EL-13-155Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 184807 Permit Number: EL -1 -13 -155
Scheduled Inspection Date: February 28, 2013
Inspector: Devaney, Michael
Owner: HURTADO, JOSE LUIS
Job Address: 166 NW 110 Street
Miami Shores, FL 33168-
Project: <NONE>
Contractor: A PLUS ELECTRICAL TECH INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360030140
Phone: (305)216 -1164
Building Department Comments
REPLACE EXISTING 4 CIRCUITS OF CLOTH WIRING TO
NEW ROMEX WIRE 4 CIRCUITS
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
F1/46,/_61 (.3
February 27, 2013
For Inspections please call: (305)762 -4949
Page 8 of 35
111111111111111111111111111111111111111111111
CFN 2013R0074-852
NOTICE OF COMMENCEMENT
OR EC RECORDED 1/ Ps `720' 114:5
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION HARVEYER VI Ne CLERK 0f d5OURT
HARVEY RIlItTNp CLEE.Y, D1=' COURT
MIAIII-DADE COUNTY, FLORIDA
LAST PAGE
PERMIT NO. / . in TAX FOLIO NO. 11- 2 (3 4 3 —0 NO
STATE OF FLORIDA.
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street / address:
Miami S‘ Noce S EXt Pt H3- 90 L_04F t'1 (ILK 211 Lo4 SiZe. 75.000 x 12 I or
18371 -852 1298 I. or 01371 —OR 5'Z 1298 00
2. Desc .lion of improvement
3. Owner(s) nam =`"- nd address:
dose Luis Mverkado Sr. R( Rabe 1v.otiroc %t.wrtado
tba iIVW 110 ST, Mictrwt Shore&._ FL, 3316$
Interest in property: 20/4
Name and address of ee simple ti holder:
G'Z'�swe
5. Surety: (Payment • •nd r uired bj owner from contracto , if any)
Name and Address: A.°19
Amount of bond $
6. Lender's name and address:
.44%.
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., F,)orida Statutes.
Name and Address:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provi•e
in Section 713.13(1)(b), Florida Statutes.
Name and Address:
9. Expiration date of this Notice of Commencement (the expiration date is 1 year from the date of recording
dill -rent d- e' •)
Ili: /
illfft*M■
,4
Owner's Name use LL.;s Htartct d%® Sr.
Sworn to and subscribed before me -pis g- J day of
Notary Public..
1 ii . �.
Print Notary's Na a Win State of Florida
My commission expires: TiaiNallettfintl . .r s - -- --
'l1QQ" Commission # EE 128810
•.F Uf i \Gp`�
4.u, ''a` Bonded Through National Notary Assn.
Prepared by
MAP 41 20 13
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical .�
JOB ADDRESS: / jk i '2 // ® �1
JAN 2 2 pJ,
FY
FBC 20
Permit No.. l �s1
Master Permit No.
6
City: Miami Shores Countd Miami Dade Zip: ��
Folio/Parcel#: // -?-, ° 003 0 /
NO ` Flood Zone:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholder):
Address:
City: ir v 9/ $,#p
70
Tenant/Lessee Name:
Email:
State:
Phone#: i'J L
Zip: '3/41
Phone#:
CONTRACTOR: Company Name: !' Pax �I Fes` r/ � % J /€ Phone#: a #J7 tC
Address:
City:
Qualifier Name:
4111 9
MUMUMMMW
State:
Adr- -
Zip: "3 g
t/ C Phone#: 1�;�[ /�_ // 9
State Certification or Registr on #: re,1� �.. 99 3 Certificate of Competency #:
Contact Phone#: _�' l' 4 - �t Rmail Address: el y fr( 77-`7.3 %o,� D e;yea 4—
DESIGNER: Architect/Engineer: ems' Phone#:
Value of Work for this Permit: $ 0_2s--z7 ®O Square/Linear Footage of Work:
ONew air/Replace
Type of Work: OAddress
Description of Work:
C
DAlteration
!]Demolition
m r C`� Cad v
******** * * * * * * * * * * * * * * **k * * * * * * * * * * * * ** Firms * * * * * * * * * * * * * * * *******P IA * *** ***************
Submittal Fee $ Permit Fee $ /1-212'®e' CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 1 [4
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
/ft,
Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State i/ 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 abse , of such posted notice, the
inspection will not appr . r .' . ' reinspection fee will be charged
Signature
wner or Agent
The fo _ ..oing instrument was . �...t . wled:
day o _ tat , 20 1 5 b
w I o is own to me or who has produced
° — As identification and who did take an oath.
NOT ' PUBLIC:
Sign:
Print
My Commission Ex
. My corm Expires SeP
Commission # EE 128810
i∎ :∎* Bonded Through National Notary
Signature
The fo
day of
w h o i s - r'
knowledg
orally
to me or who
dentification and who did take an oath.
OTARY PUBLIC: -
Sign:
Print
My Commission Exp
' 4 IF , cusuos
• tv 1 / i.ilR -State of Florida
�. .a a- 3 2015
t')„ Commission # EE 128810
:'4 ar 1; °'s Bonded Throng
Assn
** * * * * * * * * * * * * * ** ;:' ******************** * * * *** * * * * * * * * * * * * *** ***** * **** * * *** *** * *** B *** * ** ** ** * *** k*******
APPROVED BY et/ Plans Examiner Zoning
Structural Review
(Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06/10t2009)(Revised 3/15/09)
Clerk
ACCORD
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
01/14/2013
PRODUCER
SafeGuard Casualty Ins
9996 Pines Blvd, Pembroke Pines. FL 33024
Phone: 877- 613 -5042
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
A PLUS ELECTRICAL TECHNOLOGIES, INC
2240 N 61 AVE
HOLLYWOOD, FL 33024
INSURER A: TRAVELERS INSURANCE
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
I:
• D
, ; .
11/:d ., I. -. 1: _ ■
POLICY NUMBER
POLICY EFFECTIVE
. 1 . "A. .116A/14
POLICY EXPIRATION
� I— I, .1 DJ.
LIMITS
A
X
GENERAL
UABILRY
COMMERCIAL GENERAL LIABILITY
660- 5A330937
08/08/12
08/08/2013
EACH OCCURRENCE
$ 1,000,000
X
pRaEM SES 4t,
$ 100,000
■■
CLAIMS MADE X OCCUR
MED EXP (My one person)
$ 5,000
■
PERSONAL & ADV INJURY
$ 1,000,000
■
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APP�LIESPER:
PRODUCTS - COMP /OP AGG
$ 2,000,000
J POLICY n EC�T I ( I LOC
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per acddent)
GARAGE
UABILRY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
■
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
EXCESS 1 UMBRELLA UABIUTY
EACH OCCURRENCE
$
■ OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
RETENTION
$
■
$
$
WORKERS
AND EMPLOYERS'
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER
(Mandatory
If yes, describe
SPECIAL
COMPENSATION
LIABILITY YIN
WC STATU- OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
$
EXCLUDED?
E.L DISEASE - EA EMPLO s
$
In NH)
under
PROVISIONS below
E.L DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
Miami Shores Village
10050 N.E. 2nd Ave.
Miami Shores, FI. 33138
SHOULD ANY OFTHEABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2009101)
1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AC# 6303735
7HIS ')betI Vf Nyf '7 C
A "T CDr S7c71O` N fv1 CHOP 1J° INU „U K ' PATENTEo:fe:F ril
STATE OF FLORIDA
I) paRrmmWrop BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
SEQ# L12082501042
DATE
BATCH NUMBER
LICENSE NBR
08/25/2012 126004502 EC0002993
The ELECTRICAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: A170 31, 2014
VAZQUEZ, RIGOBERTO
A PLUS LECTRICAL TECHNOLOGIES, XN
2240 N 61Sfi 'AV1
HOLLYWOOD FL 33024
RICR . SCOTT
• GOVERNOR
DISPLAY AS REQUIRED BY LAW
KEN LAWSON
SECRETARY
JEFF ATWATER
STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' CONWEALSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
This fortifies that the individual listed below has elected to be exempt from Florida Workers' Compensation taw.
10 -12 -2011
EFFECTIVE DATE:
PERSON:
FEIN:
10/1212011
VAZQUEZ
452137777
BUSINESS NAME AND ADDRESS:
A PLUS ELECTRICAL TECHNOLOGIES INC
2240 PEWRTH 81ST AVE
HOLLYWOOD FL 33024
SCOPES OF BUSINESS OR TRADE
1- ELECTRICAL/ ELECTRICIAN
EXPIRATION DATE 10/11/2013
RIGOBERTO JR
IMPORTANT: Pursuant to Chapter 440 . O$ff4y, F.S., as officer of a corporation who elects exemption from this chapter by flung a certificate of election ander this
section may not recover benefits or compensation under this chapter. Pursuant to Chatter 440.051121 F.S.. Certificates of election to he exempt.. apply only within the
scope of the business or trade limed en the notice of election to be exampL Pursuant to Chapter 440.05213) F.S., Notices of election to be exempt and certificates of
election to be exempt shall be smbject 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 certificate at any time for failure of the person
named on the coati lane to meet the requirements of this section.
OWC -252 CERTIFICATE OF B.ECTtoN TO BE EXEMPT REVISED 01 -11
QUESTIONS? 1850) 413 -1609
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
CONSTRUCTION INDUSTRY
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS' CONIFENSAffON LAW
EFFECTIVE 10/12/2011 EXPIRATION DATE: 10/11/2013
PERSON: RIGOBERTO VAZQUEZ OR
FEIN 452137777
BUSINESS NAME AND ADDRESS:
A PLUS ELECTRICAL TECHNOLOGIES INC
2240 NORTH 61ST AVE
H01.LYW000. FL 33024
SCOPE OF BUSINESS OR TRADE
1- ELECTRICAL/ ELECTRICIAN
IMPORTANT
rt 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
1- under this section may not recover benefits or compensation under this
D chapter.
H Pursuant to Chapter 440.05(12), F.S., Certificates of election to be
exempt.. apply only within the scope of the business or true listed on
the notice of election to be exempt.
E 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 certificate at any time for failure of the
person named on the certificate to meet the requirements of this
Section.
QUESTIONS? (850) 413 -1609
CUT HERE
& Carry bottom portion on the job. keep upper portion for your records.
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11
rame-ows co iYY
4040 W. LER° ST.
let FLOOR
MUUYN. I?1- 33130
689528 -9
BUSINESS NAME / LOCATION
A PLUS ELECTRICAL TECHNOLOGIES
INC
DOING BUS IN DADE CO
WORM TAX RECEIPT 2013
MIA I DADE COUNTY STATE OF,FIA A
EXPRES SENT; 30, 2013
MUST BE DISP�1Y�ED;A'rPLACE OPT
rumwANT TO U°Urf f O0* CHAPTER BA - ART: l,&
THIS 18 NOT A SILL — DO NOT PAY
RENEWAL
RECMPT NO. 717091 -3
STATE# EC0002993
OWNER
A PLUS ELECTRICAL
Sec. Type of Business
THE 196A ELECTRICAL CONTRACTOR
D T PesI THE
HOLDER TO VIOLATE ANY
ZONISe REGULATORY THEE
COUNTY OR CMS. NON
DOM IT MOEMPT THE
HOLDEFI FROM ANY OTHOI
mow OR LICENCE
REQUIRED BY LAW. TIM IS
NOT A THE xm EL CA�r OP
TECHNLGIES INC
PAYMENT RECTUM
MIALUMADE
COUNTY TAX
COLLECTOM
09010171001
000075.00
SEE OTHER SIDE
FIRST -CLASS
U.S. POSTAGE
PAID
MIAMI, FL
PERMIT NO. 231
WORKER /S
1
DO NOT FORWARD
INC A
LUS ELECTRICAL TECHNOLOGIES
RIGOBERTO VAZQUEZ JR
2240 N 61 AVE
HOLLYWOOD FL 33024
I„ II,,, II, ilifil, I, III, ,I,I„1„I,lli,,,!„i,iJ„iil,,,IyI