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EL-16-2725 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 5 FBC 20 lel BUILDING Master Permit No. 0, C I(o - Z.--i 7 2- PERMIT PERMIT APPLICATION Sub Permit No._6 I 16n- 29 Z5 ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 925 NE 95 Street City: Miami Shores County: Miami Dade Zip: 33138 1-3206-014-3100 X Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): 925 NE 95, LLC Phone#: Address: 600 NE 53rd Street Miami FI 33137 City: State: Zip: Tenant/Lessee Name: N/A Phone#:917.703.6010 Email: ivsucre@gmail.com �f CONTRACTOR:Company Name:_ B T/ L '_� /UIC.Q, GVH 2• Phone#:( 71-CO 3zS 9192 Address: 39 '7S /1jW HS S-t City: rlt 1 t t� V.4JjenS- State: Zip: 330 SS Qualifier Name: 316d P MU UO2 Phone#(711)325 2,32S State Certification or Registration#: Certificate of Competency#: 12-P-elnn 46 j DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ A-3,00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: K/Y&,ko pA,-,yQ_ '?our' P I,�'� , ��cti..� �<t c�--1'L�•) r'�t \�s�l�-tr,.� o� L�Gyt'� �\rtv�2t� �"o ppj{ .►a,'3Ct-S Specify color of color thru tile: Submittal Fee$ Permit Fee$ Z 4j, GL' CCF$ CO/CC$ "-- Scanning Fee$ 3 Radon Fee$ 3 - �6 DBPR$ 0) . �� Notary$ Technology Fee$ o Training/Education Fee$ I L4 O Double Fee$ Structural Reviews$ Bond$ 21(o • -1(0 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 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 Signature OWNER or AGENT CONTRACTOR The fore oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 4N4 day of 20 1(- by -ATk% day of 44=zO��IL 120 1G , by 1G� cb \jw.&1-Y1L=t)4 ,who is personally known to who is personally known to me or who has produced as me or who has produced _4�wE� L\G as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: t�z_ Print: Print: 1 '\'Chyme ►.ny�E Seal: `sdp�d ,� Ricardo Dominguez Seal: - i.1.. ; Ricardo Dominguez Commission#FF%8W ;* _ Commission#FF958686 Expires:February 8,2020 = Expires:February 8,2020 '; ' ARM On: WA4W: APPROVED BYj(�l�L /'y©�� Plans Examiner Zoning e---1 l n....:..... r1.._1. C 005390 0 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY 7101991 LB BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES MB ELECTRIC SERVICE CORP RENEWAL SEPTEMBER 30, 2017 3955 NW 195 ST 7379763 Must be displayed at place of business MIAMI GARDENS FL 33055 Pursuant to County Code Chapter 8A-Art.9& 10 OWNER SEC.TYPE OF BUSINESS 196 ELECTRICAL CONTRACTOR PAYMENT RECEIVED MB ELECTRIC SERVICE CORP 12E000401 - BY TAX COLLECTOR Worker(s) 1 $45.00 08/08/2016 ' CREDITCARD-16-046353 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license,, permit,or a certification of the holder'squalifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec Ba-276. For more information,visit www.miamidede.gov/taxcollector SNE STATE OF FLORIDA 4 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Q ELECTRICAL CONTRACTORS LICENSING BOARD (850)487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 MUNOZ,JUSEF P M.B. ELECTRIC SERVICE CORP 3955 NW 195 ST MIAMI GARDENS FL 33055 r Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and $y ^p STATE OF FLORIDA Professional Regulation. Our professionals and businesses range y from architects to yacht brokers,from boxers to barbeque $ DEPARTMENT OF BUSINESS AND restaurants,and they keep Florida's economy strong. _ PROFESSIONAL REGULATION Every day we work to improve the way we do business in order ER13014793 - ISSUED:' 08/08/2016 to serve you better. For information about our services,please + ! log onto www.myfloridalicense.com. There you can find more REG ELECTRICAL CONTRACTOR. information about our divisions and the regulations that impact } MUNOZ,JUSEF P M you,subscribe to department newsletters and learn more about M.B.ELECTRIC SERVICE CORP.. ~� the Department's initiatives. (INDIVIDUAL MUST MEET ALL LOCAL Our mission at the Department is:License Efficiently,RegulateLICENSING REQUIREMENTS PRIOR _ Fairly.We constantly strive to serve you better so that you can A TO CONTRACTING IN ANY AREA) serve your customers. Thank you for doing business in Florida, HAS REGISTERED under the provisions of Ch.489 FS. and congratulations on your new license! 1 exp.etion date•AUG 31.2018 1160800=16M DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY t STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION r ' ELECTRICAL CONTRACTORS LICENSING BOARD + ER13014793 eAL += ? The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 FS.w Expiration date: AUG 31, 2018 ': •, - i (INDIVIDUAL MUST MEETALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANYAREA) ; MUNOZ,JUSEF P M.B. ELECTRIC SERVICE.-CORP ""` ' .�. •" �' 1 ' (. 3955 NW 195 ST MIAMI GARDENS- „FL,33055 � .��.,,w, . .� ` 1 ...1 �. Era 11 Yom-sr: t _.!.'_.tom "� t:'`r . : , ,y* �3 .i �� ...?7►4�1k s_ 1 L�. �'1.,. �1 ISSUED: 08/08/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1608080001665 R& CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDIYYYY) 10/04/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS I 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 -- — NAMNTACT E Aldo J Castro �— i West Sunset Insurance Agency PHONE (305)270-6499 �A No): (305)279-2549 1 10300 SUNSET DRIVE#470F -MAIL aklo.westsun@gmail.com _ADDRESS` -- r----- Miami,FL 33173 � INSURERIS)AFFORDING COVERAGE Phone (305)270-6499 Fax (305)279-2549 1 INSURERA: GRANADA INSURANCE COMPANY _ INSURED INSURER 8: j,— M.B.ELECTRIC SERVICE,CORP INSURERC: — 3955 N.W. 195 Street !ff INSURER D: AMTRUST NORTH AMERICA MIAMI GARDENS FL 33105-5 I INSURER E: 3 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 I INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS j 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{ DL UBR POLICY EFF POLICY EXP �LTR TYPE OF INSURANCE POLICY NUMBER �jMMIDD/YYYYj MM/DDIYWY LIMITS C COMMERCIAL GENERAL LIABILITY i i I EACH OCCURRENCE S 1,000,000.00 I DAMAGE TO RENTED T CLAIMS MADE j OCCUR i PREM £S(Ea occurrere)_ !$ C _Ij MED EXP(my one person) $ 5,000.00 A 0185FL00087159-0 109/16/2016 109/1612017 — I LJ f PERSONAL 8 ADV INJURY 1$ 1,000,000.00 G�E^N'L AGGREGATE LIMIT APPLIES PER: i I I I GENERAL AGGREGATE I S 2,01]0,000.00 LJ POLICY ❑ JERCOT- ❑ LOC I I I Pi RODUCTS-CO )0A00.00 i ❑ OTHER AUTOMOBILE LIABILITYi I ) EaMaB�LNd DtSINGLE LIMIT ANY AUTOi BODILY INJURY(Per person) $ —� LJ i i ❑ALL OWNED SCHEDULED AUTOS AUTOS i 1 BODILY INJURY(Per accadaccident) 5- . I NON-OWNED PROPERTY AMAGE S l ❑ HIRED AUTOS ❑ AUTOS ! IPeraccident_,__.--_—�_`_.—._— { ❑ UMBRELLA UAB ❑OCCUR { j EACH OCCURRENCE $ { (❑ EXCESS LIAR ❑CLAIMS-MADE i ! AGGREGATE i S t DED ❑ RETENTION$ I ( $ { WORKERS COMPENSATION PER ��0TH- ( AND EMPLOYERS LIABILITY y/N I i 1 =J STATUTE J ER ANY PROPRIETORIPARTNERIEXECUTNE`--1.N/A ! I i 'E.L.EACH ACCIDENT {S 500,000,000.00 D OFFICERIMEMBEREXCLUDED? I iAWC1066749 07/10/2016 07110/2017 r ---- f (Mandatory In NH) E.L DISEASE-EA EMPLOYEE$ 500,000,000.00 if yes,describe under I I { j DESCRIPTION OF OPERATIONS below 1 ( !E.L.DISEASE-POLICY LIMIT $ 500,000,000.00 -- �— I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space is required) — MUNOZ JUSEF P.MB ELECTRIC SERVICE CORP.LICENSE 12EO00401 ii I i CERTIFICATE HOLDER �— CANCELLATION _4 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 111 Village of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. t Building Department ' 10050 NE 2"d Avenue AUTHORIZED R - --'� ----� y 1 Miami Shores FL 33138 I I 7 _ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01)OF The ACORD name and logo are registered marks of ACORD h CTQB t' Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 12E000401 M B ELECTRIC SERVICE CORP D.B.A.: mur4bz JUSEF P Is certified under the provisions of Chapter 10 of Miami-Dade County .VALID FOR CONTRACTING UNTIL 09/301201;