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EL-16-524 Inspection Worksheet Miami Shores Village , w r� � I �� ��� 10050 N.E.2nd Avenue Miami Shores,FL V V Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-268205 Permit Number: EL-2-16-524 Scheduled Inspection Date: September 30,2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: , Work Classification: Alteration Job Address:1450 NE 103 Street Miami Shores, FL 33138-2626 Phone Number (305)647-6486 Parcel Number 1132050310040 Project: <NONE> Contractor: AJL ELECTRIC INC Phone: 305-895-4971 Building Department Comments HOOK UP 30 AMP FOR BOAT LIFT Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed EJ/ Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until reinspection fee is paid September 29,2016 For Inspections please call: (305)762-4949 Page 31 of 32 (q,5 20�� Miami Shores VillageEP 2 2 2 Building Department 10050 N.EZnd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 i INSPECTION LINE PHONE NUMBER:(305)762-4949 WSW 20(4 BUILDING Master Permit No.V11S W — �1�`�� PERMIT APPLICATION Sub Permit No. 1= 11 * -- 6'a9 F-1 BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WOR CHANGE OF CANCELLATION ❑ SHOP 9 f� CONTRACTOR DRAWINGS JOB ADDRESS: 5.0 �J C 10 3,d S c City:_ Miami Shores County: Miami Dade Zip: 32, 139 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: , rConstruction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): nV(F;�V p-1 0jC.� . Q�L-�' Phone#�gC�5(C Lt(C� 0(2 Address: I q31 ppC64000CL ko�i1 gu.c. r- o --GG S��•��l g City: 1 (r�,C�. &O t•kt' State: Zip: 3-3 ?( Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: le-C,Z•(LC— Phone#: 3 Address,,: }} ( 2,5-5-5 13, S c A-y o e (3t—tJ a N City: , 0 te"C-N k' State: Zip: -3 3 ( ;? 1 Qualifier Name: �oJ-c�. J-I LL'LPu �, Phone#: State Certification or Registration#: i:C- (3 613 ,�--o $cT Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address City: State Zip: r Value of Work for this Permit:$ 0-b 0 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration Ep New ❑ Repair/Replace ❑ Demolition Description of Work: _c_-TOZ-( C c,-A rte-- �" ` L t !r Specify color of color thru tile: gr,Le."i i1 iit nAi2entar>oil:,i Submittal Fee$ Permit Fee$ f r �U CCF$ !'aza L''it ' ' i° "`?�a0° Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ + (ReVISOp2/24/2014) F_ Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address Cir 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$2500,the applicant must T promise in good faith that a copy of the notice of commencement and construction lien low hrarhurp wUl ha deli iered to the pnrSgn whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspectionfee will be charged. l Signature Signature OWNER'orAGENT 0 RACT R The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this r _day of ���� aC� 20 /(,., byj 5 day of Pie na(Sc�'C ,20 ((,g by /� �E�r2A �.Po vA ,who is personally known to f� K648yY J LL,0O -2 who is personally known to me or who has produced ss as me or who has produced as identification a th. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign 2' Sign: ."�—A-�/— a I V - 4"1 �—o Print: "'- k1M ECKHARDT �`"� •y, IIIA EL J GULO MY COMMISSION s Moloy Fidift-Strie of FWW Seal: J%mly ExPIRES:Fd*uWy 12.2019 • Concession 0 FF 994501 Aly Comm.boos AHOY 19.2020 8a tAtatgtl M�hlnal,Atotary Ate►. APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 1 - STATE OF FLORIDA DEPARTMENT OF-BUSINESS:;�D-P=ROFESSIONAL REGULATION . ELECTRICAL C TR-A&CIR6 LICENSING BOARD �q6C`I�kI02089 .. , �. The ELECTRICAL CONTRACTOR Named below IS CERTIFIEQ Under-the prQliisioJis 6f Chapter 499 FS. � - 40 Expiration date: AUG 31; 201$ LUPO,ANTHONY-J-JR -- - ~' _ ■ A J L ELECTRIC INC 12b55-BISCAYItEBO- ■ NORTH MIAMI 18ia�v _ �, 1 ■ ISSUED: 07/26/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1607260001567 . City of North Miami 776 N.E.125 Street • North Miami, FL 33161 • 305-893-6511 NORTH MIAMI Business Tax/Certificate of Use Receipt Issued Date: 10/1/2015 ELECTRICAL CONTRACTOR Expiration Date: 9/30/2016 Business Tax Receipt#: BT-002364 _ Business Name/Address: AJ L ELECTRIC, INC. 12555 BISCAYNE BLVD, BOX 826 A J L ELECTRIC, INC. NORTH MIAMI, FL 33181 12555 BISCAYNE BLVD BOX 826 Michael A.Etienne,Esquire,City Clerk NORTH MIAMI, FL 33181 NOTICE: • OR SOLD. NON-TRANSFERABLE POST IN A CONSPICUOUS PLACE NON-TRANSFERABLE 000823 p Local Business.:Tax Receipt Miami—Dade County, State of Fld'rida -THIS IS NOTA BILL - DO NOT PAY 1929745 L B T-01 BUSINESS NAME/LOCATION RECEIPT'NO. EXPIRES AJL ELECTRIC INC RENEWAL SEPTEMBER 30,2016 12408 N BAYSHORE DR 2037000 Must be displayed at place of business NORTH MIAMI FL 33181 Pursuant to County Code Chapter 8A-Art.9&10 , OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED AJL ELECTRIC INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR Worker(s) t EC13002089 $45.00 07/29/2015 CRED[TCARD-15-038787 AJLEL-1 OP ID:TR '4 CERTIFICATE OF LIABILITY INSURANCE DATE(M3/20Y6 05/03/2016 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 pollcy(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 NAME CT Roebuck Associates Insurance PHONE FAX Exchange LLC Arc N Arc No): 5599 S University Drive,111301 E-MAILssc Davis,FL 33328 Roebuck Associates INSURER(II)AFFORDING COVERAGE NAIC s INSURER A:Wesco Insurance Compan INSURED AJL Electric Inc. INSURER B:RetailFirst Insurance Company 12408 N.Bayshore Drive INSURER C:United States Liability Ins Co N.Miami Beach,FL 33181 INSURER D: INSURER E 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. ILICY LTRR TYPE OF INSURANCE POLICY NUMBER 7MWDDMIYYYYIMAD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1.000,00A X COMMERCIAL GENERAL LIABILITY P114875702 2016 05/15/2017 PREMISES Ea occurrence) $ 100,00 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,0 JECT —1 X POLICY 7 PRO- LOC $ AUTOMOBILE LIABILITY CO#ABINEDISINGLE LIMIT AN AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 130DILY INJURY(Per accident) $ AUTOS TOS NON-OWNED PROPERTY DA E $ HIRED AUTOS AUTOS PER ACCIDEN UMBRELLA LIAS X OCCUR EACH OCCURRENCE $ 2,000,00 C X EXCESS LRB CLAIMS-MADE XL1566070A 05/18/2016 05/18/2017 AGGREGATE $ 2,000,00 DED RETENTION$ $ WORKERS COMPENSATION X WRY TA IU' ER AND EMPLOYERS'LIABILITY B ANY PROPRIETORIPARTNERIEXECUTIVE YIN NIA 52047540 05/15/2016 05/15/2017 E.L.EACH ACCIDENT $ 1+000,00 OFFICERIMEMBER EXCLUDED? El (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under 1,000,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (Attach ACORD 101,Additional Remarks Schedule,N more space Is required) EC13002089 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 g ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept. 10050 NE 2 Avenue AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD m ♦501 G Miami shores Village �n Bftttlttt� CB ` �.�,. -UNWON LP 2 2 2816 Building Department � RipA 10050 N.E.2nd Avenue By.& Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR /ARCHITECT Permit N. INSLO 16 - S18-f 5 u 8 PG9,1A1T• NO : E- l 16 - 5Ly Owner's Name(Fee Simple Title Holder): V 1 j<TO 2`IN FX , LI--G Phone#. 486 " Sr31 S Oo B Owner's Address: 145-0 5-0 N C 10 3 RD STB. City: M I AM I S H O(Zr S State: F L Zip Code: S°S 158 Job Address (Of where work is being done): 1116,01 NE 403n SI E F—I City: Miami Shores State:—Florida Zip Code: 55-1S8— Contractor's 5 13$Contractor's Company Name: M 00 D 1 'E LF GN I G l NC• Phone#: 305 — 7 58 Address: 58 1Q N 961 -) ^V1 City: HQLLY W 00-D State: F -L- Zip Code: 320 2,0 Qualifier's Name: JOHN 1. MOODY Lic. Number: E C 000 1199 Architect/ Engineer of Record Name: Phone#: Address: City. State: Zip Code. Describe Work: f—Lf=-CM1 G&L FOP, SOA7• Ll I j 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 Miami Shores harmless of all legal involvement. Signature Signa :;�;� Owner or Agent Contractor or itect The foretoing instrument was aknowledged before me The foregoing instrument was aknowledged before me C this day of A 1201 ,b -e-, tA�fO&re-- this q "% day of h L 2016 by U11 X. M�c 9 Who is personally known to me or who has produced who is personally known to me or who has produced �� �" �•�(« ���5 _�� as indentification. as indentification. Notary Public l Notary P li T--- Sign: �v a Sign: Seal: Oscar Roca # Notary Pub State o3 Florida p c o My Commission FF 043914 Seal: a8 Rebece oz `> `�•c Or�G0 Expires 08/08/2017 •+�. Nly Commission FF 818344 Expires 09/08/2019 Ae oRs t, 24 Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 , Phone: (305)795-2204 7 ' Expiration: 10109/2016 Project Address Parcel Number Applicant 1450 NE 103 Street 1132050310040 Miami Shores, FL 33138-2626 Block: Lot: VIKTORINEX, LLC Owner Information Address Phone Cell VIKTORINEX, LLC 1931 CORDOVA RD Road (305)647-6486 FT. LAUDERDALE FL Contractor(s) Phone Cell Phone Valuation: $ 3,500.00 MOODY ELECTRIC INC (305)758-2000 Total Sq Feet: 00 Type of Work:HOOK UP 30 AMP FOR BOAT LIFT Available Inspections: Additional Info: Inspection Type: Classification:Residential Scanning:1 Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 DBPR Fee Invoice# EL-2-16-58826 $2'25 04/12/2016 Check#:298 $ 163.90 $0.00 DCA Fee $2.25 Education Surcharge $0.80 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $163.90 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 accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named con to do the work stated. April 12, 2016 Authorized Signature:Owner / Applicant / Cont r / Agent Date Building Department Copy April 12,2016 1 Miami Shores Village �� pea 26 20 Building Department �s 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 'A Tei:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 BUILDING Master Permit No.j 5 2j I J 3X* PERMIT APPLICATION Sub Permit No. (BUILDING WELECTRIC ❑ ROOFING ❑ REVISION [:] EXTENSION ❑RENEWAL []PLUMBING ❑MECHANICAL M PUBLIC WORKS ❑ CHANGE OF M CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: � �� �,•✓� `� ® �' ® � ��� City Miami Shores County Miami Dade zip: Folio/Parcel#: `L �I (�®�{o Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): VJe�m I N l". y. L, Phone#: f) Address: I LA �'o . `- S+rce-t-. City: d1V �S State: ��-%k Zip: 3� Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ' - Phone#: 759 -ZQ00- Address: ?)812h 19 �►� city:� -W� -State: 1 Zip: ZO Qualifier Name: Ja11r1 7 Phone#: 0 59 W00 State Certification or Registration#: Certificate of Competency#: DESIGNER:Arch*t En Phone#: W Address: City: State• Zip: Value of Work for this Permit:$ ��°f Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration [ New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee$ Permit Fee$ f��'©�' CCF$ CO/CC$ Scanning Fee$ Radon Fee$ a D8PR$ Notary$ Technology Fee$ Training/Education Fee$ �` Double Fee$ structural Reviews$ _ Bond$ �— TOTAL FEE NOW DUE$ t 63 ° C7 fad02/2412014) y Bonding Company's Name(if applicable) Olt— Bonding Company's Address City State I 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 wont 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 AFROAVIT: 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. l;F_ Signatu � Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of FNI-Q a 1�� .20 1(4 by 9 " day of Ffb f-Cid rLA .2010 .by TL+R A Hl k.Oye , ,who iWgMna)ly known to JG13 n 7- M (J .who Is personally known to 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: Sign: Print: Print: Seal: Seal: air or, Notary Pubft Sb is of Florida o00 ON Notary Public state of Florida Rebece Munoz r Rebew Munoz +� My Cornmisaton FF 818344 c �� My Comm(salon FF 918344 Expires 09/0812019 or we Facpires 09/08/2019 APPROVED BY Plans Examiner Zoning Structural Review Clerk OtevLseio2/24/2014)