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EL-17-603 i p , -603 Tf i Miami Shores Village mit 706 Elkt 10050 N.E.2nd Avenue NE �O/I � � tIQI1ft'�21��1 Miami Shores,FL 33138-0000 Ir � aW.AP��} i Phone: (305)795-2204 lilts'" {sE 3 3 ? v3K ¢ sua 0ai;4(231201T Expiration: 09/1912017 Project Address Parcel Number Applicant 600 NE 97 Street 1132060171680 Miami Shores, FL 33138-2471 Block: Lot: EDUARDO J GONZALEZ Owner Information Address Phone Cell EDUARDO J GONZALEZ 600 NE 97 Street (786)459-2356 MIAMI SHORES FL 33138- 600 NE 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 5,500.00 WEATHERMAKERS ELECTRICAL COI (786)249-8880 Total Sq Feet: 0 Type of Work:REPLACE METER CAN 225A RISER INSTAL Available Inspections: Additional Info:REPLACE METER CAN 225A RISER INSTAL Inspection Type: Classification:Residential Final Scanning:3 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# EL-3-17-63213 DBPR Fee $3.38 03/23/2017 Credit Card $200.36 $50.00 DCA Fee $3.38 Education Surcharge $1.20 03/07/2017 Check#:5595 $50.00 $0.00 Permit Fee-Additions/Alteratlons $225.00 Scanning Fee $9.00 Technology Fee $4.80 Total: $250.36 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 authorize the above-named contractor to do the work stated. March 23, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy March 23,2017 1 A.. Miami Shores Village - - -- Building Department i MAR 012017 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 6� -�_------7 INSPECTION LINE PHONE NUMBER:(305)762-4949 5A� FBC X20 ICA BUILDING Master Permit No. RC a l*7 Y?® PERMIT APPLICATION Sub Permit No. ❑BUILDING X ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL r-JPLUMBING [:] MECHANICAL MPUBLIC WORKS Ej CHANGE OF 0 CANCELLATION [-] SHOP / ,�/ CONTRACTOR DRAWINGS 6 JOB ADDRESS: ,00 1'�' 9 7 City: Miami Shores County: Miami Dade Zip: 3✓a/3 Folio/Parcel#: J I J. ,906 m�17— I C 9® Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction TJType: / Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): gaOogdo / 67m za/oz Phone#: Address: /I600 I✓� 2-7 City: P04W Stater Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: �fV-�Gl � ia�lC{'/� �'�(`l�7 Phone#: 77V P70 Address: )3 Zs � 9 AV e City: Q f ` State: Zip: -7,3/Pia Qualifier Name: 6`erc?! A/V Phone#: 7F&-g0o9—"1:31.3 State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ -5—.5-00 Z quare/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New Repair/Replace ❑ Demolition a // Description of Work: �ecC04-40r, e61 ji / C'✓` 5 Oczr�i r G/e_ I AxP /As y epT / Specify color of color thru tile: ��s�o� -- Submittal Fee$ 60 Q�� Permit Fee$ y'/�l�CCF$ �� CO/CC$ Scanning Fee$ 457( Radon Fee$ DBPR$ Notary$ Technology Fee$ _ Q� Training/Education Fee$ 0 Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) Jk 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 b nsep ction fee will be charged. Signature SignatureC OWNERorA ENT CONTRACTOR The -foregoing instru ent was acknowledged before me this The foregoing instrument was acknowledged before me this 1 day of 20 1- by day of /y///7G� 201 [2 l by do who is rsonally known who i personally know to me or who has produced as me or who has produced as tion and who did take an oath. identification and who did take an oath. PUBLIC: NOTARY PUBLIC: UM@aal; Sign: gp; ��Z Print: fYf .P�"PSB,, NSO Seal: Notary Public-State of Florida lnFNAFOULQS GONZALEZ :• Commission#FF 906263 156861 ' My Comm.Expires Sep 22,2019 RE> Bonded through National Not Assn. Tr••...•ae.' -no ydlhruN�AaryPubc 0rvrriters APPROVED BY-&�<' Plans Examiner Zoning Structural Review Clerk (ReVised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CWTRACTORS LICENSING BOARD ' 'EC.13006657 ! The ELECTRICAL CONTRACTOR Named below IS CERTIFIED_ ' Under the provisions of Chapter 489 FS, Expiration dates AUG 31;2018 " ti -FLINGO�,_GERALD WILD � � TriERMAKERS-EL LC CONTRA TO I_ 4 y ♦MIAI��SNV';'I.'I J".��E _ - `,v,�r'' 0. REQUIRED ISSUED: 09/11!2016 DISPLAY AS .... .. .._.. .._,_ D BY LAW SEQ# L1609110003184 i i i � r WEATH-2 OP ID: U ACORO DDmYY) TE(MM/ �� CERTIFICATE OF LIABILITY INSURANCE DATE 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 CONTACT Wilson,Washburn and Forster NAME: 16505 N.W.13th Avenue AIC No Ext:305-666-6636 A/C No):305-662-7778 Miami,FL 33169-5719 E-MAIL certificates@WWfins.com Sarah J.Washburn Carfare ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Hanover American Insurance Co. 36064 INSURED Weathermakers Electrical INSURER B:Bridgefield Employers Ins.Co. 10701 Contractors,LLC 13955 SW 119th Avenue INSURERC: Miami,FL 33186 INSURER D: 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 hDDL R POLICY EFF POLICY EXP LIMITS LTR NSD WVD POLICY NUMBER MM/DDIYYYY MM/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE FXI OCCUR LZJ7562104 04/01/2016 04/01/2017 PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- F7 LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE UHJ A897187 00 04/01/2016 04/01/2017 AGGREGATE $ 1,000,000 DED I X I RETENTION$ 0 Products $ 1,000,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE X ER B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 830-21007 04/01/2016 04/01/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? F-1 N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below IE.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) License#EC13006657 CERTIFICATE HOLDER CANCELLATION MIASH01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Ave Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 008M Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY �. 6115984 _ LBT BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES WEATHERMAKERS ELECTRICAL CONTRALLCRENEWAL SEPTEMBER 30, 2017 13973 SW 119 AVE 6378913 Must be displayed at place of business MIAMI FL 33186 Pursuant to County Code Chapter SA-Art 9&10 OWNER SEC.TYPE OF BUSINESS WEATHERMAKERS ELEC CONTRACTOR ujV6 ELECTRICAL CONTRACTOR PAYMENT RECEIVED 07EO01067 BY TAX COLLECTOR Worker(s) 6 $75.00 07/25/2016 CREDITCARD-16-043456 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is nota license, permit,or a certification of the holders qualifications,to do business. Holder most comply with any governmental or nongovernmental regulatory laws and requiremems which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec Ba-276. For more information,visit www miamidade govAncollector i I I I � 1 t I