The URL can be used to link to this page

EL-16-26921 BUILDING PERMIT APPLICATION ❑ BUILDING 1 ELECTRIC PLUMBING ❑ MECHANICAL JOB ADDRESS: 7/ 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 ❑ ROOFING ❑ PUBLIC WORKS Master Permit No. Sub Permit No. ❑ REVISION ❑ CHANGE OF CONTRACTOR REC EIVFD OCT 0 3 '1Ji1G BY FBCl[E 2C_ 14 'te2692- ?c 7-23 ❑ EXTENSION ❑ RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zig: Folio/Parcel#: l/ '.' 013/ --b/3-b)OD Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder): Address: City: / 5 - /o ys7X 1f4 c/9J 4--"e State: %�� Flood Zone: BFE: NO FFE: Phone35'03 Zip: 33 /5,‘ Tenant/Lessee Name: Phone#: CONTRACTOR: Company Name: elet(e/.5s*e—,Phone#: Email: /' 4/lor:c Address: �,,�J City: "kir 414-/ /f / State: Zip: '3/97 Qualifier Name: ""'"C 1 ` , Cg .i 0 Phone#: State Certification or Registration #: Certificate of Competency #: / 0 (�a3 00 DESIGNER: Architect/Engineer: Phone#: Address: /City: State: Zip: Value of Work for this Permit: $ Gtr VIs Square/Linear Footage of Work: 9 c'e=6 Type of Work: ❑ Addition ❑ Alteration ❑ New Description of Work: terfoc c---t4c.44c,"4 /L -c -Q -c4 re /77,...-1 epc. Rep c Demolition Specify color of color thru tile: A/c9A< 0 8a O 9 �• Submittal Fee $ a • Q Permit Fee $ til00r,5�, CCF $ 1 z • o o • J ,CO/CC $ Scanning Fee $ 3 Radon Fee $ / O • DBPR $ /0 • Notary $ Technology Fee $ 1 (o 1"6Training/Education Fee $ y • Double Fee $ q 0'5 • Structural Reviews $ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ 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. Signature CONTRACTOR The foregoing inst ument as acknowledged be or- me this The foregoing instrument was ac nowledged before me this 20 day of , 20 (C, , by day of , 20 / o , by P-' poeT- UL-\,z5,/?.e �'�� w •ersonally kno to C PA D , whocs-verso_=ally kno to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: as me or who has produced identification and who did take an oath. t NOTARY PUBLIC: Sign: Print: Seal: ****************************************************************************************** APPROVED BY (Revised02/24/2014) G/®'C%r/ Plans Examiner Zoning Structural Review Clerk AO JOSE is certified under the provisions of Chapter 10 of Miami -Da de County C T Construction Trc es ualifying Board BUSINESS CERTIFICATE OF COMPETENCY 16E000300 TRANSFORMERS ELECTRIC LLC D.B.A.: 11 Business Tax Receipt rami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY S NAME/LOCATION RMERS ELECTRIC LLC �KELL BAY DR APT 407-C 33131 RMERS ELECTRIC LLC R CHAO 1 RECEIPT NO. RENEWAL 7486204 1131" EXPIRES SEPTEMBER 30, 201; Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 SPEC ELECTRICAL CONTRACTOR 16E000300 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 08/22/2016 FPPU11-16-015525 pis Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, mit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. For more information, visit www.miamidade.gov/taxcollector 20161005_125357.j pg Mun ci pal Contractor's Tax Recei pt rtA rniDade County, State of Florida -THS IS NOT A BILL - DO NOT PAY �N� 16E000300 EUEP\ ESE, NA M E/LOCATION TRAN5-73FfAERS aECTRIC LLC 1420 BRILL EiAY DR APT 407-C PL.. 33131 OWNER TRANScORMERS aECTR/C LLC 0 R CHAO MA MIAM DE2 RECEIPT NO. 74 94 893 EX PIRES SEPTEMBER 30, 2017 TYPE OF BUSINESS SPECIALTY ELECTRICAL CONTRACTOR Pursuant to County Code Sec 10-24 PAYM ENT RECEIVED BY TAX COLLECTOR 200.00 10/05/2016 0202-17-000020 This receipt is not valid in the following Municipalities: Aventura, Doral, Hialeah, Key Biscayne, Miarri Gardens, %arra Lakes, Palmetto Bay, Pi necrest, Sunny Isles Beach, Town of Wier Bay. For more i nforniati on, visit w ww .rri ani dada o AWR13- CERTIFICATE OF LIABILITY INSURANCE DATE (MM(DDIYYYY) 09/22/2016 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(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 Brite Choice Insurance Services 8337 S.W. 40th St Miami, FL 33155 Phone (305) 229-1199 Fax (305) 226-8899 CONTACT NAME: PHONE (AIC No Ext): E-MAIL ADDRESS' Pauline R Rivera (305)229-1199 FAX No): (305) 226-8899 Gabriel@britechoiceinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Ascendant 13683 INSURED Transformers Electric Lic# 16E000300 1420 BRICKELL BAY DR # 407C Miami, FL 33131 INSURER B : Normandy Insurance Co 13012 INSURER C: INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF NISURANCE 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 POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF IMMIDDIYYYY) 06/13/2016 POLICY EXP (MM/DDIYYYY) 06/13/2017 LIMITS EACH OCCURRENCE $ 1,000,000.00 A d COMMERCIAL GENERAL LIABILITY ❑ CLAIMS -MADE VOCCUR ❑ N N GL -52751-0 DAMAGE TD PREMISES (EaEoccu ence) $ 100,000.00 $ 5,000.00 MED EXP (Any one person ❑ PERSONAL & ADV INJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLES PER: ❑ POLICY ❑ PR ❑ LOC ❑ OTHER GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ AUTOMOBILE UABIUTY ❑ ANY AUTO ALL OWNED SCHEDULED ❑ AUTOS ❑ AUTOS NON -OWNED HIRED AUTOS ❑ ❑ AUTOS ❑ ❑ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ ❑ UMBRELLA LIAR ❑ OCCUR ❑ EXCESS LIAR ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N N 1 A N N H FL0054052016 06/15/2016 06/15/2017 ❑ STATUTEPER ❑ OT EL EACH ACCIDENT $ 500,000.00 ANY EXCLUDEDXECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE - EA EMPLOYE $ 500,000.00 EL DISEASE - POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Transformers Electric Lic# 16E000300 CERTIFICATE HOLDER CANCELLATION Village of Miami Shores 10050 N.E.2nd Avenue Miami Shores, Florida 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Pauline R Rivera ACORD 25 (2014/01) QF ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD