EL-16-1551 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL C 5
Phone: (305)795-2204 Fax: (305)756-8972 J�v
Inspection Number: INSP-261837 Permit Number: EL-6-16-1551
Scheduled Inspection Date: December 19,2016 Permit Type: Electrical- Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: FARID, MEHRDAD MAC Work Classification: Alteration
Job Address:726 NE 92 Street 11 L
Miami Shores, FL Phone Number
Parcel Number 1132060440490
Project: <NONE>
Contractor: EVOLUTION ELECTRICAL CONTRACTORS Phone: (786)351-5784
Building Department Comments
REPAIR AND REPLACE ELECTRIC WORK IN KITCHEN Infractio Passed Comments
AREA REMOVE INSTALL NEW ELECTRICAL PANEL INSPECTOR COMMENTS False
Inspector Comments
Passed Add receptacles on left side of kitchen counter, under panel and bathroom.
Remove all cloth and rubber insulated conductors.
Add smoke)carbon monoxide detectors.
Need as built plan showing no dish,washer disposal, clothes washer and
Failed ❑ dryer.
G �
Correction
Needed
Re-Inspection ❑ ;
Fee /� f
No Additional Inspections can be scheduled until
re-inspection fee is paid
December 16,2016 For Inspections please call: (305)762-4949 Page 11 of 60
t, Miami Shores Village E jsl[ �tla
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
F Phone: (305)795-2204
ORtI
z�
Expiration:
.1 13/2 1
Project Address Parcel Number Applicant
726 NE 92 Street Number: 11L 1132060440490
Miami Shores, FL Block: Lot: MEHRDAD MAC FARID
Owner Information Address Phone Cell
MEHRDAD MAC FARID 726 NE 92 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 1,600.00
EVOLUTION ELECTRICAL CONTRACT (786)351-5784 Total Sq Feet: 0
Type of Work: Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Review Electrical
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# EL-6-16-60064
DBPR Fee $2.25
DCA Fee $2.25 06/16/2016 Credit Card $ 110.70 $50.00
Education Surcharge $0.40 06/03/2016 Credit Card $50.00 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $160.70
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.
OWNERS AFFIDAVIT: I certify that he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Fut ore uthorize the above-named contractor to do the work stated.
June 16,2016
Autho ed gnature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 16,2016 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 �•
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 Sf�
FBC2014
BUILDING Master Permit No. G to 13 as
PERMIT APPLICATION Sub Permit No.
F-1 BUILDING •R ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
p CONTRACTOR DRAWINGS
JOB ADDRESS: 7 Z `P �£ o� S ""'� # ti L-
City Miami Shores County: Miami Dade Zip:
Folio/Parcel#: %\' -3 20 Ce OLN ~ 6"0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: . Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): M"Rmt> -�A f-xb Phone#: Cl 2(- 2`f 0-7of 32)
Address: qC�5 � &Xjf. -4 29(I
City: N(-f+-tj State: - -L Zip: 3 3 c 3
Tenant/Lessee Name: Phone#:
Email:
IAIC
CONTRACTOR:Company Name: OLI)r1j941 4;teCr1?/6A6 c D.v?'�/�c:To�Phone#:
Address: ��W�� .'ll w .S`—i>- P/-
City: State: // / Zip: a.2
Qualifier Name: /-/tel/f'/7�//'l1 CC/ �� Phone#: ,
State Certification or Registration#: j!57R /.361/4 �C))` Certificate of Competency#: C'004110
DESIGNER:Architect/Engineer: J Ogf A 0AsN P��t.� � •� °"a�' Phone#: 95Y-'/Ke-'75")l
Address: V-0. 86ke2►11J City:PLjA114T*11p(4 Stater Zip:333(t
Value of Work for this Permit:$ l��� a Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Jl Repair/Replace ❑ Demolition
Description of Work: y '41,140 O �N%J
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ A / CCF$ d `2►4*3 CO/cC$
Scanning Fee$ 9 A ® Radon Fee$ 0DBPR$ Notary$
Technology Fee$ o::5 Training/Education Fee$ 405. 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-Propetty-is subject-to-attachment.-Also;-a-certrfied-copy of the recar&d77Mltr-of oammencement-must-b-e-p7J3tedwfa 1dG►te
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.
Signatur Signature
OWNER or AGENT ONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before/me this
®��day of 20 /� by day of��� 20 /cf� .by
LI who is persona ly known to ANTd 41i� XC®S>�4 who is personally known to
mor 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: a
Print - oM Print 'Z 1 •
Seal: Nolary Pubft sorer,of ode Seal: KARLA P. GARCIA
Oscar M Zaragoza MY COMMISSION N FF140421
apo MExpires 12(08/2019 939267 �PdO EXPIRES:July 10,2018
*#+k��akY�W*+F+t 6r �*+B&k��c*NsanR�Rb*�ks#�B�Y�Ia S+k�Y+k iwk�k�kii�6+N�k�k�s�k�k�R*�lsok#kPi�rr�kduR xc�s�+k�k+i¢*+kfib*�*
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
CTQB
Construction Trades Qualifying Board
BUSINESS CERTIFICATE OF COMPETENCY
IOE000610
EVOLUTION ELECTRICAL CONTRACTORS INC
D.B.A.7
ACOSTA ANTONIO
Is certified under the provisions of Chapter 10 of Miami-Dade County
jr,110 FOR. CONTRACTING UNTIL 091300 01T:
QUALIFYIAG TRADE(S)
0001 ELECTRICAL
0002 BUF.3LAR ALARM
0004 FIRE ALARM SPECLT
mt�
Jubar•a M 58We P E.
5euetaryotthe Bca+tl / waw tme+neatle gavtacciro+ny
Local Business Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOTA BILL-00 NOT PAY "� LBTJ
8738299
BUSINESS N"WLOCATION RECEIPT NO. EXPIRES
EVOLUTION ELECTRICAL RENEWAL SEPTEMBER 30, 2016
CONTRACTORS INC 7011810 Must be displayed at place of business
11831 NW 58 PL Pursuant to County Code
MIAMI,FL 33012 Chapter BA-eat.9&10
OWNER SEC.TYPE OR BUSINESS PAYMENT RECEIVED
EVOLUTION ELECTRICAL 196 ELECTRICAL BY TAX COLLECTOR
CONTRACTORS CONTRACTOR 76.00 08/17/2016
Worker(s) 1 10E000610 FPPU02-15.018652
This local Badness Tax Receipt only cculiuss payment of Oe local Business Tax.The Receipt Is no a license.
permit or a certification of the holder's qualHloalloas,to do busiueas.Holder curet comply with any governments!
or nongoveniffiantal regulatory taws and repbenionto which apply to the btrelmtss
The RECEIPT N0.above Buret be displayed an all copposmW veh -Mlaat-Dada Cale Sao Be-2713
® yw more information.visit
Municipal Contractoes Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOT A BILL-00 NOT PAY M C
CC NO: lOE000610
BUSINESSN"BILOCATION RECEIPT NO. EXPIRES
VOLUTION ELECTRICAL CONTRACTORS SEPTEMBER 30, 2016
11631 NM 58 PL 7472447
MIAMI,Fl. 33012 Pursuant to County Code
Sec 10-24
OWNER TYPE OR BUSINESS
EVOLUTION ELECTRICAL ELECTRICAL CONTRACTOR PAYMENT RECEIVED
CONTRACTORS BY TAX COLLECTOR
200.00 09/23/2015
0246-15-005541
TAI$receipt is not 0811d In 1110loliaaing Mustalpalties Avesturs,Boral.Histea11,Key Bisaeyne,
M(ami Gardens.11111 takes,Pahatto Bay,PAoarest,Sunny Was Beack Tatra of Cutler Bey.
MIAMFor more infontmtlan,visit
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850)487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
ACOSTA,ANTONIO
EVOLUTION ELECTRICAL CONTRACTORS, INC.
11631 NW 58TH PLACE
HIALEAH FL 33012
Congratulations! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range STATE OF FLORIDA
from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND
and they keep Florida's economy strong. `° PROFESSIt3tV, REGULATION
Every day we work to improve the way we do business in order to ER13014537 ISSUED. :06/26/2014
serve you better. For information about our services,please log onto f
www.myfloridalicense.com. There you can find more information + REG ELECTRICALCONTRACTOR
about our divisions and the regulations that impact you,subscribe ACOSTA,ANTONIO
to department newsletters and team more about the Department's EVOLUTION ELECTRICAL CONTRAG FORS,
Initiatives. (INDIVIDUAL MUST'1UtEEI ALL LOCAL
Our mission at the Department is:License Efficiently,Regulate Fairly.
LICENSING REQlfiRFiF-NTS 'RIOR
We constantly strive to serve you better so that you can serve your TO CONTRACTING IN ANYAREA)
Customers. Thank you for doing business in Florida, HAS REGISTERED under the provisions of Ch.488 FS,
and congratulations on your new license! Ezdsto'AUG 31.20+6 uaCSzRuoo,os,
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
ER13014537 '
The ELECTRICAL CONTRACTOR ""
Named below HAS REGISTERED
Under the provisions.of Chapter 489 FS.
Expiration date: AUG 31,2016
(INDIVIDUAL MUST MEET ALL LOCAL LICENSING
REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA)
0
ACOSTA,ANTONIO
EVOLUTION ELECTRICAL CONTRACTORS,INC..
11631 NW 58TH PLACE
HIALEAH FL 33012 _ i
• roi
ISSUED: 0626/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1406260001081
JEFF ATWATER
CHIEF FINANCIAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS'COMPENSATION
**CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law.
EFFECTIVE DATE: 11/19/2014 EXPIRATION DATE: 11/18/2016
PERSON: ACOSTA ANTONIO
FEIN: 273616053
BUSINESS NAME AND ADDRESS:
EVOLUTION ELECTRICAL CONTRACTORS INC
11631 NW 58 PL
HIALEAH FL 33012
SCOPES OF BUSINESS OR TRADE:
LICENSED ELECTRICAL ELECTRICAL WIRING ELECTRIC LIGHT OR BURGLAR AND FIRE
CONTRACTOR WITHIN BUIL POWER LINE C ALARM INSTALL
Pursuant to Chapter 440.05(14),F.S..an officer of a corporation who elects exemption from this Chapter by filing a certificate of election under this section
may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only
within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be
exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,
the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609
EVOLUTION ELECTRICAL CONTRACTORS INC.
11631 NW 58TH PL
HIALEAH, FL 33012
Telf: (786) 718 8562— Fax: (305) 822 8211
June 7,2016
State of FLORIDA
Country of MIAMI DADE
Before me this day personally appeared ANTONIO ACOSTA who, being duly sworn,deposes and
says:
That he or she will be the only person working on the project located at: 726 NE 92ND STREET
Sworn to (or affirmed) and subscribed before me this 20 day of MAY , 201_, by
ANTONIO ACOSTA
Personally know
OR Produced Identification
Type of Identification Produced
r�
Print,Type of amp Name of Notary
KARLA P. GARCIA
MY COMMISSION 8 FF140421
EXPIRES:July 10,2018
A -R"� CERTIFICATE OF LIABILITY INSURANCE DATE(MMA70/`rYYY)
116
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER oTHIS
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(ies)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 — '— CONTACT
NAME:
I
Southern Star Insurance Agency,Inc WE
8338 SW 8th Street A ANo,Ext): (305)262-2740 FAX NoI: {305}262.2647
Miami,FL 33144
ADDRESS: SOUthemStarinsuranceMmail.eom
Phone (305)262-2740 iNSURER(S)AFFORDING COVERAGE NAIC#
FaX (3Q5)262-2647 INSURER A: GRANADA INSURANCE CO
INSURED
EVOLUTION ELECTRIAL CONTRACTOR,INC INSURER 8:
INSURER C:
11631 NW 58TH PL INSURER D:
HIALEAH,FL 33012 305-978-8537 INSURER E:
COVERAGESINSURER F:
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.
1NSR ADDLSUBR
LTR TYPE OF INSURANCE POLICY NUMBER
. D.. POLICY EFF (PO�CY
INSR WVLIMITS
GENERAL LIABILITY (MWDD/YYYY) )
_EACH OCCURRENCE $ 1,000,000.00
I/ COMMERCIAL GENERAL LIABILITY - GE TO RENTED --
CLAIMS-MADE d OCCUR PREMISES(Ea occurrence, $ 100,000.00
A N y 0185FL00072497-0 07/30/2015 07/30/2016 MED EXP(Any one person) $ 5.000.00
PERSONAL 8 ADV INJURY $ 1,000,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2,000.000.00
V POLICY JECT LOC PRODUCTS-CO_MP/OP AGO $ 2,000,000.00
AUTOMOBILE LIABILITY $
COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) S
ALL OWNED SCHEDULED BODILY INJURY(Per person) S
AUTOS AUTOS
HIRED AUTOS NON-OWNED BODILY INJURY(Per amdent) S
AUTOS PROPERTY DAMAGE $
(Per acc dent)
UMBRELLA LIAR $
OCCUR
EXCESS UAB CLAIMS-MADE EACH OCCURRENCE $
_
—.--DED RETENTION$ AGGREGATE $
WORKERS COMPENSATION -- --— — ___ _ $
AND EMPLOYERS'LIABILITY Y j N WC STATU- GTH- ———'—' —ANY PROPRIETOR/PARTNER/EXECUTIVE TORY LIMITS ER
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L EACH ACCIDENT $
llyes describe under E.L.DISEASE-EA EMPLOYEE$
DESCRIPTION OF OPERATIONS below
E.L.DISEASE-POLICY LIMIT S
DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
ELICTRICAL CONTRACTOR
UC410E000610
CERTIFICATE HOLDER CANCELLATION
Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Building Department ACCORDANCE WITH THE POLICY PROVISIONS.
10050 NE 2nd Avenue
AUTHORIZED REPRESENTA.T"
Miami Shores,FL 33138
ROBERTO OJEDA
ACORO 23("TOMS)OF �i Tro (
RO CORPORATION. All rights reserved.
The ACand logo are registered marks of ACORD