is being done):_ ° 10 k)ws 10 (, 5 A- City: Miami Shores State:—Florida Zip Code: 3 3 p ,-6 Contractor's Company Name: LeAric S,,Ic- Phone#: -48 6 -3 `/I - + l Address: 3 3Z ,-p r, City: y - c State: r�-- r% Zip Code: 3 3 c e 3 Qualifier's Name : -To 5C �-k Lic. Number: Architect/ Engineer of Record Name: Phone#: Address: City: State: Zip Code: 1 Describe Work: 5ns -k� ee� ��lo�c� -r� I?,o 03t,� "Ra ��,- eL- lL •/5'-3v SZ 1 hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the iami Shores harmless of all legal inv eme' Signatur r Signature Owner or Agent Contractor or Architect The foregoing instrument was aknowledged before me The foregoing instrum t was aknowledged before me this day of u s �-,20 f l,by A' "� - this day of es v� , 20�(j by v�r C4�`I c/°PJ 6' NVho is personally known to m or who has produced who is personally known o me or who has produce as indentification. G 2d3®®19 3 46'0 `` a1 N piton. Notary Public- Notary P I>lic: �`�P�.�� ssipy Sign: Sign. / ycp *WY 20 .o•� Seal: Seal: SS,-.9; FFF 933020 *a I(A UMELUR i : Baaen�+.�•:OQ MY COMMISSION#IT 067564EXPIRES:October 31,2017 i�f '•. Aerie Uri;:•'Q�� '��,aWdl$ BV&T1"B N*rYSWieeir