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EL-16-836 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-268400 Permit Number: EL-3-16-836 Scheduled Inspection Date: October 17,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: TADDEO, FRANK Work Classification: Alteration Job Address:341 NE 92 Street Miami Shores, FL 33138- Phone Number (305)758-7493 Parcel Number 1132060136380 Project: <NONE> Contractor: EMPIRE ELECTRIC MAINTENANCE&SERVICE INC Phone: 305-264-9982 Building Department Comments ELECTRICAL FOR KTICHEN AS PER PLAN Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed �/� CREATED AS REINSPECTION FOR INSP-268317.Add smoke/carbon l I monoxide detectors and arc fault protection. Label panel correctley. Failed � Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid October 14,2016 For Inspections please call: (305)762-4949 Page 19 of 43 `y�toaE„�s yt MI Miami Shores Village w Perms Tyre_Elelctrical:-1 � 10050 N.E.2nd Avenue NE 01* 4' Miami Shores,FL 33138-0000 `s Phone: (305)795-2204 ° plrt tom . "'1 .: �... Issute {� Expiration: 101301201 Project Address Parcel Number Applicant 341 NE 92 Street 1132060136380 Miami Shores, FL 33138- Block: Lot: FRANK TADDEO Owner Information Address Phone Celt FRANK TADDEO 341 NE 92 Street (305)758-7493 MIAMI SHORES FL 33138-3133 Contractor(s) Phone Cell Phone Valuation: $ 4,958.00 EMPIRE ELECTRIC MAINTENANCE& 305-264-9982 Total Sq Feet: 186 Type of Work:ELECTRICAL FOR KTICHEN AS PER PLAN Available Inspections: _ Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 DBPR Fee $2.61 Invoice# EL-3-16-59195 DCA Fee $2.61 05/03/2016 Check#:10274 $ 190.22 $0.00 Education Surcharge $1.00 Permit Fee-Additions/Alterations $174.00 Scanning Fee $3.00 Technology Fee $4.00 Total: $190.22 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. OWNEWofllfid�SIgnature.Wwner I fy that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construt ore,I authorize the above-named contractor to do the work stated. May 03,2016 / Applicant / ontractor / Agent Date Building Department Copy May 03,2016 1 Miami Shores Village �� - Building Department MAR 29 2816 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 Y INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC M4 BUILDING Master Permit No.?-C,16 - �3s<s PERMIT APPLICATION sub Permit No. EL—t(O 'C6-3t ❑BUILDING MELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP C( CONTRACTOR DRAWINGS JOB ADDRESS: I /h l" 6 �� City: Miami Shores 22County: Miami Dade Zip: Folio/Parcel#: 11—3Zo ata—&>55d Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: `/l Flood Zone: BFE:: FFE: n OWNER:Name(Fee Simple Titlehholder): F9AW V— J . �T1X � Phone#:M NO))-5Z5-S Address: .3,44 N S7 d ` ,City: wAmk State: fr-71 Zip: Tenant/Lessee Name: Phone#: `I Email: y CONTRACTOR:Company Name: j0lp , "Fl /A/C Phone#: \Address: =zn _ City: -State:State•/ �L! f � p: Qualifier Name: /eq Phone#: -30S- State ,OS TAT State Certification or Registration#: , /;274 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: 2 p City: State: Zip: Value of Work for this Permit:$ —! / / ��. Square/Linear Footage of Work: Type of Work: ❑ Addition El Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: i�l��T/� 57 Specify color of color ru tile: Submittal,Fee$ Permit Fee$ �' � O� CCF$ CA3 CO/CC$ Scanning Fee$ c�e`� Radon Fee$ o�•��, DBPR$ o� • I Notary$ Technology Fee$ —[ 00 Training/Education Fee$ GZ5 Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 150 o (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 a posted at t r for the first inspection which occurs (7) days after the building permit is issued. 1 the absence to noti , the inspection will not be approv reinsp ction fee will be charged. Signat a Signature ER or AGENT NTRA The foregoing ins rume t s acknowledged before me this The foregoing instrument was acknowledged before m this ag day offs 420 ,by /�day of20 by �— C '7--A-"b"b w G ,who is sonally know o A,*110 E, o is personally k own 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: j Sign: ' Print: .ter PutBE„T.....,,. Print: WCOWISSION#FF19D711 _ Notar Public-State of orida Seal: # * Seal• Y EXPIRES:Mende 26+2019 e `; ,aa. Qc My Comm.Expires Feb 8,2017 tl%oFF�O�O BOTtlfUetNOtBry$81Ylm �ZrEOFF� Commission#EE 854852 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) From Empire Electric 1.305.264.1974 Fri Apr 22 09:26:19 2016 MST Page 1 of 1 EMPIR-8 OP ID: KY AC CERTIFICATE OF LIABILITY INSURANCE o`-re`m ' x3/3012016 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 QCT MatthOW Seese BROWN&BROWN OF FLORIDA INC NE .305-364_7800 305-714-4401 14800 NW 79th Court Sulteacc Miami Lakes,FL 33016-5869 Matthew Seese INS AFFORDING COVERAGE NAIC d INSURER A:Amerisu re insurance Company 15488 INSURED Empire Electric Maintenance INSURER B:Amerisure Partners Ins.Co. 11050 and Service Inc. WSURERC:Amerisure Mutual Insurance Co 23396 Empire Fire Safety,LLC" W RERo:Philadel hia Indemnity Ins Co 18058 2200 SW 67th Avenue Miami,FL 331SS alstlReRE WSURER 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. LILT TR TYPEOF1NSIIRANCE ADDLILY ER HFP EXp LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCLiRRENCE 8 1,000,00 CLAMS-MADE a OCCUR CPP21006690001 0313112016 03/31/2017 pREW� E 5 100,0 MLU EXP(Any one pm en) s 10,000 PERSONAL&ADV INJURY $ 1,000,0 GERL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,00 POLICY D PRO- LOC PRODUCTS-COMPIOPAGG $ 2.000,00 S JECTAUTOMOBILE LIABILITY EOTHE& M D sI LIMIT S 1,000,0 B X ANY Auro CA21006MODS 031311201 B 0313112017 BODILY INJURY(Per Pw8w) S ALLOWNEDSCHEDULED BODILYINJURY(Per aeddent) S AUTOS AVTOS NONd�WNED OP D lira HIRED AUTOS AUTOS 8=OW* S X UMBRELLA UAB I X OAR EACH OCCURRENCE s 5,000. C EXGESSLIAB CLAIMS MADE CU21006700002 0313112016 03/31/2017 AGGREGATE $ CD0, OED I X I RETENTION S 10-000 $ WORKERSCOMPENSATION X ATUfE ER AND EMPLOYERZ UABILn7 YIN yJMIOW710001 03/31/2016 03131/2017 E.L.CACHACODENT S 1,000,00 A ANY PROPRmTORIPARTNERrEXECUrNE OFnCERIMEMBER EXCLUDED? N N r A E.L.DISEASE-EA EMPLOYE S - 1,000,00 (Mandatory hi N14) Mad deaerW urwier E.L.DISEASE-POLICY lJA1rr S 1,000,00 DE IPTI OF OPERITIONS below O General L(Bbility' PHPK14749l16 03/31/2016 03131r2017 OCdAgg $1MI$2 p UmbrellaLiabiW PHUBGSSSGS 03131IMS 03/31/2017 OccrAgg DESCR FMON OF OPERATIONS r LOCAMONS r vEMCLES•(ACORD 101,Add t ntd RWMM Sdmduk%may be attadmd n mm space IS ) Electrical Contractor-State License EC#0001214 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 13E CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village 10050 N.E.2nd Avenue AUTHORREOREPRESENTATIVE Miami Shores,FL 33138 Btowwn and Brown of Florida,Inc. ®1988-2014 ACORD CORPORATION. A8 rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD