EL-16-2628 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-268125 Permit Number: EL-9-16-2628
Scheduled Inspection Date: September 29,2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: ir%A
Owner: BEN ZVI, ITAY Work Classification: Service Change
Job Address:366 NE 99 Street
Miami Shores, FL 33138- Phone Number (917)514-8517
Parcel Number 1132060135560
Project: <NONE>
Contractor: CAYAMAS ELECTRIC CORP Phone: (305)227-4222
Building Department Comments
REPLACE ELECTRICAL SERVICE AND CHANGE Infractio Passed comments
ELECTRICAL PANNEL INSPECTOR COMMENTS False
r� Inspector Comments
Passed
r
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 28,2016 For Inspections please call: (305)762-4949 Page 22 of 26
� 1�"�y -;"?610W_
Jr = 3 ,v 7 i 3 IMI
9hnc°Rr-„S 14 Miami Shores Village i"�19�WTI � 11
10050 N.E.2nd Avenue NE .
....,. Miami Shores,FL 33138-0000 �
hrP— � Phone: (305)795-2204 a
Prr�ttt Status= P i� �D
�YORNp' �
Expiration: 0 /25/2017
Project Address Parcel Number Applicant
366 NE 99 Street 1132060135560
Miami Shores, FL 33138- Block: Lot: ITAY BEN ZVI
Owner Information Address Phone Cell
ITAY BEN ZVI 366 NE 99 Street (917)514-8517
FL
366 NE 99 Street
FL
Contractor(s) Phone Cell Phone
CAYAMAS ELECTRIC CORP Valuation: $ 2,000.00
(305)227-4222
_..... _...,.,. . Total Sq Feet: 0
Type of Work:REPLACE ELECTRICAL SERVICE AND CHAN Available Inspections:
Additional Info:REPLACE ELECTRICAL SERVICE AND CHAN Inspection Type:
Classification:Residential Review Electrical
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
Invoice# EL-9-16-61446
DBPR Fee $2.25 09/26/2016 Credit Card $ 115.70 $50.00
DCA Fee $2.25
Education Surcharge $0.40 09/22/2016 Credit Card $50.00 $0.00
Notary Fee $5.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $165.70
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.
O NE S AFF AVI I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
co trcoon o n Futherm e,I authorize the above-named contractor to do the work stated.
September 26,2016
Autho zed Signature Owner / Applicant / Contractor / Agent Date
Building Department Copy
September 26,2016 1
(912.-3(201 G
Miami Shores Village IRECRYNnED
. r1 Building Department S P 22 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: _
Tel:(305)795-2204 Fax:(305)756-8972 05 t-h
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2014
BUILDING Master Permit No. 6� 1 CD - 2(_0 23
PERMIT APPLICATION Sub Permit No.
❑BUILDING (LflE_J.ECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 34 G A)
City: Miami Shores County: Miami Dade Zip: .3 )
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: l Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): =7� ���/9/ Phone#:_ / `� � 1,7
�p, //
�,'t0 �i C)9
Address: P�
City: "'( .<-t " --r +iL�y State: Zip: 33
Tenant/Lessee Name: Phone#:
Email: 13=f)7—Z—V G'014
CONTRACTOR:Company Name: �/� �S 91e_e-1R:c C'a'p Phone#:
Address: ®!� � � -4 6f-j-
City: TI f Il State: Zip: l
z
Qualifier Name: �l-r'��1�� �A���� �� Phone#: 0,(
State Certification or Registration#: 0049 `' Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ or Square/Linear Footage of Work: ED
Type of Work: ❑ Addition [j3--,Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Re awl
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ /������ CCF$ 20 CO/CC$
Scanning Fee$3' W Radon Fee$ 2. 1215 DBPR$ 2 , 2G Notary$ c,• oz)
Technology Fee$ ' 60 Training/Education Fee$ ® ' 4o Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(RPvicPdn7/74/7n141
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 s i sued. in the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature—:;��� Signat
l
OWNER or AGENT CONTRA OR
The foregoing instrument was acknowledged before me this The foregoing instrument was"a"cknowwlledged before me this
20 day of S^ ( N1 20 ( G ,by -2�-2rd day of� '�F-+t_Y`Y�1f11U�r .20 , by
.vh ; )o is personally known to O C�q U i in � • �r A1C who is personally known to
me or who has produced U-7M VEP—uQ)rz--NS;F as me or who has produced Driwy l a CSV u-#, as
identification and who did take an oath. identification and who did take
NOTARY PU IC: NOTARY PUBLIC:
Sign:
Print: �( (�I � ,a1.5�� _ _ Print: Y'i
Seal: Seal: ...... YANADYPRIETO
;o00 P4B`• Notary Public State of Florida �;_ MY COMMISSION#FF 214031
Sindia Alvarez �'•. ia: EXPIRES:March 25,2019
a My commission FF 158750 `'1 AF4P' BondedThm NoteryPubl'cUndennriters
E ires 09103/2018
APPROVED BY Plans Plans Examiner Zoning
Structural Review Clerk
/De A—Am mA mnl Rl
RICK BCOTT, GOVERNOR - KIEN LAWSGR, SE'CRE'rARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD 's
� f
EC0000507 ?
The ELECTRICAL CONTRACTORA�
Named below IS CERTIFIED
Under the provisionvnf Chapter 489 FS.
Expiration date: AUG 31,2018
All
MENENDEZ, JOAQUIN R
CAYAMAS ELECTRIC CORP'_, 1'
8225 SOUTHWEST 41ST"TFRRAGF� ,. . �_ �•
MIAMI FL.:S3155-42480
ISSUED: 08/11/2016 DISPLAY AS REQUIRED BY LAW SECT# L1608110003080
003651
Local Business-Tax cel
Miami—Dade County, State of Florida
—THIS IS NOT A BILL—DO NOT PAY Li3T
403634
BUSINESS NAME&OCATION RECEIPT NO. EXPIRES
CAYAMAS,ELFCrRIGCORP REMWAL SEPTEMBER 30, 2017
M5 SUV 41 TERR, 40 634 Must.be-displayed at place of tusiness.
MIAMI FL-33155 Pursuant to County-Ctide
Chapter BA-Art.9&10
OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED
CAYAMAS ELECTRIC CORP 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR
EC0000507 $75.00 07/11/2016
b4�or>cer(sJ f 0 EREDITCARD—I 6-037938
This Local Business-tax Receipt only confirms;payment of the Local Business Tax.The Racelpt is not license,
permit,or a certification of the holders qualifications,to do business.Holder must comply with any governlneilhil
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sac Be-276.
For more Information,visit www miamidade govhaxcollectar
i 1r
ACORCERTIFICATE OF LIABILITY INSURANCE DA-MMMIDDITYYY)
09f22/2010
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: N the certificate holder Is an ADDITIONAL INURED,the Pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed.
H SUBROGATION IS WAIVED,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 Ileu of such endomeme s.
PROMx=
HI-Tech Insurance Agency,Inc. 3ps-2Zs-sa11 30s�79.s,7s
P.O.Bohr 441748 xdj�ENO
Miami FL 33144
srovaehse tis
INSURER A:Ascendant Commercial Insurance Inc
NIII� -
Cayamas Electric Corp mum e:F U B A
82228 S.W.41 Ter INSURER C:
Miami FI 33155 INSURER D:
INSLUM E:
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.
RM
TYPE OF INSURANCE LamCOwnRGIALOBwftL BIUTY EACH OCCURRMCE 51,000, 0.
A CLAMMADE L_J occurs OL-359424 09/23/2018 09/23/20173100,000
ACED EXP era $5,000
PERSONAL&ADV INJURY 31,000,000
�i L ACiOREOATE LIMIT APPLIES PER GENEM AGGREGATE 32,000,000
POLICY,ECT LOC PRODUCTS-COMPIOPAGG 51,000,000
OTH[3i: 3
AUTWIOSILEL1ABMTY S
ANY AUTO
BODILY INJURY(Par pneeeq 3
OWNED SCHEDULED ) 3
AUTOS ONLY AUTOS BODILY INJURY
HIRED NON-OWNED
AUTOS ONLY AUTOS ONLY DAMAGE 3
S
USISRELLA L AB OCCUR Li EACH OCCURR89CE 3
EXCESS UAB CLA M54AADF $
DEDRETENTION 3
B r coAt�►TION 10643891 04/0112018 04/01/2017
AND EMPLOYERS'UABI ITY Y I N ER
ANYPROPRIETORIPARTNERAXECUTIYE ELEACHACCIDENT $500,000
OFFlCwwd�u CLUpBp7 NIA
E.L.DISEASE-EA EMPLOYEE 8500,000
OP OPERATIONS E L.DISEASE-POLICY LIb11T 500,000
0
OBSCF PTADN OF CPRMTIONS I LOCATIONS I VE1=8(ACORD tea,Aditww Ramnb schs&s s,may be mnm*Ad N mars spa A►rr*gWrodl
Elecblcal Contractor
CERTIFICATE HOLDER CANCELLATION
Miami Shore Village SHOULD ANY OF THE ABOVE OESCRISED POLICIES BE CANCELLED BEFORE
Bldg Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10050 N E 2nd Ave ACCORDANCE MIRM THE POLICY PROVISIONS.
Miami Shores,FI 33138 AnvE
r, .
r
��J
019UQOIS ACORD CORONOOMQN.All ftbis reserved
ACORD 25(2018103) The ACORD name and logo are registered marks of ACORD
Produe"ush m Fera So"pleb Soewars.ww.Pommaaoss.00m(a)ImpmasM Publishing 880,20&IWT
VA Oe
�eI T
� ��� � h� rP ,�� 2016
s4I � a Vt T BY:
r
Vi
�Bc t C IQ SPA ok I
ht vtwaUC �( '0
c Qp
��«c{ N
uJ N�#(
�� �� 1�G
��
C
1
p � lVr
a-
-_____ �' �;i Sr1C�(;?J L�1���fie• .�
PF'RJ\jFL) BY DATE
ELDI. DEFT
S'U'BJECT iO CCh.IPI PNCE WI(H ALL FEUERAL
STATE ANj(,C I-jN, f HLL-S ACJD REGULA PO�,JS