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EL-17-1532 pe dii, � ' ' -1532 o, Miami Shores Village C/17/t y E t#'i si`-I + ai ntia ;, 10050 N.E.2nd Avenue NE Abo _, oapon.Addition/AltBon Miami Shores,FL 33138-0000 e � Phone: (305)795-2204 = „ Pe #Status:APpROVE F[OR'" X2/2417 v Expiration: 1 0912 17 Project Address Parcel Number Applicant 126 NE 107 Street 1121360070220 Miami Shores, FL 33161-7032 Block: Lot: ILEANA ESTHER FAJARDO Owner Information Address Phone Celt ILEANA ESTHER FAJARDO 126 NE 107 Street MIAMI SHORES FL 33161- 126 NE 107 Street MIAMI SHORES FL 33161- Contractor(s) Phone Cell Phone Valuation: $ 2,200.00 ALLBRITE ELECTRIC&SERVICES IN, (954)583-6788 (954)214-0489 _....-_, . __ ,...... Total Sq Feet: 0 Type of Work:1200 AMP 120/240 VOLT SINGLE PHASE Available Inspections: Additional Info:1200 AMP 120/240 VOLT SINGLE PHASE 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 $1.80 Invoice# EL-6-17-64262 DBPR Fee $2.25 06/12/2017 Check#:2186 $ 118.30 $50.00 DCA Fee $2.25 Education Surcharge $0.60 06/08/2017 Cash $50.00 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $168.30 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-ncontr22� the work stated. �IM1s June 12,2017 Authorized Signature:Owner / Applicant Contractor / ent Date Building Department Copy June 12,2017 1 Miami Shores Village DECEIVED Building Department JUN n R 7017 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Y Tel:(305)795-2204 Fax:(305)756-8972 �1-�I' r ^G1 11 INSPECTION LINE PHONE NUMBER:(305)762-4949 S-� FBC 20 l 1 BUILDING Master Permit No. 1� CS 3 PERMIT APPLICATION Sub Permit No. ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ®RENEWAL ❑PLUMBING ❑ MECHANICAL [-]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 6JOB ADDRESS: AQ A1 /0 ,7 ��a �'L�� lel;og1n �, pg-S9 City: Miami Shores County: Miami Dade Zig): d f Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE:ao FFE: OWNER:Name(Fee Simple Titleholder): l/�/4.,U/q- Al /AP Q® Phone#: s, 60 l�7 Address: A) L /0'Z -SZ-R�7 City: �f��0� �'/ �� State: ��®/'P-/D0t:-7 Zip: Tenant/Lessee Name: Phone#: Email: AO -f 1(2 gL771-i t . 00/-7? CONTRACTOR:Company Name: PLWR�� E :fix"11 11 �' SS Phone#:(615Y) Address: /-?;/- 6� ��T1 jeoAQ 9-041 St)r rF '�V 153 City:. ®og1//25 -State: 16 de/�O'�q Zip: 3 33 A 5 Qualifier Name: L 16 GEIZARE --Phone#: 4-5-LI`-68f3"67ffk State Certiflcation or Registration M 45 e® ®C5 9 Certificate of Competency M 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 [Repair/Replace ❑ Demolition Description of Work: Z 12®® "9 MAO /,�®/�� !!®LT S'/�t1Gll� �s�ASIE- Specify color of color thru tile: Submittal Fee$ Permit Fee$ 16-0.1®P CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1RPid%Pdn7/7ahmal 'Bonding Comp me(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 fiRt inspection which occurs seven (7) days after the building permit is issued in the absence of such posted notice, the inspectio ill not be ap rov neinspection fee will be charged. i Si4 Signature OW R or AGENT CONTRACTOR Theorgoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 1' day of Jen ,20 ,by day of n-2_ ,20 C ,by (J,J1 J9 d 19 IWO ,who is personally known to L 664WE& ,who is personally known to me or who has produce&-JVWQOZ&L��11-L 0" 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: P Natali Print:) State of Florida EHo A.Alvarado Seal: P,o My Commission Expires 1211812019 Seal: NOTARY PUBLIC STATE OF FLORIDA Commission No.FF 944254 Comm#FF952046 APPROVED BY F J—W-7 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) LLBRITE ELECTRIC & AC SERVICES INC. 13762 W. State Road 84, Suite#63 Davie, FL 33325 vise Providing Quality Electrical Services May 31,2017 Bid Proposal Ileena Fajardo 126 NE 107st Miami Shores Fl,33161. Reference: Exterior meter main service panel. Dear: Ileana. We are pleased to submit this proposal,for your consideration,to furnish and install as listed below. This proposal specificallyIn udes: I. U.L.rated material and labor. 2. Tools and equipment 3. Qty(1)200amp meter main combo 240v Weatherproof Panel. 4. Qty(1)200amp main circuit breaker. 5. Qty(2)Ground Rods. 6. Qty(1)Ground Bar for catv. 7. Qty(1)Bonding to cold water pipe. 8. Qty(1)Weather head 9. Permitting and all associated fees. This proposal specifically excludes: 1. Removing and replacing any drywall 2. Repairing or patching or painting 3. FPL Impact fees. Proposed Amount$2,200.00 This proposal excludes any acceleration costs by Allbrite Electric and is figured at a 40 hour work week.This p Deal is valid for thirty days.Payment terms are 50%deposit and balance due net 30 days from fi I invoice date.Your consideration of our firm for completing the subcontract E lu a appreciated.Please do not hesitate to contact me 8 you have any questions this r i. Respectfully subm ed, Gary Gallagher (0 Service Manager ' Allbrite Electric&A/C Services,Inc. (954)583-6788 of: (954)323-5513 fx (954)214-0489 cell usallashed allbrite.net PHONE(954)683-6788—FAX(954)323-5513 COMMERCIAL—INDUSTRIAL—INSTITUTIONAL-RESIDENTIAL Ut IALON titilt SICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY • a STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD �u zytl, ECO601099 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 GERBER, LLOYD A a � a ALLBRITE ELECTRIC 8n SERVICES, INC. 13762 WEST STATE ROAD 84 STE 63 Z DAVIE FL 33325 _ ISSUED: 07/07/2016 DISPLAYAS REQUIRED BY LAW SEQ# L1607070001333 FROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2016 THROUGH SEPTEMBER 30,2017 DBA.ALLBRITE ELECTRIC & SERVICES INC Receipt e:ELECTR13CAL/ALARMS/CONTRACT R Business Name: Business Type: Owner Name:MITCHELL GERBER Business Opened:oi/02/2013 Business Location:13762 W STATE RD 84 STE 63 State/County/Cert/Reg:E00001099 DAVIE Exemption Code: Business Phone:954 583-6788 Rooms Seats Employees Machines Professionals 3 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: MITCHELL GERBER Receipt, #ICP-15-00016177 13762 W STATE RD 84 STE 63 Paid 07/26/2016 27.00 DAVIE, FL 33325 l - 2016 - 2017 r� o DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/6/2017 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 Bonnie Kri sman Ext 313 BB Insurance Marketing Inc PHONE 888-728-0817F14X 954-452-0450 10167 W Sunrise Blvd,3rd Floor EMAIL Plantation FL 33322 .bkdgsman@bbimi.com INSURE S AFFORDING COVERAGE NAIC 0 INSURERA:Commerce&Industry Ins Co 19410 INSURED ALLBELE-01 INSURER a:Brid efield Employers Ins Co 10701 Allbrite Electric&Services Inc INSURER c:Ohio Security Insurance Co 3491 13762 W St Rd 84,Ste.63 INSURERD:AmGuard Insurance Company 42390 Davie FL 33325 INSURER E:Western Surety Company INSURER F: COVERAGES CERTIFICATE NUMBER:425746944 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 INSURANCEA11131-SUOR POLICY EFF POLICY EXP LIMITS LTR ISD WVD POLICY NUMBER MM/DD MMIDD C X COMMERCIAL GENERAL LIABILITY BLS56486504 1/16/2017 1/16/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO R CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence $300,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 POLICY JET LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: I $ D AUTOMOBILE LIABILITYM11iN-LINGLE LIMIT ALAU823333 1/16/2017 1/16/2018 Eaaaddent $1,000,000 ANYAUTOBODILY INJURY(Per person) $ AUTOS�ED X SCHEDULED BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPER' R PE D A $ AUTOS Per accident $ A UMBRELLA LIAB X OCCUR EBU013308162 1/16/2017 1/16/2018 EACH OCCURRENCE $1,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$0 $ B WORIMRS COMPENSATION 0830-52293 1/30/2017 1/30/2018X AND EMPLOYELIABILITY STAT RS' LITE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YNIA E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEO$1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$1,000,000 E Employee Dishonesty 63083048 2/17/2017 2/17/2018 Limit $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Electrical Contractor. Excess Liability follows General Liability and Workers Compensation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVENUE MIAMI SHORES VILLAGE FL 33138 AUTHORIZED FtYRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ILEANA FAJARDO RESIDENCE CITY 126 NE 107TH STREET MIAMI SHORES, FL 33161c- 0 rY NEW 2"RISER WITH(3)2/0 THHN CU WIRE •""• • 0 0000 0000•• •• • 0000 0 • • • • 0000.• •• • • 0000•• 0000•• • . • 0 • ZOOAMP 1 PHASE METER •••• 0000 000• • • 0••• 0000 00000 0000•• .• • 00.00 • 0 • • •V�� .• .. •• • 000000 " O •00800 0 0' LU • • 0~ • • :000:0 0000.0 t.� w g • N LL U 200MCB 200AMP MCB PANEL NEMA 3R 120/24OV 69 iAIE ••• • 0 0 �M < Q 2P80AMP �0 > 2P60AMP o� } w 2P40AMP I m u - 2P30AMP =s. ` I 1 P20AMP CATV/PHONE BOND 1 P20AMP COLD WATER BOND w Lu o TWO 1/2"X 8FT GROUND RODS 6FT APART c ` (� w WITH#6 COPPER WIRE Q m m U RECEIVED JUN 0 8 7(117 r L.LBRITE ELECTRIC SERVICES, iNC.0 PROVIDING QUALITY ELECTRICAL SERVICES SERVICE•MAINTENANCE•LED LIGHTING UPGRADES•ENERGY SAVING SYSTEMS INFARED THERMOGRAPHY•ULTRASONIC TESTING•POWER QUALITY LICENSED-INSURED GARY GALLAGHER MOBILE:(954}214-0489 SERVICE MANAGER OFFICE:(954}583-6788 LIC#EC0001099 FAX:(954}323-5513 WWW.ALLBRITE.NET GGALLAGHER@ALLBRITE.NET