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EL-15-1040 Permit No. EL-5-15-1044 �yN°mss y� Miami Shores Village Permit Type:Electrical -Residential 10050 N.E.2nd Avenue NE ' Work Classification:Addition - Miami Shores,FL 33138-0000 Perl"IlPermit Status:APPROVED Phone: (305)795-2204 FCORIOp' Issue Date:10/8/2015FExpiration: 04/05/2016 Project Address Parcel Number Applicant 333 NE 92 Street 1132060136370 JOHN LONGMAN Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell JOHN LONGMAN 333 NE 92 Street ()__ MIAMI SHORES FL 33138-3133 333 NE 92 Street MIAMI SHORES FL 33138-3133 Contractor(s) Phone Cell Phone Valuation: $ 5,800.00 LONGMAN ELECTRIC INC (305)758-1211 Total Sq Feet: 598 Type of Work:NEW 2.5 TON AC UNIT 13 SEER AND DUC Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.60 Invoice# EL-5-15-55400 DBPR Fee $3.38 10/08/2015 Credit Card $244.36 $0.00 DCA Fee $3.38 Education Surcharge $1.20 Permit Fee-Additions/Alterations $225.00 Scanning Fee $3.00 Technology Fee $4.80 Tota I: $244.36 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 and zoning. Futhermore, I authoriz above-named contractor to do the work stated. October 08, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy October 08,2015 1 Miami Shores Village —� ID .� , ,n T .� Building Department I APR 3U 15 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972By — INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 �J BUILDING Master Permit No.'9G �� Io 3(9 PERMIT APPLICATION Sub Permit No. �l-' I�— t040 ❑BUILDING ;K ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING F_� MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 3 3 3 /Y L_r S/L k 'CSC f City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): -yC*-*t' ��'� �6^q Phone#:305""-753— (001� Address: 3 3 3 /� ci 9- 5��w/- City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: e-t-A G Phone#: _30f 7`--,8_AP 1 Address: q5 NL City: /n1lq_"1 State: F_� Zip: 3 3,1 Qualifier Name: eJ )Oy s /11 Gy Phone#: 301 7 -�52 — 1 State Certification egistration#: lr G ) 3 C) -7 l 3 Certificate of Competency#: DESIGNE .Architect/ gineer: Lv ' �ILIG CA'V1c112 Phone#: lor SZg '303 7 Address: ),7 City: State: Zip: Value of Work for this Permit:$ T� Square/Linear Footage of Work: ?0 c ," Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 0V L L't Yl �✓�'1 Specify color of color thru tile: Submittal Fee$ Permit Fee$ A CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ �)_`I -` (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 commencementmust 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 d a reinspection fee will be charged. c Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of i ( 20 S by I day of A 20 J 5 by J o in L On 4 nnLL n ,who is personally known to -MiI C�A e- ) L eMmgA,1 ,who isd ersonally known o 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: 1 Sign: A Sign: Print: �a+(j L' to �. /y 1 V&1(klA Print: Z Seal: Seal: PATRICIA(.NICOLAU gdY Notary Public State of Florida Notary Public,State of Florida a Michelle Perez Commission fl FF 45906 � �P� My Commission FF 000321 APPROVED BY �� 4�t Ze t/ /S Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ® DATE(MM/DD/YYYY) . L RU CERTIFICATE OF LIABILITY INSURANCE 4/25/2015 THIS CERTIFICATEIS 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 ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATIONIS 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 CONTACT NAME: PAYCHEX INSURANCE AGENCY INC (A/CNo,Ext): c,No): (888) 443-6112 210705 P: F: (888) 443-6112 ADDRESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAICN SAN ANTONIO TX 78265 INSURERA: Twin City Fire Ins Co INSURED INSURER B INSURER C: LONGMAN ELECTRIC INC INSURER D: 844 NE 98TH ST INSURER E: MIAMI FL 33138 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 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 IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICTNUAMER POLICTEFF POLICTEXP LLNITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE —1 OCCUR DAMAGE TO RENTED S PREMISES(Ea occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-❑ LOC PRODUCTS-COMP/OP AGG g JECT OTHER $ ACOMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) S UMBRELLA AB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DE RETENTION$ $ WOR6ERS COAITENSA770N X PER OTH- AND EMPLOTERS'LIABILIIP STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEY/N E.L.EACH ACCIDENT $1, 000, 000 OFFICER/MEMBER EXCLUDED? A (Mandatory in NH) ❑ WA 76 WEG IX1296 05/01/2015 05/01/2016 E.L.DISEASE-EA EMPLOYEE$1, 000, 000 If yes,describe under E.L.DISEASE-POLICY LIMIT $1, 000, 000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICONMRD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. LIC# EC13003713 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village AUTHORZED REPRESENTATIVE F 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Lt ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD j PAYCBEX INSURANCE AGENCY INC PO BOX 33015 SAN ANTONIO TX 78265 AB 01 000682 29154 E 4 B Miami Shores Village 10050 NE 2ND AVE MIAMI SHORES FL 33138-2382 N aD m O O O ACORD 25(2014101) ` MIAMI-DADE COUNTY - STATE OF FLORIDA N/A October 08,2015 MIAM WMD } LOCAL BUSINESS TAX RENEWAL 6137004 2015 -2016 APPLICATION RECEIPT:6400147 STATE#EC 13003713 DBA/BUSINESS NAME: BUS.COMMENCEMENT DATE:11/01/2007 LONGMAN ELECTRIC INC SEC TYPE OF BUSINESS BUSINESS LOCATION: ELEC ELECTRICAL CONTRACTOR 95 NE 166 ST 1 MIAMI,FL 33162 OWNER/CORP. APPLICATION DETAILS LONGMAN ELECTRIC INC FEE AMOUNT PHONE# 305-758-1211 Receipt Fee 30.00 UMSA Fee 30.00 844 NE 98 ST Beacon Council Fee 15.00 MIAMI SHORES,FL 33138 Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi-Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 NAICS CODE: 23821 Transfer Fee 0.00 Doing Business without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0.00 Prior Years Due 0.00 Amount Recently Paid - 75.00 TOTAL AMOUNT DUE: 0.00 ................................................................................................................................................................................................................................................................................................................. If no longer in business, please notify us in writing. To pay online go to www.miamidade.aov/taxcollector Review and correct the information shown on this application. To pay by mail, make check payable to: Miami-Dade County Tax Collector A 25%penalty will be assessed to anyone found operating Business Tax without a paid local business tax, in addition to any other 200 NW 2nd Avenue penalty provided by law or ordinance(Sec 8A-176(2)). Miami FL 33128 To pay in person go to: A Certificate of Use and/or City Business Tax 200 NW 2nd Avenue Receipt may also be required. (305)270-4949,fax(305)372-6368 A service fee of not less than$25.00 up to a minimum of 5% will be charged for all returned checks. t RETAIN FOR YOUR RECORDS t ................................................................................................................................................................................................................................................................................................................. MIAMI-DADE COUNTY- 1 DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT 1 N/A October 08,2015 STATE OF FLORIDA LOCAL BUSINESS TAX RENEWAL 016 -2016 APPLICATION I I II I II,II�III�IIII I�III II IIII III(IIII RS ATE#E6400147 C13003713 6137004 BUSINESS LOCATION: 95 NE 166 ST MIAMI,FL 33162 BUS.COMMENCEMENT DATE:11/01/2007 SEC TYPE OF BUSINESS OWNER/CORP. ELEC ELECTRICAL CONTRACTOR LONGMAN ELECTRIC INC 1 APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPATION DESCRIBED HEREON.I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT. I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT. LONGMAN ELECTRIC INC MICHAEL LONGMAN PRIES 844 NE 98 ST SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE MIAMI SHORES,FL 33138 Please pay only one amount.The amounts due after Sept 30th include penalties per FS 205.053. If Received By Oct 31,2015 Nov 30,2015 Dec 31,2015 Jan 31,2016 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000006400147201600000007500000000000000