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EL-15-1598Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-256233 Permit Number: EL -6-15-1598 _ Scheduled Inspection Date: April 27, 2016 Inspector: Devaney, Michael Owner: UKAZIM, UCHENNA Job Address: 960 NE 97 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: UNITED ELECTRICAL SERVICES INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition Phone Number (561)901-3471 Parcel Number 1132060143160 Phone: (786)797-2188 Building Department Comments INSTALL NEW LIGHT FIXTURES AND ELECTRICAL AS PER PLANS 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 CREATED AS REINSPECTION FOR INSP-256166. Need low voltage first. Oe- /igx--, /7i April 26, 2016 For Inspections please call: (305)762-4949 Page 25 of 49 . Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. EL -6-15-1598 ■t Permit Type: Electrical - Residential •� ' Work Classification: Addition Permit Status: APPROVED Issue Date: 10/16/2015 Expiration: 04/13/2016 Parcel Number Applicant 960 NE 97 Street Miami Shores, FL 33138- 1132060143160 Block: Lot: UCHENNA UKAZIM Owner Information Address Phone Cell UCHENNA UKAZIM 960 NE 97 Street MIAMI SHORES FL 33138- 960 NE 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone UNITED ELECTRICAL SERVICES INC (786)797-2188 Cell Phone Valuation: Total Sq Feet: $ 19,400.00 2700 Type of Work: INSTALL NEW LIGHT FIXTURES AND ELEC Additional Info: Classification: Residential Scanning: 2 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $12.00 $10.19 $10.19 $4.00 $679.00 $6.00 $16.00 $737.38 Pay Date Pay Type Amt Paid Amt Due Invoice # EL -6-15-56133 10/16/2015 Check #: 95056112 $ 737.38 $ 0.00 Available Inspections: Inspection Type: Review Electrical 1 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 informa .I is :c urate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-na -...n ractor to.do the work stated. -4 1 — October 16, 2015 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date October 16, 2015 1 Miami Shores Village .)lk-C'(2,1 C Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION UNE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ELECTRIC ❑ ROOFING EPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 960 NE 97 ST City: FBC 2010 Master Permit No. - L 1 5- 1 5 3 3 Sub Permit No. �- 1 5 - VS -`1 ❑ REVISION ❑ EXTENSION ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR ❑RENEWAL ❑ SHOP DRAWINGS Miami Shores Countv: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Uchenna Ukazim Phone#: 561.901.3471 Address: 1521 Alton rd 426 Miami Beach FL 33139 City: State: Zip: Tenant/Lessee Name: Phone#: t CI 0 l *N UUKAZIM@GMAIL.COM Email: /� / 1 CONTRACTOR: Company Name: t T�,r ° G�0 l -k U S'E-v (�^-� Phone#: �B b ` 2 l ag Address: 2f,' 53 SvJ 1 3 S City: 14pi`'l� y 1b State: zip: 3 3o 3 2 . Qualifier Name: MA-10Uel- (141 -LI - Phone#: 3 6 "9-1". 21 3 8. State Certification or Registration #: Ell 1 3O 1' C' w el Certificate of Competency #: 12 C 000 j -12. DESIGNER: Architect/Engineer: 1440 9Z' 4 4 Co 1.5 S) L71,N1S Phone#: 30 S 110 tis t5S • 19-1 O o • �S fir/ �'c aSl%'- 20 e\ City: 'UAB 1 S State: L zip '31 0 a Address: Value of Work for this Permit: $ I �� ) 400 D Type of Work: ElAddition lir-Alteration (4t. Descriptionork: �� A�� of ofW Square/Linear Footage of Work: 2 , 0 ❑ New El Repair/Replace 0 Demolition Specify color of color thru tile: DO Submittal Fee $ Permit Fee $ 61 -et CCF $ 12 . O Scanning Fee $ ( . 0 v Radon Fee $ IQ . 161 DBPR $ Technology Fee $ 1 b. 00 Training/Education Fee $ y. O b Structural Reviews $ (Revised02/24/2014) co/CC $ to. Notary$ Double Fee $ Bond $ TOTAL FEE NOW DUE $ �" 3"- • 38 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Ever Bank Mortgage Lender's Name (if applicable) Mortgage Lender's Address 301 W Bay ST Jacksonville FL 32202 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 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 " U OWNER or AGENT The foregoing instrument was acknowledged before me this 3 0 day of Ma VC: h , 20 13 , by Ur\P o t\) 'J ‹Ot�VV , who is personally known to me or who has produced FL Ov4ei L cEr Se as identification and who did take an oath. NOTARY PUBLIC: Signature ll 0 CONTRACTOR The foregoing instrument was acknowledged before me this 30 day of 11 ter(l-C t* , 20 1 S , by F who is personally known to me or who has produced ' 9 n-AvE u LC Kas identification and who did take an oath. Sign: \ ^ISG.(�►).., G�nc^ \ l ► i CATALINA MUNOZ Notary Public - State of Florida 4 ? iii : �' My Comm. Expires Mar 4, 2018 '%F vlOF«o,•P`. Commission # FF 098394 NOTARY PU11' Sign:ik4 Print: Seal: APPROVED BY (Revised02/24/2014) al: Plans Examiner Structural Review Notary Public - State of Florida •c My Comm. Expires Aug 31, 2016 d; Commission # EE 200665 'oFc''��`� ••�,�, ����� Bonded Through National Notary Assn. Zoning Clerk (8 no leidos) - unitedelectric67 - Yahoo Mail 10/6/15, 10:38 PM CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 12E000192 UNITED ELECTRICAL SERVICES INC —D.BA.: IA MANUEL 0 Is certified under the provisions of Chapter 10 of Miami -Dade County https://e1-mg6.mail.yahoo.com/neo/Iaunch7.rand=a9kbttsrgug3e Page 1 of 1 (8 no leidos) - unitedelectric67 - Yahoo Mail 002650 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6983507 BUSINESS NAME/LOCATION RECEIPT NO. UNITED ELECTRICAL SERVICES INC RENEWAL 26453 SW 135 CT 7162894 MIAMI FL 33032 OWNER UNITED ELECTRICAL SERVICES INC Worker(s) LBT EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 ELECTRICAL CONTRACTOR 12E000192 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 08/30/2015 CREDITCARD-15-043031 This Local Business Tax Receipt only coatings payment of the Local Business Tax. The Receipt is mot a license. permit, or a certification of the holder's geabliications, to do business. Helder must comply with any gorernmen/at or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. For more inlomratioa, visit www.miamidade.00v/taxcol lector 10/6/15, 9:54 PM https://e1-mg6.mail.yahoo,com/neo/launch?.rand=91f17024s8198#8907033252 Page 1 of 1 (8 no leidos) - unitedelectric67 - Yahoo Mail >; STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION E R 13014669 ISSUED: 08/27/2014 REG ELECTRICAL CONTRACTOR GARCIA, MANUEL 0 UNITED ELECTRICAL SERVICES INC. (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under the provisions of Ch.489 FS. Expeatxm date AUG 31. 2016 L1408270004427 RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER 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) GARCIA, MANUEL 0 UNITED ELECTRICAL SERVICES INC. 26453 SW 135TH COURT HOMESTEAD FL 33032 ISSUED: 08/27/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1408270004427 10/6/15, 9:52 PM https://e1-mg6.mail.yahoo.com/neo/launch?.rand=d344fihvmo07t Page 1 of 1 (8 no leidos) - unitedelectric67 - Yahoo Mail 10/6/15, 9:55 PM 002905 Municipal Contractor's Receipt Miami -Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY 12E000192 BUSINESS NAME/LOCATION UNITED ELECTRICAL SERVICES INC 26453 SW 135 CT MIAMI FL 33032 OWNER UNITED ELECTRICAL SERVICES INC Category(s) I RECEIPT NO. 7471753 SEC. TYPE OF BUSINESS ELECTRICAL CONTRACTOR 12E090192 MC EXPIRES SEPTEMBER 30, 2016 Pursuant to County Code Sec 10-24 Far puma ialom,M o ..sit wuLyy.eioniidade aoa/taacolleetot PAYMENT RECEIVED BY TAX COLLECTOR 8200.00 09/14/2015 CREDITCARD-15-045957 https://e1-mg6.mail.yahoo.com/neo/launch?.rand=91f17024s8i98#8907033252 Page 1 of 1 'RFI CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/09/15 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: f 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 Florida Bankers Insurance 7278 SW 8 Street Miami, FL 33144 Phone (305)266-6493 INSURED • United Electrical Services Inc 26453 SW 135 COURT HOMESTEAD, FL. 33032 Fax (305)262-0679 (305) 262-6743 CONTACT MARTA ALONSO NAME.._....-... MILE FAx 305)262-0679 E.MAIPJLL,_E�U,_ ._ (305)266-6493 - (A ,aJ__ ApDBES,5; maria@fiondabankersmsurance.com tNSURERjSJ AFFORDING COVERAGE i NAIC # IINSURERA: FEDERATED NATIONAL INSURANCE CO INSURER B ; SOUTHERN INSURANCE CO INSURERC;_ I� 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 POLICYPERIOD 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. NSR - - - IADDLSUBRI - i POLICY EFF POLICY EXP LTR ,_ TYPE OF INSURANCE�D.. POLICY NUMBER (MMlOD/YYYY).(MMII)DJYYYY) �_-.,.__. LIMITS I I: EACH OCCURRENCE i $ 1,000,000.00 { DAMAGE TO RENTED 100,000.00 i !_PREMISES (Ea occurrence) $ ! GL -0504008126-04 I MED EXP (Any one person) $ 5,000.00 N ! N 10/06/2015 10/06/2016 PERSONAL &ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE : $ 2,000,000.00 ! PRODUCTS - COMP/OP AGG ! $ 2,000,000.00 GENERAL LIABILITY C✓ COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE [ OCCUR E GEN'L AGGREGATE LIMIT APPLIES PER: 11 POLICY — JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS nISCHEDULED LJ AUTOS NON -OWNED ❑ AUTOS ❑ ❑ ❑ UMBRELLA LIAR ❑ OCCUR ri EXCESS LIAR ❑ CLAIMS -MADE I L_ -J DEO .❑ RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? " ---ti N /A (Mandatory in NH) If yes, desoribe under DESCRIP rION OF OPERATIONS below PWC008467-13 i $ COMBINED SINGLE LIMIT (Ea accide(1t) _ _ $ I BODILY INJURY (Per person) I $ BODILY INJURY (Per accident/ $ PROPERTY DAMAGE $ (Per acudent) EACH OCCURRENCE AGGREGATE © WC STATU- TORY LIMITS LJ ER E.L. EACH ACCIDENT $ 1 000,000.00 11/20/2014 11/20/2015 _...._..._..._. EL. DISEASE - EA EMPLOYEE $ 1,000,000.00 I Et DISEASE - POLICY LIMIT; $ 1,000,000.00 :$ 1 I DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space la required) LIC # 12E000192 CERTIFICATE HOLDER VILLAGE MIAMI SHORES 10050 NE 2 AVE MIAMI SHORES, FL 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) QF © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD