EL-16-1662 Inspection Worksheet
Miami Shores Village
V V I
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-270566 Permit Number: EL-6-16-1662
Scheduled Inspection Date: November 07,2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: MARKUS, DAVID Work Classification: Alteration
Job Address: 1190 NE 92 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132050270460
Project: <NONE>
Contractor: FRONT LINE ELECTRIC LLC Phone: (561)777-8835
Building Department Comments
REMODEL MASTER BATHROOM UPDATE ELECTRICAL Infractio Passed Comments
GFCI OUTLETS SWITCHES AND LIGHTS INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 04,2016 For Inspections please call: (305)762-4949 Page 31 of 36
Y
P,
c
Miami Shores Village Pellt•#lt TO ,)e )G�1�,-Re�)� 1�1 4
g� 10050 N.E.2nd Avenue NE
rmt
tt7r t $068 c>'rt A[toro
Miami Shores,FL 33138-0000 `
Phone: (305)795-2204 Pert�'.� rF=APRVE!}
issua tya 7> Cl2t}1 -:: Expiration: 012212017
Project Address Parcel Number Applicant
1190 NE 92 Street 1132050270460
Miami Shores, FL 33138- Block: Lot: DAVID MARKUS
Owner Information Address Phone Celt
DAVID MARKUS 1190 NE 92 Street
MIAMI SHORES FL 33138-2935
Contractor(s) Phone Cell Phone Valuation: $ 2,085.00
FRONT LINE ELECTRIC LLC (561)777-8835
Total Sq Feet: 115
Type of Work:REMODEL MASTER BATHROOM UPDATE ELEC Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Review Electrical
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80
Invoice# EL-6-16-60197
DBPR Fee $2.25 07/26/2016 Check*4006 $ 162.30 $0.00
DCA Fee $2.25
Education Surcharge $0.60
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $2.40
1 1
Total: $162.30
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 A IDAVIcertify hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction a ni Futh ore,I authorize the above-named contractor to do the work stated.
July 26, 2016
A thorize Signat e: er / Applicant / Contractor / Agent Date
Building Department Copy
July 26, 2016 1
Miami Shores Village -
Building Department JN 201
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 20145�
BUILDING Master Permit No. t �P f
PERMIT APP ATION Sub Permit No.
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: GZ��� �� 5;zt .
City: Miami Shores County: Miami Dade Zip: _�- ! 3 9)
Folio/Parcel#• 1' 3;?0,6-'0 2 7- (0'/6 o Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
Sas- y1o2 - 6
OWNER:Name(Fee Simple Titleholder): /✓/�) 1V'4e_Ls/j Phone#:7,k6 - .a 2 7��
Address: / f u A/ S r
City: f'�1%h}/�7 i S R CS State: I Zip: < 3
Tenant/Lessee Name: Phone#:
Email: &L.07tY
CONTRACTOR:Company Name: ff / g/Ar� Phone#:
�
Address: '1 �� D'j����
City: jVS(jVe 104//c ,�/ State: N— Zip: —3;-!;Qualifier Name: V-F—.4 Cr Phone#:
State Certification or Registration#: Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ��� Square/Linear Footage of Work: J 1{
Type of Work: ❑ Additiocn� Alteration
� ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: �u�-cy� Mr �r/ 1t t&� ' (JPL�' / ilLer
Specify color of c for thru tile: g ,
Submittal Fee$ Permit Fee$ C✓'��< ®® CCF$ II (L CO/CC$
Scanning Fee$ 'p Radon Fee$ Dsey�BPR$ - Notary$
Technology Fee$ o1 Training/Education Fee$ L? 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 thefirst inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
in ction will not be approved a reinspection fee will be charged.
Signature Signatu
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 120 by � '1day of 20 by
who is personally known to .*0V D� wh i�person�allyknownto
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 PUBLIC:
Sign: T Sign:
Print: �®°1'�" �-• [L-e�b Print: JyO�n hie �- • 1
Seal: ��,,q,,�, Dp�L�SEAN Seal:
' '�,. MY 0 MMVOON 9 EE 845044 ,K)ANNE L DEAN
41. F3 N4 r 4,2018 ?iA MY COMMISSION 9 EEExPi845044
�' Bwded TW,N Pubac UWelll m `Q EXPIRES.�yvember PuPublk Unde forte
APPROVED BY '��'/��� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Client#:25021 FRONTLIN
ACO Dtu CERTIFICATE OF LIr BILITY INSU 06/01/20NCE DAT 101= 6
16
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(%AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:If the ce►1lfhsate holder Is an ADDITIONAL INSURE , o Iso 1cyj6W)must he ondased.if SUBROGATION 13 WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate dam not confer rights to the
certificate holder In lieu of such endorsement{s�
PRODUGBR e" Carissa LaFreniere
Cypress Insurance Group .994 771-0300 N®;954 772 9424
PO Box 9328 E-MAI CaarissaLcypressinsuranc+a.Corrl
Fort Lauderdale,FL 33310-9328ADDRESS- INSURERM
:Old DAFFORDINGCOVERA" NAlce
954 771-0800 INSURERAominion Insurance Company 40231
r
INSURED INfRiRER®:Briedgeflald Casualty Ins Co
Front Line Electric LLC :
.. -----
8072 Pinnacle Pass Way INsaIRER+a
Boynton Beach,FL 33473 INSURER D: -
INSURER E:
INSURER P,
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 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 ANO CONDITIONS OF SUCH POLICIES_ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
f TYPE OP INSURANCE ADD H POLICY NUMBER .PO EPP LIaUT3
p GENERAL LIABILITY MP043551) 0610312016 06/03/201 7 EAom uRRENcE 31,000,080
COMMERCIAL GENERAL LABILITY — yg 550,0,000
- E CL81MS-MADE ®OCCUR I !MED EXP 4? Y maa pertan} $10ti _ ___._
PERSONAL 6 ADV INJURY S1,000 000
�. GENERAL AGGREGATE *12,000,000
GM AGGREGATE LIMIT APPLIES PER: PRC oum.CoMPlOP AGG 52,000,000
POLICY 7 pR� 7 LOG S
AUTOMOBILE LIABILITY N&ELVIT
e� n
i ANY AUTO BODILY INJURY[Pet pars=) i'S
ALL MS ED SCHEDULED Bowe f IN.IURY IPw 130aw o $
N®N•owvED P E S
KIRE®AUTt3S AUTOS
UMBRELLA LUU3 OCCUR ala OCCURRENCE S
EXG888 LUfB CLAIMS RADE AGGREGATE S
DEC) RETENTION S _ S
13 WORMS CONFENaAMOH 19631594 (1610312016!06103120117 X Yrc sTATad ;DTia
AND eelpLOYER9`LIABILITYEa
ANY PROPRI€:TOR/P CUTrvE Yr N LL.EACH ACCIDENT $600,000
OVFIOER SEX LU ED ® NIA
1Mandmrdi in NH) E.L.DISEASE.EA EMPLOYEE SM,000
61WtP yOs, undar
WIPTaON PFOPERATICINShelaw E.LDISEASE-POLICYLIMIT 5500000
i
DESCRIPTION OF OPERATIONS I LOCAMOMS I VEHICLES JAWO ACORD 101,A*Mfow1 Rsm ft Sobedule,IT more space Is required)
Workers Compensation applies to Florida operations and employees only.
License#14ECOOOTI I state Lic#ERI 3014953
CERTIFICATE HOLDER CANCEL.LATI N
Villa a of Miami Shores t31d SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
9 g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Dept. ACCORDANCE WITH THE POLICY PROVISH)NS.
10050 NE 2nd Avenue
Miami,FL 33138 AUTHORIZEDREPRES/OffAATIVE
/
0 ISM2010 ACORD CORPORATION.All rights reserved:
ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S2238451M223785 CC