ELC-12-1647Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 178056 Permit Number: ELC -9 -12 -1647
Scheduled Inspection Date: June 17, 2013
Inspector: Devaney, Michael
Owner:
Job Address: 8880 BISCAYNE Boulevard
Miami Shores, FL
Project: <NONE>
Contractor: AJL ELECTRIC INC
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Repair
Phone Number (305)754 -7551
Parcel Number 1132060200870
Phone: 305 - 895 -4971
Building Department Comments
EMERGENCY WIRE REPAIR WORTH WITH BURNED
WIRES PHASEOUT
Passed
,/
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
l%L
■771/' ze° it
June 14, 2013
For Inspections please call: (305)762 -4949
Page 4 of 34
GI\ At _
UILDING
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
CIIIERMIT APPLICATION
FBC 20 0
Permit Type: Electrical
OWNER: Name (Fee Sim le Titleholder): )069
Address: W /}� � /"
City: /1l « t.1
Permit No.
LRE_
SEP 052012
�.�2-- Ibo`n--
Master Permit No.
evrolff-
Phone #: o5 v 75 7537
State: Zip:
3S
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS:
City: Miami Shores County: Miami Dade
Folio/Parcel #:
igko Pitug
Zip: 33/ 3E
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: t- Ek72 fi l "he_ Phone #: 3D5 S95:: W7/
Zip: 33/8/
Address: /ASzy797 . /v 41 l30 City:
Qualifier Name: p
State Certification or Registration #: ra/ ! 30O.,® Certificate of Competency #:
Contact Phone #: - ✓ > RV/ Email Address: p L P 1Qe 9 C,
DESIGNER: Architect/Engineer:
It State: FL_
y �
Phone #:
Phone #:
Value of Work for this Permit: $ Z-0# Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration
Description of rk:
Wr r-6S lcseort
C
New
epair/Replace
rt-..
ODemolition
temed
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* ** * * * * * * * * * * * * * * * * * * * * * * * * * * * **
• Submittal Fee $ • c.I° Permit Fee $ /.41°?/00 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
giO
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 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
Owner or Agent
The foregoing instrument was acknowledged before me this 5
day of Sea° r , 20 / by I AN 41b -AD w 1LDS714- of ';+. ± , 20 101, by Ah) ?A/ J Lu4003;'
who is personally known to me or who has produced Ft-- who i ersonally known, o me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
Sign:
Print:
My Commission Expires:
. • r,
• 03 0612016 '•
NOTARY PUBLIC
•
Commission 1 :•
u'• „.:••.. EE113059
6,� /Rlnivilli "
APPROVED BY J5'/' Plans Examiner Zoning
NOTARY PUBLIC:
Sign:
Print:
My Commission E
MY COMMISSION # EE58977
ae7 EXFIRES: January 26, 2015
or
1- 800.3.NOTP.RY fl. Notary Disc m! Asro . CO.
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Structural Review Clerk
AC# 6161777
tTATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
SEQ #L12061301043
06 13 2.012 118201527.
LICENSE NBR
EC130:0208; -,..
The ELECTRICAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chaptettw
Expiration date: AUG 31, 2014
8
LUPO, ANTRONY J JR
A J L ELECTRIC INC
12555 BISCAYNE BLVD
NORTH MIAMI
RICK SCOTT
GOVERNOR
#826
FL 33181
DISPLAY AS REQUIRED BY LAW
KEN LAWSON
SECRETARY
RTH'MIAMI
F L ❑ R I ❑ A
City of North Miami
776 N.E.125 Street • North Miami, FL 33161 • 305 - 893 -6511
Business Tax Receipts
Issued Date: 10/1/2011
Expiration Date: 9/30/2012
Business Tax Receipt #: BT- 002364
A J L ELECTRIC, INC.
12555 BISCAYNE BLVD
BOX 826
NORTH MIAMI, FL 33181
ELECTRICAL CONTRACTOR
Business Name / Address:
A J L ELECTRIC, INC.
12555 BISCAYNE BLVD, BOX 826
NORTH MIAMI, FL 33181
Clerk
NOTICE: BUSINESS TAX RECEIPT MUST BE
TRANSFERED WHEN BUSINESS IS MOVED
OR SOLD.
NON- TRANSFERABLE • POST IN A CONSPICUOUS PLACE • NON- TRANSFERABLE
192974 -5
BUSlP►` L
H12408 CNWAV
33181 NORTH
FIRST-CI-ASS
U.S. POSTAGE
PAID
MIAW1,. FL
PERWT`NO: 231
03700 -0
22084
AJL ELECTRIC INC'
f
TINS IS ONLY A LOCAL
BUS *ESS TAX RECEWT, IT
DOES- NOT PERMIT THE
}OLDEN TO VIOLATE ANY
MONO REGULATORY OR
ZONING LAWS OF THE
COMM OR CITIES. NOR
DOES IT EXUWT THE
HOLDER FROM ANY OT ER
PERINI
IMOUSIED B LAW. MS IS
HOT A cERTWICATIOW OF
Wit HOWER'S OUwFlQA-
P[i11 D i',nt a TAX
COLD . rnn -rogiM t
DO NOT FORWARD
AJL ELECTRIC INC
ANTHONY JAMES LUPO PRES
12555 BISCAYNE BLVD BOX 826
NORTH MIAMI FL 33181
AJLEL4 OP ID: TR
TE�uoo
CERTIFICATE OF LIABILITY INSURANCE oA 08114112 lvrrr)
THIS CERTIFICATE is ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFIC:ATE<HQLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR •NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE :AFFORDED BY: THE POLICIES
BELOW: ;rHIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE.. CERTIFICATEJ{QLDER.
I ORTANT: If the oertlflcate holder is an ADDmONAL `INSURED, the pofcy(les) must be endorsed. If SUBROGATION IS WAIVED, isUbleor to:
the terms and conditions of the ;policy, cartaln poUcles may require an endorsement. A statement on this certiflcate does not confer ,loots to the..
certlflcate holder'in Ilea of sixty endorsement(s).
PRODUCER
Roebuck ,Associates Insurance
Iccttange LLC
5593 s Urilversfly Drive, #301
Davie, FL 33328
854-616-1800
854 - 81,6-1.880
c
1 (A mot
ADOI2ESSS
INSURERS} AFFORDtNG•C0VERAGE
NAM el
INSURER _Nova Casualty Insurance Co.
INSURED AJL Electric Inc.
12408 N. Bayshore Drive
N. Miami Beach, FL 33181
COVERAGES'
nasURetB:Guarantee Insurance Company
INSURER C :
INSURER D •
:INSURER E;.
INSURER F>
CERTIFICATE:NUMBEI . REVISION'NUMBER
THIS IS To CERTIFY THAT THE P0I ICIES:,OE INSURAINCE LIST t;11.BELC W HAVE BEEN. ISSUED TO THE' INSURED NAMED ABOVE I QR T E •POUQY PERIQD .'.
INDICATED. NOTWITHSTANDING ANY REQUIREMENT; TERM • OR .coNomON '"OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH Tt11S
OERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE uVSUJRANCE. AFFORDED BY THE POLICIES , DESCRIBED -HEREIN IS SUBJECT TO ALL THE - TERMS
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES .LIMITS SHOWN MAY HAVE.BEEN REDUCED�BY'PAID • CLAIMS.
ILA RAf7L:FUeFa ROLICyEFF POLICY -EXP
lYPEOF'INSURANCE njglr itiv POLIGYNUMBER tMNW MVYt pMMMDDA!r,'v
DINERAL LIASLflY
A X :COI RCIAL GENERAL. wAB Y 09AL20120515 051110/47 05115113
1 c AIMS-MADE OCCUR,
B
GEM. AGGREGAAE LIMIT APPLIES PER:
nI POLICY f fl LOC
mere
EAcH-QMORRpieg _
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PREMISES :Ma deecur eo .
MEV e( jAiny'o e
PERSd1VA.8 ADV inquiet
0ENERI,^41. CS AGGGF EGGATTE
:PRODUCTS 1 c M OtoP AOG
Q`. ... 11000,00C
108;00.0
5 00
1;00%Olit
2,000 ooc
1,,000,000
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accident)
smut INJURY (Per person) ;I
WOO INJUR1f tRer,ScOids�tj
PO
P
er IAMACrB
$
EACII,OCCURi2ENC5.
AGGREGATE
WORKERS COiaPENSATION
AND E LO'i I B t YL N
ANY P m ARTr t vE. CUTIt 0
OFFICFRRr EXCLLIDEEP
(Mandatory Iii NH)
B.. 'Qeleiltid under
SORIPTIONOF:OPERATIONS Wow
NIA
351000505180112,
05/15112:
05/15/13
x I -'rSPITAles I
E.L. EACH ACCIDENT
E.L AISEASE- FAEIvLOYJ=E
$
0oi..
E.L. bISEASE'- POLICY LIMlt $
L
IESCRlF•ION OF OPERATIONS 1 LUCATiONSJ VEMICLEB IAttaehACORD 40Q1„AddWoml; Remark Schedule, W more spaceJs required)
CERTIFICATE HOLDER
CANCELLATION
Miami Shores Village
Building 'Dept.
10050NE 2Avenue
Miami Shores, FL.33138
SHOULD ANY OF THE<ABOVE DE$CRIBED. POLICIES BE ICB4.ED BEFORE
THE EXPIRATION ,PATE THEREOF,. NOTICE WILL, BE DsIERED IN
ACCORDANCEvimi:'niEIioLid t oROYsIONS.
AUn4OBRED REPRtESENTATIVEE
ACQRD 25 (2010/05)
O 1 "988- 2010ACORD CORPORATION. :AR r'ighls wary
TherACORD name and logo are registered marks ofACORD