The URL can be used to link to this page

EL-12-1971 aC 1 -2-- IqLZt Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-180309 Permit Number: EL-10-12-1971 Scheduled Inspection Date: December 18, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: WATSON, LEONARD Work Classification: Addition/Alteration Job Address: 165 NW 99 Street Miami Shores, FL 33150-1742 Phone Number Parcel Number 1131010230390 Project: <NONE> Contractor: ELECTRICAL MASTERS INC Phone: 305-265-7996 Building Department Comments ELECTRICAL WORK FOR NEW ADDITION OF KITCHEN Infractio Passed Comments AND FAMILY ROOM INSPECTOR COMMENTS False Inspector Comments Passed (� Failed C,2 . Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 17,2014 For Inspections please call: (305)762-4949 Page 3 of 29 1► Miami Shores Village , Building Department ` oeovoeeevoomeoo9o�od 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit NoIE� 12- PERMIT 2PERMIT APPLICATION Master Permit No. Permit Type: Electrical JOB ADDRESS: Z 6 5 /(W 0 '1 51 City: Miami Shores County: Miami Dade Zip: 0 Folio/Parcelk Is the Building Historically Designated:YesNO Vl Flood Zone: // OWNER:Name(Fee Simple Titleholder): lie-0 mx,Y� t C`t6wfi� skk Phonek 3e 5"- Address: 1 A 5 N c_J !2Q 3 F .&- City: llm'tm i State: —F-(0 Y Zip: 815- Tenant/Lessee Name: Phonek Email: ��-- CONTRACTOR:Company Name: `� , f Phonek Address: 1� loo CJ t�1 S-L City: State:_F:7�4 Zip: Qualifier Name:VG 1A= Phonek State Certification or Registration#: ®� Certificate of Competency#: e 0000 1 3 Contact Phone#: /Rq2�� Email Address: Z I DESIGNER:Architect/Engineer: E' 1�2�t M r e /n L Phonek (:k(:k - ,�2-633 2- Value of Work for this Permit:$ S®00 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ew ORepair/Replace ❑Demolition Description of Work: -:,vr �ex Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ < V Bonding Company's Name(if applicable) Bonding Company's Address 00 LJ l s City (�1 A 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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. Signature �< wam,�,,ayd, Signature Owner or Agent Contractor The fo in i tru t was knowledged efor m thi The foregoing instrument was acknowledged before me this day o 20 L by day of .AC-�o s 20/�,by S��1 � �, ��- h is persoIBLIL ly kn n to me or who has produced who is personally known to me or who has produced f�_ ' i cation and who did take an oath. as identification and who did take an oath. NOTARY NOTARY PUBLIC: Sign: Sign: A44�aizL.1� Print: ��PJ kale os,2��9 Print: , RDJ2 / z MyCommission ,,;p ., N°lacy Pm �xp\�e#EE 12aa y PSS° My Commission Expires: ;z +y;_�Ay Gomm�sU9�N3��°��a�NO . Ra. State of Flod� f��QiIin�za=k:kek �ionEE013368/2014 APPROVED BY JsiZ �� Y Plans Examiner Z ing Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) To: Poga 2 04 2 20'i 3-07-03��:�2:22 EOT �j� '13052200785 From: i®ure_ OP ID:SISI CERTIFICATE OF LIABILITY INSURANCE DATE 31201 'Y) 07/03/2013 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). CONTACT PRODUCER Phone: 305-223-2533 NAME: iSure Insurance Brokers Fax: 305-220-0765 PHONE FAX 2700 SW 137 AVE C No' o E A/C No): Miami, FL 33175 Teresa R. Carmona, Agent ADDRESS: CUSTOMER ID i::ELECT-1 INSURER(S)AFFORDING COVERAGE NAIC/ INSURED Electrical Masters Inc. INSURERA:Florida Citrus, Business FUB 8400 SW 14TH Street INSURERB:Travelers Insurance Co. Miami, FL 33144 INSURER C: 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. INSR R1 POLICY EFF POLICY 5XP LTR TYPE OF INSURANCE POLICY NUMBER M/DD M/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B X COMMERCIAL GENERAL LIABILITY 660-7A846384 10/09/2012 10/09/2013 PREMISES Ea occurrence $ 50,000 CLAIMS-MADE F OCCUR MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 X BLANKET ADD'L INSURED GENERAL AGGREGATE $ 2,000,000 GENLAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ ANY AUTO (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE $ (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIABHCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN X TORY LIMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE 10640035 04/01/2013 04/01/2014 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED' ❑ N!A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEJ$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,K more space Is required) lectrical Contractor CERTIFICATE HOLDER CANCELLATION CITYMI1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. Fax:305-756-8972 10050 NE 2 Ave AUTHORIZED REPRESENTATIVE Miami, FL 33138 COZ�Q/ ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD