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EL-15-2789 Permit NO. EL-11-15-2789 `yam°Rts rt Miami Shores Village ma Permit Type:Electrical -Residential 1♦�� 10050 N.E.2nd Avenue NE ' Work Classification:Alteration Miami Shores,FL 33138-0000 Perill ' Permit Status:APPROVED tied Phone: (305)795-2204 FLORIDA Issue Date:11/4/2015 Expiration: 05/02/2016 Project Address Parcel Number Applicant 161 NE 106 Street 1121360060380 SECTION M INC Miami Shores, FL 33138-2036 Block: Lot: Owner Information Address Phone Cell SECTION M INC 3821 EL PRADO Boulevard (786)408-3661 MIAMI FL 33133- 3821 EL PRADO Boulevard MIAMI FL 33133- Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 SUNSHINE ELECTRICAL CONTRACT( (305)265-4958 (786)273-6194 __ ._ __... .._..., ... _,,.. _ Total Sq Feet: 0 Type of Work: REPLACE FIXTURES,OUTLETS,SWITCHES Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-11-15-57636 DBPR Fee $2.25 DCA Fee $2.25 11/02/2015 Check#: 1077 $50.00 $ 116.70 Education Surcharge $0.40 11/04/2015 Check#: 1084 $ 116.70 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $166.70 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 one by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING,MECHANICAL, 1 DOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: rti t he foreg ' g i ormation is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo ' F ther r riz ove-named contractor to do the work stated. November 04, 2015 A orized Signatu scan / Contractor / Agent Date Building Department Copy November 04, 2015 1 _ 1 Miami Shores Village .CFITVED Building Department NOV 022015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972Y'— INSPECTION LINE PHONE NUMBER:(305)762-4949 ,) FBC 20(q BUILDING Master Permit No. Rc r 7"l�� 76v� PERMIT APPLICATION Sub Permit No. V ❑BUILDING [ AlECTRTC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP N /� CCOONNTRACTOR DRAWINGS JOB ADDRESS: cc I E �,. & S 1 City: Miami Shores rr County: Miami Dade Zip: Folio/Parcel#:�I- 21�i6- �Ob "0310 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: �A �r-,�/Flood Zone: BFE: ¢QF�F'E: OWNER: Name(Fee Simple Titleholder): ��(t f On! ` 1 PIC-' Phone#: �� 1 r Address: �02 i 11—A f�n N kA City: State: ��/ Zip: 33(33 Tenant/Lessee Name:N one Phone#: ` Email: - // �pj'�' /� ) CONTRACTOR:Company Name: �� S bl?,)C C� -7c) �l p Phone#:0Cd'l'=;L(0 Address:/—3 o O 5 W 7 57 d�cf— - J City: i�� / /� / State: t Zip: /�� / Qualifier Name:i'' r �'�-� �N� p4y �`� ��—flt� Phone#:�o��W 5 `f � State Certification or Registration#: -�1-vJ� U ! Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New f Repair/Replace El Demolition Description of Work: R2A6c �f x+ur e-,- Ou+lck . sw!LL" . S G /6°�r��s. ��S�ou•� pr CT�cto 2 S Specify color of color thru tile: Submittal Fee$ Permit Fee$ l dimes CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ ( r TOTAL FEE NOW DUE$ ! �� (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State A 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 [identification gnature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this e foregoing instrument was acknowledged before me this day of ,20 , by day of 20 1`� by who is personally known to who is personally known to me or who has produced ase or who has produced as identification and who did take an oath. and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI Sign: Sign: _ L Print: Print: �..�J1 S s/2-VA4A�� 'P'0•N", LUIS FE Seal: Seal: * * RNANI)EZ A4YC 9ft3IOIV t EE 838180 s, P EXPIRES:November),2016 ATFpF FL f"I Bonded ThmSudget Notary Services ############################################################################################################ APPROVED BY G� zX-fd� -*/s' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 41 A�EP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDnYY1f) 10/27/2015 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 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 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 endomement(s). PRODUCER CONTACTNAME: Sarai Medina Emmanuel Insurance 8#038;Associates,Inc. PNCNN Ftl: (305)693-0003 No, (305)691-4381 2370 E 8TH AVE ADDRESS: sarai@emmanuelinsurance.com INSURER(S)AFFORDING COVERAGE NAIC t HIALEAH FL 33013-4236 INSURER A: RetailFirst Insurance Company 10700 INSURED INSURER B: SUNSHINE ELECTRICAL CONTRACTORS CORP. INSURERC: SANTIESTEBAN,MARIANO J INSURER 0: 1300 SW 85TH CT INSURER E: MIAMI FL 33144-4023 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 A00L3U3K POLICY EXP LTR TYPE OF INSURANCE INSp WVD POLICY NUMBER MMIDD MMIDD LIMITS COMMERCIAL GENERAL LIABILnY EACH OCCURRENCE $ RENTED_DAMAGE TO CLAIMS-MADE FIOCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY Eo- LOC PRODUCTS-COMPIOP AGG $ OTHER: $ AUTOMOBILE LUU31LnY COMBINED Ea accident) N T $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTIONS $ WORKERS COMPENSATION STATUTE ER AND EMPLOYERS'LIABILITY 1,000,000.00 ANY PROPRIMBER/PARLUDEDXECUTIVE Y❑ NIA 0520-49417-0 12/10/2014 12/10/2015 E.L.EACH ACCIDENT $ 1,000'000.00 A OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 1,000,000.00 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached I more space is required) Electrical Contractor. Any Changes or alterations Done to this document after being issued shall constitute it null and void. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shore Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department AUTHORIZED REPRESENTATNE 10050 NE 2 Ave Miami Shore,FI 33138 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD