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ELC-17-413 � Fera it ntC:.E l� a-Za' Miami Shores Village '0 PBIf11f> 10050 N.E.2nd Avenue NE AitionlAlteration •• Miami Shores,FL 33138 0000 ft,•`�s W Phone: (305)795 2204 ' to�,APPir1/ED GORIDP` Expiration: 0 /02/2017 Issue t`�at+�:3/61201� Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Fine Arts Quad 1121360000050-06 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone Valuation: $ 8,625.00 ACRES ELECTRIC CORPORATION [Ni (954)327-7227 Total Sq Feet: 0 Type of Work:ELECTRICAL WORK AS PER SUBMITTED PL Available Inspections: Additional Info:ELECTRICAL WORK AS PER SUBMITTED PL Inspection Type: Classification:Commercial 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 $5.40 Invoice# ELC-2-17-62973 DBPR Fee $3.88 03/06/2017 Check#:31031 $233.91 $50.00 DCA Fee $3.88 Education Surcharge $1.80 02/28/2017 Check#:30986 $50.00 $0.00 Permit Fee $258.75 Scanning Fee $3.00 Technology Fee $7.20 Total: $283.91 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 06,2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy March 06,2017 1 Miami Shores Village Building Department 0 17 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 _- INSPECTION LINE PHONE NUMBER:(305)1762-4949 FBC 201q BUILDING Master Permit No.NIL'•1-I4-191 PERMIT APPLICATION Sub Permit No.&( G— [-=k —cl I 2) F-IBUILDING ❑■ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ORENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �pnn ➢ fl'^'���� —CONTRACTOR r-�, DRAWINGS JOB ADDRESS: RAR_ V�IV� ftt / Aga 2 -9F(ML City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: ��I1 Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): IV+FI'�� Phone#: Wg• 9,0I 2. 321s Address: o Nig !U AA A'r City: State: �iz Zip: Tenant/Lessee Name: Phone#: Email: IaOIA CONTRACTOR:Company Name: Acres Electric Corp Phone#: 954-327-7227 Address: 5480 SW 16th Court City. Plantation State: FL Zip: 33317 Qualifier Name: Kevin Besancon Phone#: 954-325-4983 State Certification or Registration#: EC13002120 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ J;ibZS •®O Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: G-LE- iVIC :L XWOK Pmt SlJBMlTrEp PLA+-J � Specify color of color thru tile: Submittal Fee$ Permit Fee$ � 'i k3 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 Comp'any'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 issue In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. i Signature , Signature -- OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foreging instrument was acknowledged before me this i� day ofr,P�"-Au 120 13 ,by day of � N-> ,20 1� by who is personally known to y���` Ss����'\,who is �nallyknoo meorwho has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PU IC: NOTARY PUBLIC: Sign Sign: Pri Print: d Notary Public State of Fiorlda a, SeaJeffry J Yao Seal: JEANETTB PIETt10WCM My Commission FF 168481 Noll"PuMlo-SM o1 Florltla Exphu 11/122018 Commttlitalon•FF 985542 My Comm.Expim Fab 29,2020 sit IIe+k+k qe�k de qe Nide�k�k��**��k**4****ffiekffi&#�k�k�ffi�Ic�k�k ye 8e��*ffi&�k�k+k aka*ffi�**4i4�M�ekffiN��k�k*&ffiNe�k ek�k�k �k�k APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 0STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 BESANCON, KEVIN DOUGLAS ACRES ELECTRIC CORPORATION, INC 9715 W BROWARD BLVD#232 PLANTATION FL 33324. Congraaffulationsl With this license you become one of the nearly ` one million Floridians licensed by the Department of Business and STATE OF FLORIDA Professional Regulation. Our professionals and businesses range STATE OF FL OF BUSINESS AND from architects to yacht brokers,from boxers to berbeque r PEPARTM ALF BUS LATION restaurants,and they keep Florida's economy strong. Every day we work to Improve the way we do business in order EC13042120I $UlTI3; :.08/05!2016 to sere you better. For Information about our services,please tog onto f.myfloridalicense.com. There you can find more CERTIFIED ELEC' I�AL C *OR information about our divisions and the regulations that Impact BESANCON, you,subscribe to department newsletters and learn more about ACRES ELEC?'l IellCf O�l.ON3.INC Me Departments Initiatives. Our mission at the Department Is: Incense Efficiently, Regulate Fairly.We constantly strive to Serve you better so thaty0U can Is-CERTIFIED under the provisions of ch.488 FS. serve your customers. Thank you for doing business in Florida, fKon dds AUft31,2018 L160803Q061612 and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD b�{r, SEEMENROM EC93ofl29go The ELECTRICAL CONTRACTOR i Named below IS CERTIFIED ' = Unger.the provielons-of Chapter 45.9 FS. ExpIfatien adta: AVG V 1,y'" INV ®. BESANCON, KEVIN DQUG4AS ��ti ACRES ELECTRIC CORR1"bN, INC w aRo rARD St • LApdTATiolatt �za ° .n i ISSUED: 08/05/2016 DISPLAY AS REQUIRED BY LAW _. SEQ0 i.16o6os0001e12 ���i,.,;,x ...N c .,._x4♦'i" ;8 . ..._ ._.. ..,. ._. moi.. �FXk'�':�fi �i..n a§"_...Ya�t.�i.�i�+k�';Y.�..w.. . BROWARD 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 I p 181-3498 r DBA: Recei t#: ACRES ELECTRIC CORP INCa. EELECTRICALACONTRACTORRACT"t Business Name: Business Type: �a r� Owner Name:KEVIN DOUGLAS BESANCON Business Opened:02/23/200.9 Business Location:9715 W BROWARD BLVD #232 State/County/Cert/Reg:EC13002120 61 PLANTATION Exemption Code: IM Business Phone: Rooms Beats Employees Machines Professionals a t i For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSP Pee Penalty Prior Years Collection Cost Total Paid r 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 r 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 t" 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. g Mailing Address: 5 KEVIN DOUGLAS BESANCON Receipt #ICP-15-00022128 9715 W BROWARD BLVD #232 Paid 09/06/2016 27.00 PLANTATION, FL 33324 I l 2016 2017 _ __. _..._.. r%r%^11AiA ren, /►P1I ILI'MJ M ^0%A I n11e+5s11re%e% TAv N%1-0 1-11 "r City of Plantation Certificate#157299 LOCAL BUSINESS Plantation TAX CERTIFICATE Account#OC15-0784 de pw;s gwna Valid from 10/01/2016 to 09/30/2017 THIS CERTIFICATE MUST BE CONSPICUOUSLY DISPLAYED Classification:(4)d.13 Electrical Contractor Business Name&Address: a Besancon, Kevin Douglas Acres Electric Corporation, Inc. 9715 W. Broward Blvd #232 CITY CLERK SIGNATURE Plantation FL 33324 NOTICE: if Business is sold this Certificate must be transferred within 10 days or it becomes null and void. ® DAT )CR CERTIFICATE OF LIABILITY INSURANCE 12130/2016 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(les)must have ADDITIONAL INSURED provisions or 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 Libertate Insurance LLC NAME T Libertate Insurance LLC 707 East Washington Street PHONE 844-571-0810 AIAXC No): 407-613-5477 Orlando, FL 32801 EMAIL ADDRESS: info libertateins.com INSURERS AFFORDING COVERAGE NAIC# www.libertateins.com INSURER A: Technology Insurance Company,Inc 42376 INSURED INSURER 8: Resource Management, Inc. 281 Main St. Suite 5 INSURERC: Fitchburg MA 01420-4371 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 33568543 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. ?NSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MP�pY EFF IP�p EXP LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ GE CLAIMS-MADE OCCUR PREM SES Ea occurrence $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PROS= POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER; $ AUTOMOBILE COMBINEDSINGLE LIMIT $ Ea•ccident ANYAUTO BODILY INJURY(Per person) $_ OWNED SCHEDULED AUTOS ONLY AUTOS 80DILYINJURY(Peraccident) $ ' HIRED NON-OWNED PROPERTY DAMAGE AUTOS.ONLY AUTOS ONLY Per'accident UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION TWC3602457 1/1/2017 1/1/2018 �/ STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YINSTATUTE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) PEO Client:Acres Electric Corporation, Inc Effective:01/01/2017 Coverage is extended to the leased employees of alternate employer in all states except in monopolistic states. State Certified Electrical Contractor EC13002120 CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EXPIRATIONTHE E ILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shores Village FL 33138 AUTHORIZED REPRESENTATIVE Paul R.Hughes ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 17/18 AmTrust I Thelma Brooks 1 12/30/2016 9:15:58 AM (EDT) I Page 1 of 1 This certificate cancels and supersedes ALL previously issued certificates. ACoRL> CERTIFICATE OF LIABILITY INSURANCE DATE(MANDD/YYW) 01/24/2017 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 NAME: Jori Rock The Contractors Choice Agency PHONE (800)918-3584 Ne: (977)684-9951 PO Box 13645 E-MAIL ADDRESS: g Jon@n insuranceonline.com INSURER(S) AFFORDING COVERAGE NAIC 0 Chandler AZ 85248 INSURERA:United Specialty Insurance Co. 12537 INSURED INSURER B: Acres Electric Corporation Inc. INSURER C; 5480 SW 16th Court INSURER D: INSURER E: Plantation FL 33317 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1712435335 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 S BR POLICYNUMBER IDDYEFF MPOMIDDYEXP LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TEN 50,000 A CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ SII10173206373 02/06/2017 02/06/2018 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY E]JEa LOC PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE IT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per scoldent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIABi CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION R 0 - AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑NIA E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yea,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) License # EC13002120 CERTIFICATE HOLDER CANCELLATION (305)756-8972 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 Shores, FL 33138 .gyp Robert Rock/JON ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)