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EL-17-2238Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 1218 NE 98 Street Miami Shores, FL 33138-2561 Owner Information REX AND GABRIELA HENDERSON Permit Address Parcel Number Permit NO. EL -9-17-2238 Permit Type: Electrical - Residential Work Classification: Service Change Permit Status: APPROVED Issue Date: 912212017 1132050090350 Block: Lot: 1218 NE 98 Street MIAMI SHORES FL 33138-2561 Expiration: 03/21/2018 Applicant REX AND GABRIELA HENDERSI Phone Cell Contractor(s) FPL ENERGY SERVICES INC Phone (561)681-3048 CeII Phone Valuation: Total Sq Feet: $ 2,590.00 0 Type of Work: ELECTRICAL PANEL CHANGE AND METER R Additional Info: ELECTRICAL PANEL CHANGE AND METER R Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.80 $2.25 $2.25 $0.60 $150.00 $9.00 $2.40 $168.30 Pay Date Pay Type Invoice # EL -9-17-65086 09/18/2017 Check #: 4235 $ 50.00 $ 118.30 09/22/2017 Check #: 4264 $ 118.30 $ 0.00 Amt Paid Amt Due Available Inspections: Inspection Type: Review Electrical 1 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-rj. med contr cto?f?do the work stated. 19)11/-L Authorized Signature: Owner / Applicant Contractor / Agent Building Department Cop September 22, 2017 Date September 22, 2017 1 V) Miami Shores Village �1 ' (--Building De artment p BUILDING PERMIT APPLICATION 0BUILDING ❑■ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 Master Permit No. V-1-41 -22_38 Sub Permit No. PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1218 NE 98TH STREET City: Miami Shores Folio/Parcel#:11-3205-009-0350 County: Miami Dade Zip:; I og Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): REX & GABRIELLA HENDERSON Address: 1218 NE 98TH STREET Phone#: 305-803-8019 City: MIAMI SHORESState: FL Zip: 33138 Tenant/Lessee Name: Email: Phone#: CONTRACTOR: Company Name: FPL ENERGY SERVICES, INC Address: 6001 VILLAGE BLVD Phone#: 561-681-3048 City: WEST PALM BEACH State: FL Qualifier Name: MICHAEL HORUTZ Zip: 33407 Phone#: 561-681-3048 State Certification or Registration #: EC13006338 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City:State: Zip: Value of Work for this Permit: $ 2,590.00 Square/Linear Footage of Work: Type of Work: ❑ Addition n Alteration ❑ New ❑■ Repair/Replace ❑ Demolition Description of work: ELECTRICAL PANEL CHANGE AND METER REPLACE Specify color of color thru tile: Submittal Fee $ 50 ' CV Permit Fee $ /ilm / ®, CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ .2 O TOTAL FEE NOW DUE $ 1 I • (Revised02/24/2014) 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. The foregoing instru da of OWNER or AGENT ent was ackno ledged before me this 20 j / , by o is personally known to me or who has produced ' L—' as identification and who did take an oath. NO PUBLIC: Sign: nU,,,, Print: Seal: ..,,• OF Fl.i FPL Energy Services- FPLES Electrical Services 6001 Village Blvd. West Palm Beach, Florida 33407 1-844-MY-FPLES (1-844-693-7537) Job #3811 License: EC13006338 Employee: Frank Gutierrez 561-281-5139 Date: 8/7/2017 Customer Name:Gabriela Henderson Address: 1218 NE 98th St Email (1): rgchenderson@gmail.com City: Miami State: FL Z i A : Property zipi ' e Daytime Phone #: 305-803-8019) 30 livening Phone #:_ :tial to enter sr�wri? 1. Estimate( 2. Invoice E Description. of Work(3):. ElectricalPanel Change install new 200A meter can, overhead, service head and feeder wires. nstall new 200A main breaker panel inside the house. Remake grounding system. ompany is not responsible for any damage to walls, ceiling etc. ; work alvei tie- in acco artae's i .and= i sped l' 61r #; uiy *Capta€ iris a *> *This Estimate's for tkeilbovp U r,rdes Work mil a it sl 3eti unless a, - �+ �andTNa t?rder?Es Sitried" TOTAL: $2750.00 10% OFF on labor $160.00 TOTAL PRICE $ 2,590.00 Cusco r S gnatt i! (acre to e_of esti date) Customer Signature (acceptance of completed work) Date Payment Method Credit Card: Check No. (1) Your e-mail address will allow you to be notified about products and services that may be of interest to you. You can unsubacribe at any time. (2) Estimate is valid and executable for 30 days. (3) AR Work rs subject to the attached Terms, which are incorporated into this Estimate by reference. (4) BY YOUR SIGNATURE. YOU REPRESENT THAT YOU ARE AUTHORIZED TO PROCURE WORK TO BE PERFORMED OR INSTALLED AT THE SITE. Additional Services: fl SurgeShield. F Electronics Surge Protection Miami Shores Village Building Department CONTRACTORS' REGISTRATION 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. ' COPY OF QUALIFIER'S STATE LICENCES B. 'COPY OF LOCAL BUSINESS TAX RECEIPT C. ✓COPY OF LIABILITY INSURANCE* D. ✓ COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: LEA ea-gt j CmiC S, ►nc . BUSINESS ADDRESS: (Oi VACqL6hpce CITY 0143 STATE 1:;(— ZIP 391)-0/ BUSINESS PHONE: (a')) Lz2 I '66435 FAX NUMBER ( ) CELL PHONE ( ) QUALIFIER'S NAME: IL -40,W 1 U� l� Z QUALIFIER'S LIC NUMBER: 1 300(033 ii•ooit STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ` F�1 ELECTRICAL CONTRACTORS LICENSING BOARD 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 HORUTZ, MICHAEL LAWRENCE FPL ENERGY SERVICES INC 773 SW MCCRACKEN AVENUE PORT ST LUCIE FL 34953 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR LICENSE NUMBER (850) 487-1395 isaaw.....sir - ...+ r.. -----fir 4 r STATE OF FLORIDA DEPARTMENT'OF BUSINESS AND PROFESS.LOIIALLREGULATION i EC13006338 , — S.S JED -',07/19/2016 CERTIFIED ELECTe1GA1 CONTSptC�� OR HORUTZ, MICi AE.;.,LA1, FPL ENERGY SER_V_ICtS ...,.:,..:-:'' ..4 _•t. .;I:"t'-`�'-. IS CERTIFIED under the provisions of Ch -489 FS. R1 1:„p Gon iiate� AUG 31, 268•T 11607190001481 r DETACH HERE KEN LAWSON, SECRETARY - _ STATE -OF FLORIDA DEPARTMENT. OF BUSINESS AND PROFESSIONAL REGULATION • - - ELECTRICAL' ,CO JTRACTORS LICENSING BOARD • The ELECTRICAL CONTRACTOR Natned•below IS CERTIFIED • Under the provisions of Chapter4'89-FS. Expiration date: AUG 31, 2018 - w1 Cit; _ �,.,;� L..;..” • •HORUTZ;_MIGHAEL L-AWRE r` FPL ENERGY SERVICES 773 SWMCCRACRIO :AVENO1E • PORT=ST LUCIE�""� FL 3'4953 i �.:,. • • 'y'"^9;y-..'`�••—•",may,.. .. n 1 _t_ y1. 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 DBA: Business Name: FPL ENERGY SERVICES INC Owner Name: MICHAEL HORUTZ Business Location: 7200 NW 4 ST PLANTATION' Business Phone: 954-979-7578 Rooms ' Seats'. Receipt #:E 8 C.- Tx. CAL/ALARMS/CONTRACT Business Type: (ELECTRICAL CONTRACTOR) Business Opened:o3/12/2015 State/County/Cert/Reg:EC13 0 0 63 3 8 Exemption Code: Employees Machines ` Professionals 10 For Vending Business Only • Vendin4 Tvae: Tax Amount Transfer Fee ... NSF Fee . ' .. Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 5.40 0100, 25.00 57.40 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: FPL ENEGRY SERVICES INC 6001 VILLAGE BLVD WEST PALM BEACH, FL 33407 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 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 notindicate that the business is legal or that it is in compliance with State or local laws and regulations. 2016 - 2017 Receipt #02C-16-00001830 Paid 12/06/2016 57.40 ACORN®DATE 416.... -----CERTIFICATE OF LIABILITY INSURANCE (MM/DD/YYYY) 09/07/2017 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(ies) 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 MCGRIFF, SEIBELS & WILLIAMS, INC. Box 10265 Birmingham, AL 35202 CONTACT NAME: PHOP.O. INC. o. Ext): 800-476-2211 476-2211 (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Federal Insurance Company 20281 INSURED NextEra Energy, Inc. including FPL Energy Services, Inc. Attn: Erica McNabb, Risk Management Dept 700 Universe Boulevard Juno Beach, FL 33408-2657 INSURER B :Everest National Insurance Company 10120 INSURER C : 09/15/2018 INSURER D : $ 1,000,000 INSURER E : $ 1,000,000 • INSURER F : COVERAGES CERTIFICATE NUMBER:U9WCSE9T 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 37110930 09/15/2017 09/15/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISES (EaENTEoccu ence) $ 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE X POLICY OTHER: LIMIT APPLIES JET PER: LOC PRODUCTS-COMP/OPAGG $ 1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/ N N N / A EN4WC00030-171 (AOS) EN4WC00031-171 (M I) 09/15/2017 09/15/2018 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 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) RE: Electrical permit required to do a service change and a panel upgrade. , CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Avenue 10050 Miami Shores, FL 331384-1 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 7 G/X/ ACORD 25 (2016/03) Page 1 of 1 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD September 13, 2017 State of -I- 1_ County of bacl-e_ Before me this day personally appeared duly sworn deposes and says: FPL Energy Services - A NEXTERA ENERGY, INC. COMPANY achod tfrnt-z who, being That he or she will be the only person working on the project located at: I g I g"Kit- caul Skeig Oi i shot3g v0' Contractor Signature Sworn to (or affirmed). and subscribed before me this 9 byll--�iGX>rr,�-e FPL Energy Services, Inc. day of .20 / Personally Known Or Produced Identification Type of Identification Produced (407) 308-0153 GESELLA p MY COMMISSIONr; . e or Stamp Name of Notary EXPIRES October 10, 2017 Floridallota,,Service.com 6001 Village Blvd West Palm Beach, FL 33407 0 IZ a. GABRIELA HENDERSON 1218 NE 98TH STREET MIAMI, FL 33138 005)803-8019 OR (305)301-1486 LLJ < s <I CASE#: 3811 RECEIVED EP 1` 2017 e *INSTALL NEW 200 AMP MAIN LUG PANEL WITH 3-2/0 COPPER WIRES AND 1-#6 COPPER WIRE IN 2" SCH. 80 PVC FROM NEW METER/MAIN COMBO TO NEW 200 AMP MAIN LUG PANEL *ISOLATE NEUTRALS AND GROUNDING CONDUCTORS IN PANEL *INSTALL NEW BREAKERS SIZED TO CONDUCTOR OR TO RATING OF DEVICE ACCORDING TO NEC MICHAEL LAWRENCE HORUTZ EC13006338 INSTALL NEW 200 AMP METER/MAIN COMBO WITH 2" HUB -2" RIGID PIPE -2" STRAPS -2" SERVICE HEAD AND 3-3/0 COPPER WIRES FROM NEW METER/MAIN COMBO TO NEW SERVICE HEAD 2" PVC SCH. 80 • ... • •••• • •• • • •• • 300 ••• AMP • •• • • • • •• • • • • • • • •• • • •••i •• • •• ••• • • • .•• • • •• • • • i• • • • • INSTALL 2 -NEW GROUND RODS AND GROUND CLAMPS WITH INTERCONNECTING BONDING BRIDGE AND #4 COPPER WIRE FPL Energy Services FPLES Electrical Services 6001 Village Blvd. West Palm Beach, Florida 33407 1-844-MY-FPLES (1-844-693-7537) Job #3811 License: EC13006338 Employee: Frank Gutierrez 561-281-5139 Date: 8/7/2017 Customer Name:Gabtiela Henderson Address: 1218 NE 98th St Email en: rgd enderson©gmall.com City: Miami Daytime Phone #: 305-803-8019) G 5 1. Estimate (2 2. Invoice E State: FL. Zip: Pervert/ 7.i0 3 5{ { .venirtg Phone #: Click t rater Chen0. •••• 11. Description of Work(3}::Electrical Panel Change •' • • .: •• • • •+ • •• Y • • Install new 200A meter can, overhead, service head and feeder wires. . .i • install new 200A main breaker panel inside the house. .. • • • i •• •• Remake grounding system. • • • •• • . • Company is not responsible for any damage to walls, ceiling etc.• • • . • . Ali:wark yr8i'. bdcrt3e' "- te yapd;r'ecd bi,ie, cir 4"'Cai o ;_ . , eats rtot�ed''�'� is€ar: , * 'i "�'h l Estit�ltate the aiH�ve Upjles t?1� t� �tk�iiv�rlc Abe include:;i iaile� � -Change'Oriter.is.S.igned'�*" TOTAL: $2750.00 10% OFF on labor $160.00 TOTAL PRICE $ 2,59000 Customer Stinaier,e folacceptance tsf estimate) o/i Date Customer Signature (acceptance of completed work) Date Payment Method Credit Card: Check. No. (1) Your e-madd address wilt allow you to be notified about products and services that may be of interest to you. You can unsubscribe at any time. (2) Estimate is valid and executable for 30 days. (3) Alt Work is subject to the attached Terms, which are `incorporated into this Estimate by reference. (4) BY YOUR SIGNATURE, YOU REPRESENT THAT YOU ARE AUTHORIZED TO PROCURE WORK TO BE PERFORMED OR INSTALLED AT THE SITE. Additional Services: fl SurgeShielde fl Electronics Surge Protection ...• • • •.•. • .•.• • ..• • • ••• •••• • • • •.•. • ••••