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EL-16-1928 e Inspection Worksheet Miami Shores Village � 10050 N.E. 2nd Avenue Miami Shores, FL 'J Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-263010 Permit Number: EL-7-16-1928 Inspection Date: October 11, 2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: KLEIN, NELSON Work Classification: Pool - Private Job Address:9310 BISCAYNE Boulevard Miami Shores, FL 33138- Phone Number (786)344-2378 Parcel Number 1132060141610 Project: <NONE> Contractor: GLOBAL ELECTRIC SERVICES LLC Phone: (305)218-0752 Building Department Comments POOL LIGHT AND GROUNDING OF POOL LADDER Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Ef Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 October 11,2016 Page 1 of 1 I� Miami Shores Village OCT 0 � 2�;6 to i n^C� C n 1 Building Department $Y: 0 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2014 BUILDING Master Permit No:j>�:P f,' I Ct 2— PERMIT PERMIT APPLICATION Sub Permit No. E I (o — 1 92 - ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION F-1 RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP f CONTRACTOR DRAWINGS JOB ADDRESS: 3I c (i City: Miami Shores County: Miami Dade Zip: l Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): K L'E I N S Q-t-QA4 ddy V655— "6 N U Phone#: ? ,S6-3 zfL/.< 3 r 3 Address: 5,50 OF A) i7 Tt 2 City: State: t- Zip: J 12 Tenant/Lessee Name: Phone#: Email: / / CONTRACTOR:Company Name: k7 LO. a t 470' e- S.VLI((1(5 GLCPhone#: Address: City: State: LFL Zip: P j Qualifier Name: Phone#: State Certification or Registration#: /ao I!q S,�9 Certificate of Competency#: 000 Z � DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration EJ New E:1Repair/Replace F-1Demolition Description of Work: C Dr C Specify color of c for hru tile: Submittal Fee$ Permit Fee$ p®'099 CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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 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—aznd co s r coon lien law-hroharp 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 ap ed and a reinspection fea-will be charged. Signature Signature L° OWNER or AGENT NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of (_3'_ _ .20 by P3 day of fx_e o3 c 2 .20 l im by who is personally known to who is personally known to me or who has produced �v+22 as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: `10og IIIINi/ NOTARY PUBLIC: Sign: aC: °• ,� .99 e _ _ Sign: Print: `�Jf ''�2 k! Print: My cOMMISSION#GG29585 Seal: o V°���'A-: EXPIRES:September 13,2020 ��'•;a '�; r e Seal: M'n 4~ O�r�Illl11111N���'gp\' \a APPROVED BY � ���G�/� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) a ♦51Nu�S G� Miami shores Village Knell� �o m��� Building Department fiR'Ipp► 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 �® I o� CHANGE OF CONTRACTOR / ARCHITECT Permit N. `U l P 4�J2191 Owner's Name (Fee Simple Title Holder):KVI[N) 4AUft (I f)-1fgI` S LCA- Phone#: 365,9q Z 313 Owner's Address: /) E: lW ei-o IE rz City: f�/ � State : ( Zip Code--'3 3 Job Address (Of where work is being done): ,j l 4u 19G A Z �? City: Miami Shores State: Florida Zip Code: 3 31 3 Contractor's Company Name: f'� '1/7 Phone#: Address: q&1231 City: e ® State: Zip Code: 33 — /Z 3 ° Qualifier's Name: Lic. Number: C — /? Od3 2— Architect/ Engineer of Record Name: Phone#: Address: City: State: Zip Code: Describe Work: 1 hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the a ,_---,---Miami Shores harmless of all legal involvement. Signature Signature Owner r Agent ontractor or Architect The for oing instrument was raknowledged before me The foregoing instrument was aknowledged before me thisday of _,20��1,by this (� day of�,29(by Who is persy kno n to me or who has produced who is p rso nown to me or who has produced MA as indentification. 'Z" tification. ti e° E GUEVARA Not ubl lc: eyke_ E GUEVARA Nota l iG Yp�;= MY COMMISSION#FF 075127 MY COMMISSION#FD ?*d =*= EXPIRES:April 6,2o18 Sign: ,,� EXPIRES:April 6Sign: a• `;�, Rf,...` Bonded No P Seal: Seal: DRIVER LICENSE CLASS E 0;524-640-70-106-0 OSMANI GONZALEZ VINA 15905 Sw 105TH CT MIAMI. FL 33157-1571 1)05: 03-2F-1970 SEX: M ,ISSUED: 03-05-2012 HGT: 5-09 EXPIRES: 03-26-2020 t REST ENDORSE: REPLACED: 12-18-2ft_ SAFE DRIVER ve!71cle constitutes consent In an%- sobriery tett inquired bN IaM / TQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 12EO00422 GLOBAL ELECTRIC SERVICES LLC D.B.A.: GON LEZ OSMANI Is certified under the provisions of Chapter 10 of Miami-Dade County w r 01"eu L)Y-Iua RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIONe I ELECTRICAL CO"RACTORS LICENSING BOARD j EY12000297 - The ALARM SYSTEM CONTRACTOR 1 Named below HAS REGISTERED - p+ "°' •` �o,isse ,: E. Under the provisions of Chapter.489 FS. Expiration date: AUG 31,2018 f� "> (INDIVIDUAL MUST MEET ALL LOCAL;LICENSING E _ REQUIREMENTS PRIOR TOG IN ANY AREA) 1 Y C' - GONZALEZ,OSMANI ❑ ❑ ";; ' GLOBAL ELECTRICS LLC t 15905 SW 105 CT .� � MIAMI - Yr3i td MIAMI -.1_ e�rw�.�,•` . ISSUED: 07r2=16 DISPLAY AS REQUIRED BYLAW SEQ A L160720000164 RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY (l� STATE OF FLORIDA ( DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1 =a? 1 The ELECTRICAL CONTRACTORPo Named below HAS REGISTERED - -- ." `.. s Under the provisions of Chapter 489 FS. = , r Expiration date: AUG 31,2018 s (INDIVIDUAL MUST MEETALL I: pSLICENSING i REQUIREMENTS PRIOR.T EA) G IN AN L• .._ _�• Yom'• . .`� ` GONZALEZ;OSMAN! GLOBAL ELECTRIC S, ILC v .:,,: -15905 SW 105TH C s `r���,° e �• 4`i V. ,`.�°:''� Al It R ISSUED: 0720/2016 DISPLAY AS REQUIRED BY LAW SEQ 0 L1607200001620 Scanned by CamScanner Y Local Business Tax Receipt Miami-Dade County, State of Florida THIS IS NOT A BILL-DO NOT PAY 7052889 1 . �LBT ---� BUSINESS NAMEILOCATION RECEIPT NO. EXPIRES GLOBAL ELECTRIC SER CES LLC RENEWAL SEPTEMBER 30, 2017 15905 SW 105 Cr 7330376 Must be displayed at place of business MIAMI FL 33157 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS GLOBAL ELECTRIC SERVICES LLC 196 ELECTRICAL CONTRACTOR PAYMENT RECEIVED i 12E000422 SY TAX COLLECTOR warker(s) 1 875.00 07/26/2016 CREDITCARD-16-043958 This Local Busiaoss Tax Receipt only confirms puym qt of the Local Business Tax.The Receipt Is not a license, Permit or a cernm6ficatioa of the holder's qualifications,to do business.Holder trust comply with any gorarmmettW or nongoverental regulatory laws aad requirements which apply to the business. i The RECEIPT NO.above mast be displayed 010;;vnearercial vehicles-Miaml-pada Code Sac Ra-ZIB. for more infnimatior., WO', y(p '41l� , 1� � Miami Shores Village i "3e �(6 � � Itlill�Il °y: 10050 N.E.2nd Avenu !P7 e ftrk>ulalss� ti� + rIV� Miami Shores,FL 33138-0000 ee, k Pen»t5tatu AfiP13 � . Phone: (305)795-2204 ,+ , 1 Expiration: 01/21/2017 Project Address Parcel Number Applicant 9310 BISCAYNE Boulevard 1132060141610 KLEIN 8 SALOME INVESTMENT Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell KLEIN&SALOME INVESTMENTS LLC 9310 BISCAYNE Boulevard (786)344-2378 MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 250.00 AE TECH CORPORATION (786)245-0733 __..._.. „r,._. Total Sq Feet: 50 Type of Work:POOL LIGHT AND GROUNDING OF POOL LA Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:1 Light Niche a •:� 9 �:.�� �;�� Bonding �jj Review Electrical it J00 Alarms Al TIMES 3 r rP %W f Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-7-16-60556 DBPR Fee $3.36 DCA Fee $3.36 07/25/2016 Credit Card $241.36 $0.00 Education Surcharge $0.20 Notary Fee $5.00 Permit Fee-Additions/Alterations $225.00 Scanning Fee $3.00 Technology Fee $0.60 Total: $241.36 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction an J zoning. Futheunore,I authorize the above-named contractor to do the work stated. July 25,2016 Auth ized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy July 25,2016 1 I t Miami Shores Village JUL 201x ' 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 FBC 20/ BUILDING Master Permit No.- " �7 PERMIT APPLICATION Sub Permit N®.0 t 16 `" / 0X- ❑BUILDING ® ELECTRIC ❑ ROOFING REVISION EXTENSION []RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: S I u 3 I S GA -fAJ <�) 1:) City Miami Shores County' Miami Dade Zip: 3 3 1 3 folio/Parcel#: 11 - 3<O(- O 1" - I(x' 10 Is the Building Historically Designated:Yes NO -� Occupancy Type: Ow1<161- Load: Construction Type: c f,C FlloodZone: BF�E: FFE: OWNER:Name(Fee Simple Titleholder): 3,lq 37��""►J �� Phone#: Address: j City: A, / ti rig 6(ff, State: Zip: 53167 � — Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company A� 71e Name: Corg0y'ay llo✓, Phone#: �7XG) aS- 07.33 Address: t,�,J� `� X 5330,51 City: /(�a.-n* State: F' /= zip: 3315 Qualifier Name: Cir 10.S Gan C.&-do Phone#: State Certification or Registration#: Cr 13003 112- Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ G(J Square/Linear Footage of Work: SO Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition Description of Work: f(/4,C 4AA0 4641t4f% &E PPy�-l/-t 0lXXg/L Specify color of color thru tile: z o y c � Submittal Fee$ ," Permit Fee$ � dF$ Q-. (00 Co/CC$S Scanning Fee$ c;3 Radon Fee$ 2�3-'G DBPR$ :39 Notary S Technology Fee$ Training/Education Fee$ 6 , 2-0 Double Fee$ Structural Reviews$ Bond$ /,, TOTAL FEE NOW DUE$ ` J`w (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address - City _State Zia 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 the; no .pork 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 low brochure vvill 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 Signature —4� OWNER or AGENT VCONTRACTOR The foregoing instrumet was acknowledged before me this The foregoing instrument was acknowledged beforemethis _day of 2U , by day o' p 20�'" by f 1 dexersonally known to a who is personalty kno vn to me or who has produced as me or who has produced as Identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: %. dy ;� Si Sign: n n 1 24,' -- -- nnt ,• �r �.� irP1iS21S Seal: c�00uoo o ry uW ate of Florida Seal: "�° h'.l1 Sla.'ltiEE2S6169 a� Joanna i1A ioiano >�,' �OtP!RES:JULY 15,2016 c M commiss on FF 082753 o Y ;1 —, Expires 01/1212018 &cera st: r,:xMbaa a7nu ca*0 is 0*,c;ar####tlrwis#,+##fr#####N###ib##a9#r5***V t*,A x#5+ #####rk#4#rk###aFYat###at********#a5ua.+5i APPROVED BY '��J��Y/lo Pians Examiner Zoning Structural Review Clerk (F.e'es�dQ2/2x,12®l�l AC� CERTIFICATE OF LIABILITY INSURANCE DATEIMMOO•'M) �� 11013/2016 THIS CERTIFICATE IS ISSUED AS A (NATTER 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: H the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be ondorsed. 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 I leu of such endorsement(s). PRODUCER co F! Ougth Grave de peralta Fortun Insurance, Inc. PHONE (305)445-3535 01 Nal;_ >r,Ball: —__- 36S Palermo Ave. ADDRM:Judieh.gravedeperalta@fortuninsurance.com INSURER(S)AFFORDING COVERAGE __ MAIC R Coral Gables FL 33134-6607_— MURERARAPFRE Insurance Co. INSURED INSURER BRetailFirst I_n_s_urca_n_c_e_company__ _ Global Electric Services LLC INSURERC: 15905 SW 105 CT INSURER O: INSURER E:- Mi ami :Miami FL 33157 INSURER F COVERAGES CERTIFICATE NUMBER:CL16 82 910084 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 NMICH 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. T TYPE OF INSURANCE AWL SUOR7 POLICY NUMBER T VOLICY eiF -P C1'f p -- - LIMITS $ COMMERCIAL GENERAL LIAWLIITY EACH OCCURRENCE S 1.000,000 A CLAIMS-MADE X OCCUR PREMISES(Ea accurrrnca' [7AMAGE Tf�L'NTED s 100,000 ,- 42SO160024165 Bj94/2086 S/30/d017 IAED E XP(Any ore person) 5 51000 PERSONAL B ADV INJURY _5 11000,000 GFN"L AGGREGATE LIMIT A•PPUES PER GENERAL AGGREGATE S 2,000,000 X POLICY JPERa LCL PRODUCTS-C OVROP AGC S 2,000,000 OTFER Frr�BenrAm 5 AUTOMOBILE LIABILITY COM61NEO SINGLE LUM11(ED omaw�ll 3 ANY AUTO _ _ BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per aiG4enll 3 ---AUTOS AUTOS ---..-- HIREDAUTaSAUTOS RPROOPE�RTY�DAMAGE f s PPeraccalcm) ---- `— UMBRELLA LIAB i OCCUR �AIGGREOAI`E CH OCCURRENCE S EXCESS LIAR CLAIMS-MADE. -_---- ---- 5 DED � TR NT I g WORKERS COMPENSATIONPEROTH- ANDEMPLOVERS'LIABILITY YIN; UT .__STATE__,__ ER iANY PROPWETORIPARTNERIEXECUTrVE E L EACH ACCIDENT e B TOFFtCERA4FUSER EXCLUOED7 _- .'�Nf A 1,000,000 (Mandatary in NN) 520-48297 7/1S/2016 7/15/2017 €.L DISEASE-EA EMPLOYEE 5 1,000,000 R ge�s.aftcnde -- LA! RIPTION O!!OPERATIONSbi-_m E.L.DISEASE-POLICY LIMN S 2,000,000 I i DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLE$(ACORD 101,Addit o Rmnarks Schedutc mey be sMufted N moo space Is required) LIC#12EO00422 CERTIFICATE HOLDER CANCELLATION (305)756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department: ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E. 2nd Avenue Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Hector FOrtan/IZ ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 r7nmml