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EL-16-599 a -P@EL-3r ' i"d)?Ij`�f�. �, _. Miami Shores Village etntl Tye �� G -Residefithil 10050 N.E.2nd Avenue NE Wo 0( 'iO4fibi Acditit nIAN6 lett Miami Shores,FL 33138-0000p1w; .... " A � Phone: (305)795-2204 Pe r1i t6s.APPROVED k1dRl12A n ... Issue i�.4114/201 Expiration: 1011112016 Project Address Parcel Number Applicant 1086 NE 96 Street 1132060143480 ANA ROJAS Miami Shores, FL Block: Lot: Owner Information Address Phone Cell ANA ROJAS 1086 NE 96 Street MIAMI SHORES FL 33138-2552 Contractor(s) Phone Cell Phone Valuation: $ 3,400.00 RING ELECTRIC INC (754)610-4534 ._ _..... _ Total Sq Feet: 00 Type of Work:ADD AND RELOCATE ELECTRICAL OUTLETS Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning: 1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W.W. Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# EL-3-16-58927 DBPR Fee $2.25 04/14/2016 Credit Card $ 163.90 $0.00 DCA Fee $2.25 Education Surcharge $0.80 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $163.90 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 i accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above- med ntractor to do the work stated. April 14, 2016 Authorized Signature:Owner / Applicant Yltonfrattor / Agent Date Building Department Copy April 14, 2016 1 Miami Shores Village - - � Building Department MAR ®4 281b 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 B INSPECTION LINE PHONE NUMBER:(305)762-4949 &-4— BUILDING naFBC 20 JL? BUILDING Master Permit No. 16 —L13 3P PERMIT APPLICATION Sub Permit No. ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [_]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: l o �6 lilG �6 �f"e City: Miami Shores County: Miami Dade Zip: 3�� Folio/Parcel#: `/- 3.-L o 6 - 61/ `f - 3 Y f-0 Is the Building Historically Designated:Yes NO z/ Occupancy Type: Load: Construction Type: �JFlood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): /PW /q," l f Phone#: 3 OT 2 Address: 10 8'6 /VE 6 f Ar.,f City: KA-h r 1' -,-e r State: G Zip: - 3t3 J" Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: c q,,g L Phone#: — 50-0 3 /c� 3� Address:�� GC> <s7- City: ��/ State: Zip: 3319 2� ° Qualifier Name: Phone#: � State Certification or Registration#. E�"r�0(D / (/2 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �d® Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: V`Z-,0 C-,f77f, ksz' �Ca-tl� y. Specify color o color thru tile: Submittal Fee$ Permit Fee$/d`ZyrlrG CCF$ ` CO/CC$ Scanning Fee$ Vim. Radon Fee$ J�' DBPR$ " Notary$ Technology Fee$ S , �v Training/Education Fee$ ®"' Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ ` (Revised02/24/2014) t 1 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 CO TRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 10 day of '1 F—�byuctV-la 20 14 by day of� Ly/ 'b ,20 / by MO,IGraaniQ, QC aS ,who is persons known to -�/� i''U0 who is personally known 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: e Sign:]Q�� Sign: Print. Angela quina Print �7 % Seal: 'a $CGMMISSIGNOEE870920 Seal: EXPIRES: FEB.03,2017 PWda Gudwm ° 1'.W;,` www.AARONNOTARY.com NOTARY PUBLIC STATE OF FLORIDA Iq41 Expires 12J21/2019 APPROVED BY >'IYAA Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �•�� RINGE-1 OP ID: MARZ ACORO DATE(MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 02/18/2016 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(ies) 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 CNAAME: Javier A.Fernandez !Sure Insurance Brokers PHONE FAX 8700 W.Flagler St.,Suite 270 A/c No Ftl:305-223-2533 aC No):305-220-0765 Miami,FL 33174 E-MAIL Certificates !SureBrokers.com Javier A.Femendez ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Western World Insurance Co. 13196 INSURED Ring Electric,Inc. INSURER B:Florida Citrus, Business(FUB) Jorge Anillo INSURER C:Progressive Ins.Co. 16214 SW 63 St Miami,FL 33193 INSURER D:Scottsdale Ins. 41297 INSURER E: 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 UB POLICY EFF POLICY EXP LIMITS LTR IND D POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE a OCCUR NPP8269437 08/19/2015 08/19/2016 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,00 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 300,00 Ea accident C ANY AUTO 08215968-4 09/23/2015 09/23/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ D X EXCESS LWB CLAIMS-MADE XBS006"36 08/19/2015 08/19/2016 AGGREGATE $ 1,000,00 DED I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE I I ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 10640006 04/01/2015 04/01/2016 E.L.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? 7 N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) ELECTRICAL WORK-WITHIN BUILDINGS CERTIFICATE HOLDER CANCELLATION CITYMI1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. Fax:305-756-8972 10050 NE 2 Ave AUTHORIZED REPRESENTATIVE �r Miami, FL 33138 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD LoW Business Tax Receipt eu Miami—Dade County,State of Flodda TMS IS NOT A BILL-DO NOT PAY 4972130 BUSINESS NAMraLOCATION RECERIT NO. �MFi33RFi3)( � RING ELECTRIC INC PENEWAL SEP7'EM�i=R 30, 2016 16214 SW 63 ST 5191830 MIAMI,FL 33193 Must be displayed at place of business Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC-TYPE OF BUStNEB$ RING ELECTRIC INC 196 ELECTRICAL PAVIVIENT RECtWD BY TAX COLLECTOR CONTRACTOR 75.00 07/14/2015 workegS) 1 EC13MI412 CHECK21-15-091534 7LB L"d Ba�a�sYax IptmtP9 aooiimos �eha fes!So4taessTascTha his aoga Hoens� pe�ora ceo�ttze 6otde�'s otraaffss�m do lis.Nsldara�tcamFiytmit6 aaggouetamelllal ar reBaWtarylau�aad enhle4aPpigO�titefJttsiaess. �� iha RECHPI'R}0. tatl�l�dispiaged oa ali camnwspalvaTedas- Goch SecBa-,278. �� fforamseit�rs�$so,eis& %i RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION — ELECTRICAL CONTRACTORS LICENSING BOA i EC130014125 _ The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 ANILLO,JORGEA RING ELECTRIC INC a 16214 SW 63RD STREET e MIAMI FL 33193 e , n m ISSUEDD05l10/2014� DISPLAYAS REQUIRED BYLAW SE-00 L1406100001547 - - DRIVER LICENSE CLASS E A640-421-59-448-0 ,?+ JORGEARMANIDO AMLLO ' 16214 STN 63RD ST MIAM),n,131934464 D08-12-084959 SEAL:M t4s13Eb:10.h#-2UD9 HGT 6-02 ' X57 .abs ffi c i te9 canWV to My smnetV—rsgaasd 6v iia.