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EL-17-1544 At ivaL 47 Miami Shores Village r�eimr(Type. Eli tr 1-Resis10Itltlal= y 10050 N.E.2nd Avenue NE Chas/ftcaVow AIS :. Miami Shores,FL 33138-0000 Phone: (305)79x2204 r� Pdt7tlit StatimAPP : t � fi[OR1Dp r Expiration: 12/10/2017 lssue»:611 01'" Project Address Parcel Number Applicant 1100 NE 108 Street 1122320280290 Miami Shores, FL 33161- Block: Lot: WILLIAM HODGES Owner Information Address Phone Cell WILLIAM HODGES 1100 NE 108 Street MIAMI SHORES FL 33161-7300 Contractor(s) Phone Cell Phone Valuation: $ 5,690.00 LS CURTIS INC (305)892-6501 __ _ _ Total Sq Feet: 0 Type of Work:SERVICE UPGRADE AND AC HOOK UP Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:2 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.60 Invoice# EL-6-17-64275 DBPR Fee $2.99 06/13/2017 Credit Card $170.73 $60.00 DCA Fee $2.99 Education Surcharge $1.20 06/09/2017 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $199.15 Scanning Fee $6.00 Technology Fee $4.80 Total: $220.73 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.All4he fo goinrg information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fut re,I au o i-tithe ove-na contractor to do the work stated. June 13, 2017 A nzed Signatur • wner / pp scant / Contractor / Agent Date Building Department Copy I ����� June 13,2017 1 l Miami Shores Village RECEIVED Building Department JUN o 9 2017 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305) 756-8972 L INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC^20 IA BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING Q ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [] CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 10B ADDRESS: 11, 940 � � %7 C City: Miami Shores County: Miami Dade Zip• Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FE: OWNER:Name(Fee Simple Titleholder): Olt -awl C `j Phone#. 305-484-6527 Address: ,}� !` � ��} s1� {7 f— City:kL"Y_1 1 k';-1- °� 'I'G State: FI Zip: ame: Phone#: Email CONTRACTOR:Company Na' e: L S Curtis Phone#: 305-933-0683 Address: 20341 NE 30 Ave 108 City: Aventura State: EI Zip: 33180 Qualifier Name: Lewis Curtis Phone#: 305-933-0683 State Certification or Registration#: ECO003175 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 ❑1Repair/Replace ❑ Demolition Description of Work: &elmo `P6-0M /, Specify color of color thru tile: Submittal Fee$ Permit Fee$ l 7` ls� CCF$ CO/Cc Scanning Fee$ Radon Fee$ DBPR$ Notary Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 4 7-3 (Revised02/24/2014) Bonding Company's Name(if applicable) .Handing 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: 1 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 low 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 — Signat /ckAnowle OWNEGENTCONTRACTOR The foregoing instrument w ' dged before me this The foregoing instrument was acknowledged before me this day of !�/ ,20/1 by 07 day of June ,20 17 by //ZVl /"�/i�l who is pers - nown who is o 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 PU IC: r P�e' .��" CASSANDRA NEBBIA CASSANDRA NEBBIA s aa Sign: • `moi Notary Public-State of Florida Sign. •` 4 v otary Public-State of Florida FF 979238 • omm ss on 1-9192311 Print: My Comm.Expires Jul 25 2020 Prin Comm.Exoires Jul 25 2020 Bonded through National Notary Assn. �''���°;,`�` Bided through National Notary Assn. Seal: Seal: APPROVED BY �trP�J� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) J Miami Shores Village Building Department artment ° NAR 1 6 211 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 �°-------------------- INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING Permit No. � PERMIT APPLICATION Master Permit No. FBC 20 Permit AHC Type: Electrical OWNER:Name(Fee Simple Title older): Phone#:3 Cj Address: 71V-j City: 'GtState: ""/e d'l'W ea Zip: 3-3 IK Tenant/Ussee Name: Phone#: Email: JOB ADDRESS: 711LZz".'e-e� 2 City: Miami Shores �yCounty: Miami Dade Zip: -3 Folio/Parcel#: C) A>— Q 0 Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Co��mjjpany Name: Phone#: Address n d City: E-7 1.4 de,l�z G /f' State: /:�ZO e/'d a Zip: 33 3 Q, Qualifier Name: s fe✓--7-o , Jr— ► �s Phone#: State Certification or Registration#: —nl-c e6! Certificate of Competency#:Ci® Contact Phone#: /S�� / ��-� Email Address: P- , DESIGNER:Architect/Engineer: ,A414 Phone#: Value of Work for this Permit:$ , ) P Square/Linear Footage of Work: Type of Work: OAddress OAlteration ONew .14epair/Replace ODemolition Desc�ri h'on of Work: e e- a dill /' U °✓'I' �— s C/) ,k-, Cf Submittal Fee$�• Permit Fee$ !�C /3' CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ Bonding Company's Name(if applicable) l/ Z Bonding Company's Address City State zip Mortgage Lender's Name(if applicable) 4v Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as ' dicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all i n o "meel he standards of all laws regulating construction in this jurisdiction. I understand that a separate �i�rt e CAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,T�and O ITIONERS,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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In he absence of such po eco notice, the inspection will n Abe approved and a reinspection fee will be charged. i Signatult�--Z—� I'll r or Agent Contractor A The foregoing ins enn7as acknowledged before me this The folegoing instrument was ackno=J.Ae befornE day o by i��iC/ter, , day of ,20�,by " who is personally known to me or who has produced (FG,/ wis personallyo o me or who has produced .- r I°V o--(. L off'. As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: A A rlla- zd"I Pant: Ch � �Gt Print: ��� ¢ucnnccnaaocuccaco � b My Commission Expires: , SUSAN A.SA RE gy My Commission Expires: � 4 ��rvT+�t_��f 1,ti pYA !'g Wmnla 6o,--u:.:,`i p�'7A �t 3 ' �Yo4i En=51r>r®i 9 L� p�� FOf�B WDfEiYWa",:v1.,WI{i � Oauu.ugiLSWpuW�Wl�llUB9tBU9� kNaHask�sk'3�Ha8a�HaIaIwkAHa�skAak��Rk �R�Ha���=kis$���a�Xa$�ssIa���Hask4aksb���8�$a�bdabAsb�$���Dsk�sk�HokikHsskskk� APPROVED BY " `_ A'' le,&Al /7 Plans Examiner Zoning Structural Review Clerk q� • (Revised(Y7/10/07)(Revised 06/10/2009)(Revised 3/15/09) NOTICE OF COMMENCEMENT i 111111111111111111111111111!11.1111111111111 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION C IF tall 2 e 11 R 018 X5013 OR Bk 27626 Ps 27121 (fps) PERMIT NO. TAX FOLIO NO. RECORDED 03/23?2011 13.21:02 HARVEY RUVINr CLERK. OF COURT MIAMI-DADE COUNTY. FLORIDA STATE OF FLORIDA: LAST PAGE COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and'in accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement. k y ��ll (S�pacg Above reserved for use of recording office 1. al description of prorty and streettad ress: LIQr✓ 6 .ff? , 2.Desc ption 9f Improve ent: �/ 'G{ tzn 4h Ct Glh E eG k ' &_ v ,t-1 'OLA 3.Owner(s)name and address: A // Interest in property: Name and address of fee simple titleholder. 4.Cont ctor's name address and ph on number. v 5.Surety:(Payment bond required by owner from contractor,If any) Name,address and phone number Amount of bond$ 6.Lender's name and address:,'4 7.Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7.,Florida Statutes, Name,address and phone number. 8.In addition to himself,Owners designates the following person(s)to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Name,address and phone number. 9.Expiration date of this Notice of Commencement. (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER:ANY PAYMENTS.MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13. FLORIDA STATUTES,AND CAU RESULT IN.YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Sig )of Owner(s)'Authorized Officer/Director/Partner/M ger Y By rint Name Print Name itle/Office ��-- Title/Office r ? STATE OF FLO IDA COUNTY OF MIAMI-DADS - The foregoing ins ment was acV wied before me this day ofGfil�'�i� By T it 12 40r U I d'dually,or-L)as V for ❑Personally known,orjl�produced the following type of Identific4tiop Signature of Notary Public; Print Name: �5C<Cf LCL ♦r (SEAL) MEAN A.SAYRE VERIFICATION PURSUANT TO SECTION 92.525.FLORIDA STATUTES Under penalties of perjury;I declare that l have-read the foregoing and _ E> ealStF019 that the facts stated in it are true,to the best of my knowledge and belief. brn ,,,.......w................ ... Signet �of Owne er(s)'sAuthorized Officer/Dir�ector/Partner/Manager who signed above. f STA OF FL RIDA OOt3NT1POF IaAI .. 12301-52 PAGE nror StdTA! �lz7�Ahfa�P,",�rirPG7iid�e�l��L " pQ J 1 IA 1�9,Ci�RI(, �fi"i dpi@ ass t S a� UAL 1. ::< 1� ■ Ali= 11-will � � f - • r.a i I 10 � M hn CTQB .......... Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 000018718 k. ;r �"�`,T-VOLT INC D.B.A.: TOLE'VVESLEY W JR Is certified under the provisions of Chapter 10 of Miami-Dade County MEW QUALIFYING TRADE(S) 0001 ELECTRICAL MI®im Herminio Gonzalez P.E. F WWW.rriamidade.govlbuildingcode Secretary of the Board ��" I� MIAMI-DADE COUNTY 2010 LOCAL BUSINESS TAX RECEIPT 2011 FIRST-CLASS TAX COLLECTOR MIAMI-DADE COUNTY-STATE OF FLORIDA U.S.POSTAGE 140 W.FLAGLER ST. EXPIRES SEPT.30,2011 PAID 1st FLOOR MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI,FL MIAMI,FL 33130 PURSUANT TO COUNTY CODE CHAPTER 8A-ART.9&10 PERMIT NO.231 317365-5 THIS IS NOT A BILL-DO NOT PAY RENEWAL BUSINESS NAME/LOCATION RECEIPT NO. 330999-4 T VOLT INC CC # 000018718 DOING BUS IN DADE CO OWNER T VOLT INC Sec.Tpe of Business WORKER/S 146 ELECTRICAL CONTRACTOR 1 THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT.IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE DO NOT FORWARD COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW.THIS IS T VOLT INC NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- WESLEY TOLE PRES TIONS' 3808 W DAVIE BLVD PAYMENT RECEIVED FT LAUDERDALE FL 33312 MIAMI-DADE COUNTY TAX COLLECTOR: 07/22/2010 60060000375 y t 1 000075.00 !l�r11l2!!lI�E,:,l�11,e, l+ lll1!}il,!!i!I?iilll!l, 1}9ii5,1 SEE OTHER SIDE MIAMI IJ7 �COUN1 Y 2010 MUNICIPAL CONTRACTOR'S, 201 T. ' " I FIRST-CLASS TA COLL�CFOR TAX RECEIPT 'I U.S.POSTAGE 1401A! :F1.AGlLER ST M1ANil DADE COUNTY'-STATE.QF FLORIDA i PAID u s'1st Fl OQBIIRSUANT TO COUNTY CODE SEC 10=24 I MIAMI,FL A�OAIVII,F4 �13Q t F�CPIAES SEPT 30 2011 �„ PERMIT NO.231 THIS IS NOT A BILL—DO NOT PAY RECEIPT NO. 30-3309994 CC NO; 000018718 RECEIPT HOLDER MAY DO BUSINESS NAME/LOCATION BUSINESS AS A CONTRACTOR T VOLT INC AS SPECIFIED HEREON. DOING BUS IN DADE CO OWNER :T VOLT INC SEE BACK OF RECEIPT FOR ELECTRICAL CONTRACTOR A LIST OF NON—PARTICIPATING MUNICIPALITIES DO NOT FORWARD Receipt holder must register in the city T VOLT I N C where work is to be WESLEY TOLE PRES done. 3808 W DAVIE BLVD FT LAUDERDALE FL 33312 PAYMENT RECEIVED MIAMVDADE COUNTY 1 AX COLLr6T 22/2010 60060000376 000200.00 MIAMI-DL DE COUNTY 2008 MUNI CIRAL CQNTRAGT -O# 201.Q FIRST-CLASS TAX COLLECTOR TAX RECEIPT U.S.POSTAGE 140 W.FLAGLER ST. MIAMI DADS COUNTY STATE OF FLORIDA, PAID 1st FLOOR pU SUAN TO0 UNTYCORESEC 7Qr24 MIAMI,FL, MIAMI,FL 33130XPIREiSEPT SA 2A1 Q PERMIT NO.231 30-3309994 Te I%UgT A SILO-O�W j ff f Y RECEIPT NO. BI�SINVFA$^�,,,N/,jl�(��/LOCATION RECEIPT HOLDER MAY DO 1 UL 1 11v BUSINESS AS A CONTRACTOR DOING BUS IN DADE CO AS SPECIFIED HEREON. OWNER :T VOLT INC SEE BAeK ,OF REeEIPT FOR ELECTRICAL. CONTRACTOR A LIST OF NON-PARTICIPATING MUNICIPALITIES Receipt holder must DO NOT FORWARD register in the city T VOLT INC where work is to be WESLEY TOLE PRES done. 3808 W DAVIE BLVD FT LAUDERDALE FL 33312 PAYMENT RECEIVED MIAMI �f p 1 CO�� OO17L.GOO2 0002.00.00 6 I SC } 114,1 7� �'�. �i,;( .,.� , e. t -, �.-. . t '} . 46.'r -t,•; .�.M°.. �'{ A. aa!S e, y'frph y..e�!n..,�. Y�S��H� r _'7^���� j,$�•r1.M a ka63rp e �} x( :k�� h7 s aV+��x} :JCb d'+� gA r i� ro y 1 'A � '�l P�`s -�, „w� a�L'•' v r� " �' e�' �d it�� � 7 - �". ti a{V.2lt.k�• t (� i y 1.Yr CI!'1C �'.� "4� �' p` .� } �F q(. i v'Ayt y..7l�.,a3C••slL f-�:£Ta'�'r^*.;a.e$.r-'•. 1! �cL� e4u .'Nfi,y..-' x v ' '�+ •.tf'•� p h!r` �(r u �a p� ,f AJ rGir`'G'd ..or'Yl l�uytt�vv±.. rs-,4I' X41 r.t v �I aNi, i4 �, t`��iivk"+i+ r•-+ta .kik �'. -'� ^ `ray*Zx �,j+ @,.i.� y"'l4' �jy .� n '�a w i�H}-g a vN< } ym��t}C �t .0 �`r�y„r r r,..� "� h d 1 k sS$. -� (& P +, ih;•'4r �R 'k}r d THI1 NI.Y }l k c r 2 8r1 N AP a f.u y. gk4s tk ? },fie iy q,{p .^' k.. DQ6a -uewsl7 DO NOT FORWARD VO4`s bae ` "R °RI�R4h T VOLT INC � ryO "°"� WESLEY TOLE PRES "dWE OR G�NBR RR UIR� RX IS e,, 3808 W DAVIE BLVD NO +4 nlp N �1 t sNO � lBy ' � 'i FT LAUDERDALE FL 33312 AAY SEE OTHER SIDE Miami-Dade County -Building Code Compliance Office rage 1 u> i Building Code Compliance w Search: 1iiYtd 0v , Contractor License Information Contractor Number: 000018718 Contractor name: T-VOLT INC Address: 3808 W DAVIE BLVD City,St,Zip: FT LAUDERDALE FL 333120 Phone: (305)792-4535 Other Phone: Fax: Email: DIB/A: Contractor Status: ACTIVE Class Ex iration Date ELEC 09/30/2009 CONTRACTOR INQUIRY COMPLETE BCCO Application Menu I BCC_O Home Page I State License Search Menu Home 1 using our.aite I AWA I Phone Directory I Privacy I Disci©imer E-mail your comments or questions to BCCO E-mail your comments,questions and suggestions to Webmaster This page was last edited on: July 17,2001 Web Site®2001 Miami-Dade County. All rights reserved. v ew ce„lae�1. l"-i�tir iii Y#!fM'1'��'Y 1/it/wrw ei'0"'W i t*d 49 iH4 1 lh�l'ff From:Janis Morton At:OMS Insurance Group FaxlD.OMS GROUP To:Susan Date:03/17/11 10:16 AM Page:2 of 2 +� OP ID:JM ACORO" DATE(MMIDD)YYYY) `,._..- CERTIFICATE OF LIABILITY INSURANCE 03/17/11 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 863-688-1751 CONTACT OMS Insurance Group@63-683-0521 P"°"E FAl P.O.Box 2 c No Ext): (A1C,No. Lakeland,FL 33802-0002 EMAIL ADDRESS: Tim Taylor PRODU CUSTOMECERRID 1.TVOLT-1 INSURER(S)AFFORDING COVERAGE NAIC f INSURED T Volt,Inc. INSURER A:Florida Retail Fed 1 Summit Ms.Olivia Tole INSURER B: 3808 West Drive Blvd. INSURER C: Ft.Lauderdale,FL 33312 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. LTR TYPE OF INSURANCE I ADDLIMI POLICY NUMBER POLICY MMIDDIYEXP YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCEDAMAGE TO RENTED $ COMMERCIAL GENERAL LIABILITY PREMISES Es ocaurence $ CLAIMS4AADE [—]OCCUR MED EXP(My one person) $ PERSONAL&ADV NJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY n PRC- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Es accident) ANY AUTO BODILY NJJRY(Per person) $ ALL OWNED AUTOS BODILY NJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per acaderd) NON-OWNED AUTOS $ $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER A ANY PROPRIETORIPARTNEWEXECUTIVE Ya NIA 0520-34503 09/26/10 091MIl E.L.EACH ACCIDENT $ 100,0()( OFRCERRAEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 -T -r' . I DESCRIPTION OF OPERATIONS I LOCATIONS I VE14CLES (Attach ACORD 101,Additional Remarks Schedule,it more space Is required) CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shares„FL 33136 a� ®1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD i CERTIFICATE OF LIABILITY INSURANCE1 3/16/11 MATE(M IDDI"YY' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDI=R. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURA14CIE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the oertyNcale holder Is an ADDITIONAL INSURED,the policyrllas)must he ondemad. If SUBROGATION IS WAIVED,s*aetto the terms and conditions of the policy.certain poncles may require an ondorsemont. A stdontent on this certiflC.ato don oat confer rights to the ealtlt)Cate holder In Ih1u of such 6-ndoraament(s). PRODUCER N WESLEY TOLE OR SUSAN CAR INSURANCE INC E FAX 17 OLD KINGS RD N IAIA.- 11 SUITE R INSUPAR AWORDINGCOVQtAGE MAID PALM COAST FL 32137 INSURER A: HERMITAGE tNBUR9D T VOLT INC WSURM e:ALLSTATE 3808 WEST OAVIE BLVD INSURERc: FORT LAUDERDALE,FL 33312 INSURERD: INSURER I!: 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. NOTWITHSTANOINC 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. ILTR TYPEOPINSURANCE POLICYNuaam POUCYEFF fmmagm= UNITS GENERAL LIAEtLnY EACH OCCURRENCE 1,000,000 X COMMERCIAL GENERAL LIABILITYCLAIMS-MADE ^ O MWED m S p CLAIMS-MADE OCCUR I—�� ESMEDEIIP am 55000 A HOL-566285-10 0510=010 0510812011 PERsomAL&AovINJURY $1,000,000 GENERAL AGGREGATE S 2,OOO,000 N1Atd3REGATELIMIT APPLES PER: PRODUCTS-COMPIOPAGG $J_000,000 POLICY m 7 LOC S AUTOMOBILE UASI,ITY F7 ANYAUTOALLf SOOILYINJURY(P6tpe S OO LAVED XE�LEO 80DAYINAIRY(Peraxlder�t) S B NONdWNED 049794029 05120/2010 05120/2011 HIREDAUTOS X AUTOS PRIER S X aentl a UMBRELLA L'" OCCUR ❑ EACH OCCURRENCE S M(Cm LIAB CWMS MAGE AGGREGATE i DED I I RETENTIONS i WORKERS COMPENSATION V1C STA AND EMPLOYERS'LIABILITY !b YIN ANY PROPRIETOR/PARTNER1129SCiUTIVE OPMEfMpMBER E)CLU�T F-1NIA7 ILL EACH AOC®ENF i (Menaemry M NH) E.L.DISEASE-EA FNIPLOM S ITyea,descdhe ua W E.LDISEASE•POLICYUMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAUach ACORD 101,AddWOM Reaade Schedule,It nrore epees b mWtled) ELECTRICAL CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 22ND AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL 33138 AMC "E'RES"NTATP FAX 305-756-8972 O 04,-nna bU&M-110ACOR15COMORATION.-AIIAreserved. ACORD 26(2010105) The ACORD nwne and logo are registered nuft of ACORD 10/t0 39Gd 31VIS11V 83SNOO OOOOL 09BE ESM 110Z/GL/E0 Miami Shores Village Building Department 10050 NE 2 Ave, Miami Shores, FI 33138 Tel: (305)795-2204 • Fax; (305)756-8972 2/12/2016 Current Owner 1100 NE 108 Street Miami Shores, FL 33161 Permit: EL-3-11-479 Address: 1100 NE 108 Street Miami Shores FL 33161 Date Expired: 10/1/2011 Dear Sir or Madam, Our records indicate that the above referenced permit has expired without obtaining the proper final inspection. In order to serve you better, we need to keep our files up to date. As per section 105.4.1 of the Florida Building Code, "Every permit issued shall become invalid (expired) unless the work authorized by such permit is commenced within six months after its issuance,or if the work authorized by such permit is suspended or abandoned for a period of six months after the work is commenced, or completed without obtaining the final inspection of the work performed." Please be advised that open permits will hinder your ability to refinance or sell this property Please contact the Building Department, within 15 days of receipt of this letter in order to take care of this matter. Sincerely, Ismael Naranjo (CBO) Building Director