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EL-16-207 Permit NO. EL-1-16-207 %s"°.'r„ yf Miami Shores Village Permit Type:Electrical-Residential r 10050 N.E.2nd Avenue NW Permi"t work Classification:Alteration Miami Shores,FL 33138-0000 Permit Status:APPROVED aF— �• Phone: (305)795-2204 CORtDp' Issue Date: 2/8/2016 Expiration: 08/06/2016 Project Address Parcel Number Applicant 13 NW 108 Street 1121360110310 Miami Shores, FL 33168-4311 Block: Lot: READ HOLDINGS LLC Owner Information Address Phone Cell READ HOLDINGS LLC 3850 BIRD Road MIAMI FL 33146- 3850 BIRD Road MIAMI FL 33146- Contractor(s) Phone Cell Phone Valuation: $ 5,000.00 GALAN ELECTRIC (305)351-6954 Total Sq Feet: 0 Type of Work:OUTLETS AND LIGHTS FIXTURES FOR INT Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 Invoice# EL-1-16-58450 DBPR Fee $3.38 DCA Fee $3.38 01/26/2016 Credit Card $50.00 $ 192.76 Education Surcharge $1.00 02/08/2016 Credit Card $ 192.76 $0.00 Permit Fee-Additions/Alterations $225.00 Scanning Fee $3.00 Technology Fee $4.00 Total: $242.76 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict nformity with t e plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I ass e r po si ii or all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICA LU I HANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT. I 1 the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo ' th rn r authorize the above-named contractor to do the work stated. February 08, 2016 Autho " edig to e: ner / Applicant / Contractor / Agent Date Building Department Copy February 08,2016 1 Miami Shores Village Building Department JAN 2 1016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 _� . _ Tel:(305)795-2204 Fax:(305)756-8972 1 I INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. �S — � u PERMIT APPLICATION Sub Permit No. IEL (C F-IBUILDING 4 ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION F-1 RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 13, A) IAJ 10 4R4, -.. .\ City: Miami Shores County:\\ Miami Dade Zip: Folio/Parcel#: \Is the B 'ding Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simpl Title older): Phone#: Address:,�f �y 7 q/ City: 1 -li Arty State: FSI Zip: 3J `7 Tenant/Lessee Name: fit&, Phone#: Email: CONTRACTOR:Company Name: ( 1�� ( /��',�'` ��® � Phone#: Address: City: U\A A State: Zip: Qualifier Name: 0/111ay- � /��.(?c—t,4 Phone#: State Certification or Registration#: ©� Certificate of Competency#: 1)q DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ - Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Iteration ❑ New Repair/Replace ❑ Demolition Description of Work: . Specify color of color thru tile: Submittal Fee$ f 0:� Permit Fee$ CCF$ -3 , CO/CC$ Scanning Fee$ `Ik> Radon Fee$ -'V DBPR$ 3 Notary$ Technology Fee$ uz) Training/Education Fee$ I ' 63 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 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 app ove a a reinspection fee will be charged. i Signature Signature NER or AGENT CONTRACTOR The fore o' g instrument nt was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 ,by day of 20 � by W. is personally knowZn to who is personally known to me or who has produced �,� —U—?q''�i/- � me or who has produced �� as q identification and who did take an oath. identificati n nL� d who did take an oath.� jfQ�GJI•p+�'ys/'U- NOTARY PUBLI NOTAR LI Sign: / - Sign: Print: yYLCA Cwt' 4 �' Print: Seal: Seal: o«pY P6e% MARIA 0.GODOY Y;:j SUNEN C011AZO .o '�' `= MY C�dMISSION i EE 874940 %, ,_ Notary Public-State of Florida € EXPII�E6:April 14,2017 �� My Comm.Expires Dec 2,2018 Commissbn• ? l?� gond�d itrcu Now Public Ue�o bfs ,'F.°;;:.�g`� t ******ss*ss ssssssss*ssss***s*ssss ssss*ssssssss*s s **s*s**s* APPROVED BY / �j✓'ii �fi� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ƒ STA TE OF Fi OR;» w DEPARTMENT OF BUSINESS AND PROPES&ONALREGUL:G& EC'] 5§ 2SUE 081016120i4 cE ImED ELECImCA[COlmCi R G»LA\O RJ SUS ' GAL§E-LECTme CO eceRTINED ,«rthe Ea+#a £cM sFE B_»data.#=»m. e4C_001_ } j \ � ��a�: Local Business Tax Receipt Miami—Dade County, State of Florida =THIS IS NOTA BILL-DO NOT PAY 6555-!35 p BUSINESS NAME/LOCATIONRECEIPT NO. EXPIRES GALATJ`ELECTRIC-CO RENEWAL SEPTEMBERQ. 201 3192 NW 45'ST- 6826316 nnttgt'i)g tli5r�lay!'rl�t•�)Int rt r)t cnt^„itict=t MIAMI, FL 33142 Pttrstt�rtt:tci Ctnu�ty I�rttl�t .14A lett.}r xt ut OWNER SEC.TYPE OF BUSINESS PAYMENT Ri:G1.IVi2D GALAN ELECTRIC CO 196 ELECTRICAL BY TAX Cot,t;i;cTOR C/O OMAR JESUS GALAN CONTRACTOR 45.Q0 08107!?01 t.� Worker(s) 1 09E000701 07.37-15-0001003 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt isnot a license, permit or a certification of the holder's qualifications,to do business.Holder most 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 Sod 80--276. MIS For more information,visit www.Mi—gMj-d-PAe&4Ybxcoflector PLEASE Cu"r OUT CARD BELOW AND RETAIN FOR FU-1 URE REFEMNCE IMPORTANT STATE OF FLOP". 13EPAMTAENT OF FINANCIAL SERViCES ha sedan amy=1 recavertiviefft cr F compensaum under this chapler. DFWSION OF WORKERS'COMPENSATION CONSTRUCTION INDUSTRY EXEMPTION 10 i L PUM—d to Chaptw440.W12).r-,S,Cwr=tes of eleeftn w be exempt-apply only vdffm the scope of tiro busaums cr&�- EF—ECTNEE CAT= EXP=TITHDATe lismia fttzd on&&nofta of clectbn to be exempt f F22aome GALM CUAR SR Purwart to Cimter'40.05!131 F-S-Mffcesf ejecdon to be exempt and c Mentes of elecrion to be exempt shall be SUSMESS HAVIE AND AMREM --A'ect to ravocal[on i$at any forte ePer the filing of the notfm M GALAN ELEC7MC GO a the issuance of the ceffcaW the pa-mon named on the notice or carOcate no longer meets,the reqt9rements of eds SaCdORfOrim Wes ceffmate.The department shOrevoks a cewicate at any Urns fcrfeflure of the pa-mon named on the WALEAR r-L 33013 ow9ft-Sle to meet the reQ,.flmrnenM of this section. SCOPES OF BUSINESS;OR TRA -LICENSED ELECTRICAL �O,Nff RACTOR #FS-F2-DV11C-262 GERP.RCATE OF ELECTION TO SE EXEMPT REVISM- 07-12 QUESMONS?(850)4131609 0112612016 13:31 Ta P.0021002 CERTIFICATE OF LIABILITY INSURANCE DATB(MM/DDrrf Y) _ 01/26/16 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 ISSUINQ INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the Certificate holder Is an ADDITIONAL INSURED,the policy(les)must ba-11 o aliGorsad. If SUBROGATION IS WAIVED,subject to the terns 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 endorsemengs). PRODUCER NAME: Marcos Alvarez -- Excellence Insurance Agency PH NE 7F—AX No,Ewe► 305)226-3900 bl1, (305)226-3997 3801 SW 107 Avenue MAIL MAlvarez®Excepenceinsurance.nat Miami,FL 33165 _ INSURER(8 AFFORDING COVERAGD NAIC 0 Phone (305)226-3900 Fax (305)226-3997 -- _.. INsurtEle A c_•Granada Insurance Company 16870 INSURED --... .._..._ INSURER 0: Associated Industries Insurance Company GALAN ELECTRIC CO. --� - - INSURER C 3192 NW 45 St INSURER D; Miami,FL 33142 305 INSURER!_•• ""''-'•'-•- INSURER P COVERAGES - _ _CERTIFICATE NUMBER: REVISION NUMBEjZ: THIS IS TO CERTIFY THA7THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 0OR 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR 701865FIL00062556-0 LTR TYPE OF INSURANCEPOLICY NUMBERIpY EFF MPM LIMITS GENERAL UABILITY EACH OCCURRENCE 1,000,000.00 ® COMMERCIAL GENERAL LV�eILrrY DAMAGE TQ RENTED ❑ ❑ CLAIMS-MADE LTJ OCCUR PREMIE Ea occur n $ 100,000.00 A MED EXP(Ary orw arson t 5,000.00 ® PD$b00 Deductible 09/08/2015 09/08/2016 " ❑ — PERSONAL&AOV INJURY i 1,000,000.00 GE s 2,000,000.00 GEN'L AGGREGATE LRAT APPLIES PER: - PR PRODUCTS•COMP/OPAGG S 2,000,000.00 © POLICY U ❑ LOC AUTOMOBILE LIABILITY OMBINEp SINGLE LIMIT ED ANY AUTO BODILY INJURY(Per par—) s ---- B ❑ AUTOS AUTOS ED ❑ BAC�HOE$ULEO ❑ BODILY INJURY(Par amidant S HIRED AUTOS ❑ ANON-OWNED UTOS P ER DAMAGE S s ❑ UMBRELLA LIAB pccuR © EXCESS LIARCLAIMS.MADE EACH OCCURRENCE S ❑ g ❑ DED ElRETENTIONS AGGREGATE WORKERS COMPENSATION S AND EMPLOYERS'LIAa1LITY Y/N EEO]WC STA - OTH- ANY PROPRIETOR/PXCLUDE EXECUTNE AWCIM284 E.L.EACH ACCIDENT s 100,000,00 B (Mandy R/MEMBER EXCLUDED? ❑ NIA N 02/24/2015 02/2412016 (MMntlatory M NN) Y Dyep daeuae under E,L.DISEASE-EA EMPLOYE s 100,000.00 DESCRIPTION OF OPERATIONS I�eiow _—... E,L.DISEASE-POLICY LIMIT 8 500,000.00 DIISCRIPTION OF OPERATiON51 LOCATIONS f VEHICLES (AU..h ACORD 107,Addltlonal Remarlrs Sehadrde,8 mon space is required) Electrical Contractor CERTIFICATE HOLDER CANCELLATION Mlaml Shores village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 9 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Avenue Miami Shoros Florida 33138 AUTHORIZED REPRESENTATIVE Fax 305-756-8972 ACORD 25(2010106)OF ®1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and 1090 are registered marks of ACORD 0112612016 13:31 TAX) P.0011002 i r Bea-l"riz Bruno General Lines Agent 3801 5W 107 Averlue, 'Miami, Florida, 33165 Phone: 305--226-3900-Fax: 305-226-3997 E mail address: bbrurto@excellenceffisurance.net subject: C�C� fax: Gozrtments; AT X22 �L�GG�`G2-GY - �d20 OSS/j22G�G'� . Thank you<<;