Loading...
ELC-16-1316Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 131 Inspection Number: INSP-268314 Permit Number: ELC-5-16-1316 Scheduled Inspection Date: October 04, 2016 Inspector: Devaney, Michael Owner: CHURCH, Job Address: 602 NE 96 Street Miami Shores, FL Project: <NONE> Contractor: STAN DAEMER ELECTRICAL SERVICES, INC Permit Type: Electrical - Commercial Inspection Type: Iugh Work Classification: Addition/Alteration Phone Number (305)754-9541 Parcel Number 1132060141410 Phone: (561)482-3391 Building Department Comments ANTENNA SWAP ON ROOFTOP OF CHURCH (6M D1113A) Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Inspector Comments et ) e7/r Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. October 03, 2016 For Inspections please call: (305)762-4949 Page 15 of 21 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. ELC-5-16-1316 Permit Type: Electrical - Commercial Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 6/3/2016 Expiration: 11/30/2016 Parcel Number Applicant 602 NE 96 Street Miami Shores, FL 1132060141410 Block: Lot: MIAMI SHORES PRESBYTERIAls Owner Information Address Phone CeII MIAMI SHORES PRESBYTERIAN 602 NE 96 ST MIAMI FL 33138-2742 (305)754-9541 Contractor(s) Phone CeII Phone STAN DAEMER ELECTRICAL SERVIC (561)482-3391 (954)214-6307 Valuation: Total Sq Feet: $ 2,500.00 0 Type of Work: ANTENNA SWAP ON ROOFTOP OF CHURCH ( Additional Info: Classification: Commercial Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.80 $2.25 $2.25 $0.60 $150.00 $3.00 $2.40 $162.30 Pay Date Pay Type Invoice # ELC-5-16-59782 06/03/2016 Check #: 1632 05/16/2016 Check #: 1560 Amt Paid Amt Due $ 112.30 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W. W. In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in comp!-nce with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the • • •er authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or e : • es. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING P work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and th construction and zoning. Futhermore, I authorize the above-named contractor to do t II work will be d-.' a iv compliance with all applicable laws regulating ork s Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy e 03, 2016 Date June 03, 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 BUILDING PERMIT APPLICATION ❑BUILDING Q ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 602 NE 96 STREET Ll oO FBC 2O(y _ Master Permit No. CG t6— (3 ( J Sub Permit No. ELC 16-13(-6 ❑ EXTENSION ❑RENEWAL ❑ REVISION ❑ CHANGE OF CONTRACTOR ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip; 33138 Folio/Parcel#:11-3206-014-1410 Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: BFE: C.k1Ua-CM OWNER: Name (Fee Simple Titleholder):l� IA0''\ 1 SN02PS ase,`(T.IPC(L) Phone#: Address:602 NE 96 STREET NO FFE: City: MIAMI SHORES State: FL Tenant/Lessee Name: T -MOBILE SOUTH, LLC Email: keshadejesus@comcast.net zip: 33138-2742 Phone#: 954-263-8764 CONTRACTOR: Company Name: S Darprwv Phone#: �O r.'-IegCc s4 Address: City: (PCZ C. State: Qualifier Name: 1Ct� State Certification or Registration #: Ct13o133a9- Zip: 3s42e Phone#: 64,1- W.2 45? Certificate of Competency #: DESIGNER: Architect/Engineer: KIMLEY-HORN AND ASSOCIATES, INC. Address: 1920 WEKIVA WAY, SUITE 200 Value of Work for this Permit: $ 2500 0,900(1,179 Phone#: City: WEST PALM BEACH State: FL Zip: 33411 Square/Linear Footage of Work: Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ANTENNA SWAP ON ROOFTOP OF CHURCH (6MD1113A) Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ a ; Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 11 2 -30 (Revised02/24/2014) Bonding Company's Name (if applicable) N/A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N/A 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 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 _artd a reinspection fee will be charged. Signature OWNER or AGENT Signature The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 3 rcl day hof m c}/ , 20 1(a , by ^^ �w,/ day of �Oy 2bot^'cui PLS 777 , who is personally known to ) 6 (D.,..t- , who is pe me or who has produced as me or who has produced as identification and who did take an oath. NOTARY PUBLI , 20 /4 , by identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: *.42 -1A -A ,a+% ESAPP Y MY COMMISSION i FF 945218 _ `:kJ EXPIRES: December 20, 2019 t ; h Bonded Thru Notary Pudic Underwriters Sign: Print: Seal: LIND Commission # FF 110250 My Commission Expires April 07. 2.01.8 ************************************************************************************************************ APPROVED BY /1%Y.0)//�i Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk CTQB Construction Trades Qualifying Board USINESS CERTIFICATE OF COMPETENCY 09E000299 TAN DAEMER ELECTRICAL SERVICES INC D.B.A.: , a ewt.e'\,, DAEMER STANLEY M Is certified under the provisions of Chapter t0 of Miami -Dade County r 001009 Municipal Contractor's Recetp Miami -Dade County, State of Florida TNl,S Is NOTA BILL - 00 NOT PAY F;7113O BUSINESS NAME/LOCATION STAN DAEMER ELECTRICAL SERVICES INC DOING BUSINESS IN DADE COUNTY OWNER STAN DAEMER ELECTRICAL SRVS INC C 'igory(s) 1 004733 RECEIPT NO. NEW 7475468 EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS MMC ELECTRICAL CONTRACTOR 09E000299 Thisiti Receipt rpayment or a certification of the holder's qualifications,t0 do business. Holder must or nongovernmental regulatory laws and requirements which apply to the busine The IIECEfPT NO above must be displayed on all commercial vehicles PAYMENT RECEIVED BY TAX COLLECTOR $200.00 11/03/2015 ECHECK-16-007964 en The Receipt is not a licse, comply with any governmental ss. -Dade Code Sec 8a-276. For more information, visit www�rn_ia_mmdaditLo°rtax- �ollectur Local Business Tax Receipt Miami -Dade County, State of Florida -THIS 1S 14O5 WA!, - tIr1 tIQT PAY 6471130 BUSINESS NAME/LOCATION STAN DAEMER ELECTRICAL SERVICES INC DOING BUSINESS IN DADE COUNTY OWNER STAN DAEMER ELECTRICAL SRVS INC Workers) 1 RECEIPT NO. RENEWAL 6740295 EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8P+-Ptt.S& 4a SEC. TYPE OF BUSINESS 196 ELECTRICAL CONTRACTOR 09E000299 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 09/29/2015 CHECK21-15-141516 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, nennit, or a certification of the holders qualifications, to do business. tl Holder hes muss . must comply with any governmental o. nongovernmental regulatory lay snquirements which apply It "ECEIPT NO. above must be displayed on all commercial vehicles - tdiai• fade Code Sec Ba -276. For more information, visit www.miamidq I e r RICK SCOTT, GOVERNOR KENLAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESS I€AL RE mow ELECTRICAL CONTRACTORS LICENSI BOARD The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 (INDIVIDUAL MUST MEET ALL LCL UCEN REQUIREMENTS PRIOR TO CONTRACTING IN AREA) DAEMER, STANLEY STAN DAEMERELECTRI, 10795 EUREKA STREET BOCARATON FL 33428 1 DISPLAYAS REQUIRED BY Li 2 6 A "' CERTIFICATE OF LIABILITY INSURANCE DATE /22/2 16 04/22/2016 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 Mabe And Associates, Inc.No 5493 Wiles Rd #103E Coconut Creek, FL 33073 Phone (954) 968-8111 Fax (954) 968-8233 CONTACT Amy Mabe NAME: ). (954) 968-8111 FAX No): (954) 968-8233 -MAIL a enc @mabeassociates.com ADDRESS: gency@mabeassociates.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : The Travelers Indemnity Co of Conn INSURED Stan Daemer Electrical Service, Inc. 10795 Eureka Street Boca Raton FL 33428 INSURER B : Associated Industries Insurance Co Inc. 11/17/2015 INSURER C : EACH OCCURRENCE INSURERD: DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER E : MED EXP (Any one person 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 LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A M COMMERCIAL GENERAL LIABILITY ❑ CLAIMS -MADE in OCCUR ❑ I -660 -9D035742 -TCT -15 11/17/2015 11/17/2016 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000.00 MED EXP (Any one person $ 5,000.00 ❑ PERSONAL & ADV INJURY $ 1,000,000.00 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- RO JECT LOC JECT GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 2,000,000.00 ❑ OTHER $ B AUTOMOBILE LIABILITY ❑ ANY AUTO ALL OWNED SCHEDULED ❑ AUTOS ❑ AUTOS ❑ HIRED AUTOS NON -OWNED ❑ AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ ❑ . $ ❑ UMBRELLA UAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N N/A AWC1052272 08/12/2015 08/12/2016 in PER ► STATUTE ❑ ERH E.L. EACH ACCIDENT $ 100,000.00 ANY PROPRIETOR/PARTNER/EXECUTIV OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYE $ 100,000.00 E.L. DISEASE - POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Electrical Contractor CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 33138 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 (2014/01) QF © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD