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EL-16-980 Permit o.;EL-4-16486`' °R s i�� Miami Shores Village P8 7i F e:Et�C'�tt#Ca(• $ Ii�fit ) 10050 N.E.2nd Avenue NE Wo ass#jloatbvAlteritioMt Miami Shores,FL 33138-0000 Or `tis a� Phone: (305)795-2204 �0*Ste � ee Issue 016 Expiration: Project Address Parcel Number Applicant 11090 NE 92 Street 1132050270410 MIAMI UP 2 VIEW LLC ; Miami Shores, FL Block: Lot: Owner Information Address Phone Celt MIAMI UP 2 VIEW LLC 720 NE 62 Street (305)778-5745 MIAMI FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 6,000.00 HEFFERNAN ELECTRIC INC 305-757-8380 Total Sq Feet: p Type of Work: Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.60 Invoice# ELC-4-16-59383 DBPR Fee $0.00 04/18/2016 Check#:3524 $481.54 $0.00 DBPR Fee $3.47 DCA Fee $3.47 DCA Fee $0.00 Education Surcharge $1.20 Permit Fee $231.00 Scanning Fee $3.00 Technology Fee $4.80 Work without Permit Fee $231.00 Total: $481.54 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 ccur and that 11 w rk will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above,r�am,edc:ntract to e w k stated. April 18, 2016 Authorized Signature:Owner / Applicant / Contract / Adent Date Building Department Copy April 18,2016 1 Miami Shores Village � 11 , Building Department �:� Z016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 S FBC 20140� BUILDING Master Permit No. F—C V5—321 PERMIT APPLICATION Sub Permit No.Ei-c 1(o 99b ❑BUILDING �K ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION F-1 RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ! / /' Ae 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): ' 0 Phone#:-?,e3l �S Address: �n City: /�:'L7�] ' State: ;2 Zip: Zip: 3R� 3 Tenant/Lessee Name: Phone#: Email: 4W0u&2& ° D CONTRACTOR:Company Name: e fyt� �- LL GPhone#: 02 ����• vv�v" Address: 0 1044ee City: OiAAffy4fccjr State: AZ*ef4i'- Zip: -3.3/31? Qualifier Name: AeINALOW 7, & -QrA46N Phone#: State Certification or Registration#: EC-13®DI YQOO Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ t� , r ®� Square/Linear Footage of Work: Type of Work: ❑ Addition R Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work:" ✓✓j� '„ VL n ! AeAke r r�+f a s to wee r 4^4' I' Specify color of color thru tile: 2 Submittal Fee$_0 Permit Fee$ 2,-71-' 0® CCF$ J•ro 0 CO/CC$ Scanning Fee$ 3• Cz Radon Fee$ DBPR$ 3• Notary$ Technology Fee$ • 8Q Training/Education Fee$ Double Fee$ 231 Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) - r OL d 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. ignature Signature 0 CONTRACTO The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ]A,t t tj ARS► 20 \Ca by ` 1�� day of kL 20 16- by vc it1L k3-t\FANS who is personally known to 1 � `���. v �('� f(lfa'1 who is personally known to me or who has produced ASS, c R o as me or who has produced ���:�eYP'.=� eCQ n5� as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: Seal: � n '� e'•,� Notary Pudic State of FloridaFbride Seal: �o SUEHAYES ROSADO Monica 1-marrega 'r: ° Notary Public•State of Florida y�- My Commission EE 175809 =,.;' ., My Conan.Expires Jan 11,2018 4a,I) Expires 03/1012016 ;9 F gyp?,` �<<. Commission I FF 078565 �*rx���*�*�* �xms�s*�x*x�•�*�x*x�mx��x�rwr*x��x�F'�'At>k**m*mss��xs***w**�******�xx��x ��*****�* APPROVED BY i/,/,�W/Alans Examiner Zoning Structural Review Clerk (Revised02/24/2014) UL IAGH HLHF RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD °� o EC0001330 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 MARTINEZ, CARLOS M ; i 0� TEAL ELECTRIC __- 1900 NW 16TH-TERRACE_---- __- -- - - -- =--- - MIAMI FL 33125' --- - ISSUED: 07/05/2016 DISPLAYAS REQUIRED BY LAW SEQ# L1607050002182 Laval Busi ness Tax Fbcei pt Miami-Dade County, State of Florida -THIS ISNOT ABILL-DO NOT PAY LRT 1565051 BUSINESS NAM E/LOCATION RECEIPT NO. EXPIRES TEAC ELECTRIC RENEWAL SEPTEMBER 30, 2017 1900 NW 16 TERR 1565051 MIAMI,FL 33125 Must be displayed at place of business Pursuant to County Code Chapter BA-Art.9 8 10 OWNER SEC.TYPE OF BUSINESS PAY ENT RECEIVED CARLOS MARTINEZ 196 ELECTRICAL BY TAX COLLECTOR CONTRACTOR 45,00 07/21/2016 Worker(s) 10 EC0001330 0230-16-004944 This Local Business Tax Receipt only con"ms payr end of the Local Business Tax.The Receipt is not a license, Kermit or a cerd"cation of the holders qusl i"caliors,to do business.Hilder nust comply with any govrsrrental or nongoverrnrsental regulatory laws and regsdrerrersts which apply to the business. 2016-11-08 10:49 Pamela Rodriguez 123 >> 1 800 685 7530 P 1/1 .eco CERTIFICATE OF LIABILITY INSURANCE DATEIMrelDD/r 11/8/20166 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 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 CONTAClMARGY tiIINIGA Gil, Garden, Avetrani Insurance Group PHONe (305)630-4777 AIC •(31153279-3029 10689 N. Kendall Drive E-MAIL .MZONIGA@GGAIG.COM Suite 208 INSURERIS1 AFFORDING COVERAGE NAIC9 Miami FL 33176 INSURERAAccident Insurance Co. INSURED INsuRERe:RetailFirst Insurance Company Teac Electric INSURERC: 1900 XIN 16th Terrace INSURERD: INSURER E Miami FL 33125 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1622408169 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN8R TYPE OF INSURANCE DDL SUER POUCYEPF POUCYEXP POLICY NUMeeR M M D UNTO GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea saw soca $ 100,000 A CLAIMS-MADE E OCCUR PP 0012319 02 /23/2016 /21/2017 MED EXP one erson $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO $ 2,000,000 T POLICY F1 PRO LOC AUTOMOBILE LIABILITY OMISINED SIN_GL_E_Crff=T Ea scolds rig i ANY AUTO BODILY INJURY(Per person] $ ALL OWNEDSCHEDULED AUTOS AUTOS BODILY INJURY(Per awltlenl] $ HIND AUTOS NON-OWNED PROPERTY DAMAGE AUTOS $ Per accltlent $ UMBRELLALIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION H WORKERS COMPENSATION WC STATU- OTORY LIMIT TH- ANDEMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN IMandatory InNMI OFFICERIMEMBER EXCLUDED7 NIA 0520-97074 /5/2016 /5/2017 E.L.EACHAGCIDENT $ 100 000 It s,describe under E.L.DISEASE-EA EMPLOYE $ 200.000 DISCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Rrmeras Schedule,It more spaaa Ig required) Electrical Contractor EC-0001330 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELMERED W Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Avenue AUTHORIZED RePReSENTATIVE Miami Shores, FL 33138 3 Rodriguez/MRGY ACORD 26(2010/06) ®1888-2010 ACORD CORPORATION. All rights reserved. INS095(zolumpi The ACORD name and logo are registered marks of ACORD Miami Shores Village 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 FBC 20 BUILDING Master Permit No. L-12- SIS 3.2 /25 PERMIT APPLICATION Sub Permit No. Lz_ ❑BUILDINGELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ///���`"` A. ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ISCHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I D-9n &C 92,�)d !jtjeet City: Miami Shores County: Miami Dade Zia: � Folio/Parcel#: 44320 .So 92V n 40 Is the Building Historically Designated:Yes�_ O Occupancy Type: Load: Construction Type: Flood Zone: BFE: ` FFE: OWNER: Name(Fee Simple Titleholder)):V,a f O ' 1,/,6 V, Lar ZZ C Phone#: Address: Z& AV— V ZZ --f Z iid' AZO City: &a In , ° State: tOrli zip:_.33131- . Tenant/Lessee Name: Phone#: Email: f CONTRACTOR:Company Name: ���?v /' C Phone#: Address: 1f OV / City: M j a / State: ( Zip: 5 7 G Qualifier Name: 6i/Z v S C') /V/f Phone#: -20 y State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Enlkneer: jj0/"lal ti�O Z C62jO Phone#- Address: .,1 3.3€L/S/ IAE S-2_d !Z_ City:A�L'ag!n ' Staterla Zip: A,��14� Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee$ Permit Fee$_ r�'coo CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ 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 gf 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. ;t Signature Signature OWNER or AGENT CO ACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 NU by 0< day of iL l ?—. 120 1 U by CILIA M7J% who is personally known to 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: Sign: Sign: Print: Print: Notary Public State of Florida oWP% Notary Public State of Flori a Seal: % Monica Luzafrga Seal: P Monica Luzarrga Q My Commission FF 987995a My Commission FF 987995 oF- Q oc w° Expires 03/10/2020 j . Expires 03/1012020 APPROVED BY �jrw- ZZ Plans Examiner Zoning Structural Review Clerk (Rev1sed02/24/2014) Shores Y ills e Miamig a"'" Building Department i, IOR' A� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT 4'L--11— `Id — X9 67. Permit N.�'!- �iI�— _6yo Owner's Name (Fee Simple Title Holder): /�`�i%�r�'j, �,[�Z !/o itV' I&Phone#: 342 � �S Owner's Address: n �/�4" g �� ' �IQ City: &tj sn c6a� State : ���1 Z421_a Zip Code-..-3 3 f Job Address (Of where work is being done): 4,o go APE _V tea/ City: Miami Shores State:—Florida Zip Code: % L 1P Contractor's Company Name: "Ph #: `3a� j �® Address: City: /14;ax-0; .3AC144 State: f Zip Code: Qualifier's Name: Al n d,6 4UI, /��r�r���� Lic. Number. Q EC/3 LXi/!f 0 _Architect/ Engineer of Record Name: Ahor y;n Phone#:_ Address: 330 t- S2 rad+ City: �n State: f/n Zip Code: Describe Work: 7" 1 hereby certify that the Work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. 1 hold the Building Oficial and the e,n,4 Miami Shores harmless of all legal involvement. A� `,j����,��� .�r�'e Min®�t-L /"`a`f?� Signature Signature tx�_7_440� Owner C ctor or Architect The foregoing instrument was aknowledged before me The foregoing instrument was aknowledged before me 2 this (� dayof this dayof. Who is personally known to me or who has produced who is personally known to me or who has produced as indentification. as indentification. NotaV P 'G Nota P lic: rids Sign: F1° Sign: r BiF. MY C�LuZa 987995 Seal. soar ny®` Notary Public State of Florida Seal: a�' mission FF 0311012020 n ;4 Monica Luzarrga CoQ My Commission FF 967995 ;r OF qo Expires 03/10/2020