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EL-14-382.0. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-208104 Permit Number: EL -2-14-382 Inspection Date: June 12, 2014 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: MIRAMONTES, CARLOS & BARBARA Work Classification: Temp for Test Job Address: 674 GRAND Concourse Miami Shores, FL 33138 - Project: <NONE> Contractor: BAND B ELECTRICAL CO Buildina Department Comments Phone Number Parcel Number 1132060171950 Phone: (305)970-5667 TEMP FOR SERVICE Infractio Passed Comments INSPECTOR COMMENTS False Passed Inspector Comments -- Failed E:1 Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid For Inspections please call: (305)762-4949 June 12, 2014 Page 1 of 1 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 FBC 20 Permit No. r/ lq - aV� Master Permit No. -12 e I S 70 JOB ADDRESS:a�� _► y�Jo City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: '—�„� OWNER: Name (Fee Simple State: „ Zip: 1 A l CONTRACTOR: Company Name:15&b P G Phone#: 3Q- = Addri City: M State Certification or Registration #y: y� Ir.,tic--U I) U b / s 0 Certificate of Competency #: C) LJM 14-1-.104--4- s Contact Phone#: 3&5' _ `-)y ani Email Address: sum', bbi la�A S(°,m_ncas' . ✓)e` DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: Type of Work: OAddress Description of Work: ONew Submittal Fee $ Permit Fee $ /10& 1 &,P CCF Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Footage of Work: ORepair/Replace ODemolition CO/CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) _ Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 boved and a reinspection fee will be charged. /I Signature ® Signature V Owner or Agent Con ctor The foregoing instrument was acknowledged before me this" day oflab 12014, 20, by gor� &2 / rOM on fe�S who is personally known to me or who has produceda �iSS .S 157 q � i% As identification and who did take an oath. NOTARY PUBLIC: Sign: �""% Notary Public State of Florida Commission Joanna M Feliciano �y� _ ° !tgortlmiseion FF 0$2753 The foregoing instrument was acknowledged before me this�� day of 20 by t11LA- 2>-%-� (C- ul wh is perso y own to me or w has produced cation and who did take an oath. APPROVED BY �%�X& �Y' .l Tans Examiner Structural Review (Revised 3/12/2012XRevised 07/10/07XRevised 06/10/2009XRevised 3/15/09) NOT. Sign: Print: My C ' -fty Public - State of Florida +oQ f�"y"�"omm. Expires Sep 19, 2014 Commission # EE 27075 Zoning Clerk BZR V3:DLS, NULALIO I B AND B lI ZZC . , CO 18021 NORTH WEST 77TH COURT 33015 HIALPM FL Congratulatlonsl 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 from architects to yacht brokers, from boxers to barbeque restaurants, and they keep FkrrWs economy strong. Every day we work to Improve the way we do business In order -to serve you better. For Information about our services, please lag onto www.rnyfloridallconse.com. There you can find more Information about our divans and the reguiaatieons that Impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department Is: License Efticlentiy, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business In Florida, and congratulations on your new license! y.. DETACH HERE :AS RF66114" I INVOICE Attn: Juan CarlosBibiana From: Raul Lliteras No: 110 Date: October 3, 2013 Sold to: Juan Carlos Job Name: Personal Residence TY DESCRIPTION AMOUNT Furnish (2) 30 watt 3000k flood light type fixtures @ $211.79/e. $423.58 Furnish one (1) 20 watt 3000k flood type light fixture @ $165.89/e. $165.89 Furnish three (3) 10 watt 3000k flood type light type fixture @ $96/e. $ 288 Miscellaneous materials — (2) photocelss, (2) junction boxes, (2) knock out covers, 6 whip connectors and 6 whips $ 115 Labor/installation $ 250 INVOICE AMOUNT $19242.47 NET UPON COMPLETION Construction des Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY SERUVIDES EULAL10 I Is certified under the provisions of Chapter 10 of Miami -Dade County ,VALID FOR; �OI1I CTING UNTI-L 09/3012015 000435 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 987488 BUSINESS NAME&OCATION RECEIPT NO. EXPIRES B AND B ELEC CO EULALIO I BERUVIDES RENEWAL SEPTEMBER 30, 2014 18021 NW 77 Cr 987488 Must be displayed at place of business MIAMI FL 33015 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED B AND B ELEC CO 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR Worker(s) 10 000O142B2 $75.00 09/22/2013 CREDITCARD-13-009859 This Local Business Tax Receipt only confirms payment of the Local Business Tex. The Receipt is not a license, permit, or a cerfifieWon of the holder's qualifications, to do business. Holder must comply with any governmental 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 Ba -276. For more on, visit mnmat imidade.govltaxcollector ---"M"N CERTIFICATE OF LlAB1LITY INSURANCE a " DATE (MMIDDIYYYY) INSIW 02/19/2014 PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION Global Insurance and Financial Services, Inc. 6175 NW 153 Si STE 100 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Miami Lakes, FI 33014 PH: (305) 512-9721 FAX: (305) 512-9889 INSURERS AFFORDING COVERAGE NAC # INSURED INSURERA: ASCENDANT B AND B ELECT.CO INSURER B: ASCENDANT 18021 NW 77 CT MIAMI, FL 33015 INSURER C: INSURER D: INSURER L COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR INSIW TYPE 0 INSURANCE POLICY NUMBER D LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE Q OCCUR GEN'LAGGREGATEUMITAPPUESPER: POLICY n PROJECT LOC GL -76520-1-3 02/19/2014 02/19/2015 EACH OCCURRENCE $ 1,000,000 PREMIE E �T r c $ 100,000 MED EXP (Any one person) $ 61000 PERSONAL& ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG $ 1,000,000 AUTOMOBILE LIABILITY ANYAUTO ALL OW NED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS COMBINED SINGLE LIMIT (Ea accident) $ rODILYINJURY rrI on) $ BODILY INJU (Peracddsntr $ Pa.E IRdYtt)AMAGE $ (IV GARAGE LIABILITY ANYAUTO AUTO ONLY- EAACCIDENT $ OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ B PLI R301E1N18f1A1TIONAND ANY PROPRIETORIPARTNER)EXECU71VE OFFICERIMEMBEREXCLUDED? IIy� describe under SPEGIIAL PROVISIONS below WC -125862 01/23/2014 01/23/2015 O Y UMITSn ER E.L. EACH ACCIDENT $ 11000,000 E.LDISEME-FAEMFLOYEE $ 110001000 E.L. DISEASE - POLICY LIMIT $ 110001000 OTHER DESCRIPTION OF OPERNrioNs I L=nORYMM E6 I EXCLUSIONS ADDED By VENDORS PiSiONS ELECTRICAL WORK Village of Miami Shores 10050 NE 2 Ave Miami Shores, F133138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR Tom 45 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 I URER, ITS AGENTS OR REPRESENTATIVES. ri r AI\ \i AUTHORIZED REPREWNTA� ACORD 25 (2001108) ( 4,\- — ®ACCJRO C%ffPOttA'VON 1988 Building MIM 11805 SW 26th Street ® Miami, Florida 33175-2474 786-315-2100 miamida&VV AFFIDAVIT FOR 30 DAY TEMPORARY ELECTRIC SERVICE ELECTRICAL CATEGORY 26 ELECTRIC SERVICE WILL BE DISCONNECTED WVITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED OR CERTIFICATE OF OCCUPANCY OBTAINED. It is understood thatthe temporary electrical approval bythel Miami -Dad i in&De a en_isgiven inconnection with the build' bein constructed under the Building Permit # �and Electrical Permit # &L l� 3R _ at address -) for owner M / enq-m 0— -P and is bein given only fo construct' n rposes or for testing the following equipment in said structure: Hyl j -6u�— The owner does hereby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and cancellation and electric power can be cut off at the discretion of the Building Official and will be disconnected if the building concerned is occupied before final inspections are approved and/or a Certificate of Occupancy or Completion is obtained. ��; 4T�,a nk i st duly sworn, depose and say that 1 am the owner of the above described property, and that f agree that the structure covered in this agreement shall not be occupied until the building tractor has obtained approval of final inspections andlor obtained a Certificate of Occupancy or Cam let' n Note: Failure to comply with the provisions of this affidavit will result in your being unable to obtain T _ _ ry for Telt permi#s. Of is Notary Public - State of Florida My Comm. Expires Sep 19, 201. Commission # EE 27075 Tature of Notary Commission Expires: and say that I am the Electrical Contractor for now existing will not create a safety hazard if Signature of Electrical Contra nature of Notary My Commission Expires: f, being first duly sworn, depose and say that I am the Building Contractor of the abow described property and that I will not permit occupancy of this building until final inspections have dbeen le for by the contractors and sub -contractors concerned and final approval by the inspection division o i a that I have the authority insofar as the owner of said property is concerned to prohibit occupancy until inaI ' spections ye obtained and/or a Certificate of Occupancy or Completion is issued. at re of Building Contractor lgnat re of Electrical Inspector 123_01424 6106 latureofNota 11 TT—---rY�rrYYYY Notary Publlo State of Florida sion Commis! � Innnna M FAIIriann Date released to FPL: My Commission FF 082753 Expires 0 111 212 01 8