EL-16-2828Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. EL -10-16-2828
Permit Type: Electrical - Residential
Work Classification: Pool - Private
Permit Status: APPROVED
Issue Date: 12/28/2016
Expiration: 06/26/2017
Parcel Number
Applicant
Owner Information
Address
Phone
Cell
DAVID KING
1000 NE 96 Street
MIAMI SHORES FL 33138-
(617)755-6875
Contractor(s) Phone Cell Phone
COGDILL SERVICES INCORPORATE[ (954)868-7199
Valuation:
Total Sq Feet:
$ 1,000.00
0
Type of Work: ELECTRICAL FOR POOL.
Additional Info:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$4.50
$4.50
$0.20
$300.00
$3.00
$0.80
$313.60
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL -10-16-61695
12/28/2016 Check #: 4736 $ 313.60 $ 0.00
Available Inspections:
Inspection Type:
Final
Light Niche
Bonding
Review Electrical
Alarms
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.
December 28, 2016
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
December 28, 2016 1
BUILDING
PERMIT APP CATION
❑ BUILDING IIVELECTRIC ❑ ROOFING ❑ REVISION
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
RECEIVED
CT 18 2016
FBC 20/
T
Master Permit No.6)- 2 CZ
Sub Permit No. a((:)_ 2-828
❑ EXTENSION RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
❑ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: 1000 NE 96 STREET
City: Miami Shores
Folio/Parcel#:
County: Miami Dade
Zip: .))-3 1-'JS
11-3206-014-3560 Is the Building Historically Designated: Yes NO X
Occupancy Type:
Load: Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): DAVID KING & CYNTHIA HERBST
Address:1000 NE 96 STREET
BFE: FFE:
Phone#: 617-755-6875
City: MIAMI SHORES
State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: CO rid ( `SPCA
Address: a� ; a5
City:'lfi►ranD Bericm
Qualifier Name: J\ (o'\\
State Certification or Registration #:
DESIGNER: Architect/Engineer: �Q
Phone#: IgCI
State:
I\IN41A P .; --ke r
Certificate
Phone#:
Zip: -33D(ptf
of Competency #: 1
acocC re
Phone#1 ri6- 35' Cy2)S
Address: r t_ ki S.'\ • (o 1-011155 City: Ri(3.(11; State: • Zip: 4.-jP'31 RCI
Value of Work for this Permit: $ 'I OW . 00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑■ New ❑ Repair/Replace ❑ Demolition
Description of Work: CONNECT ELECTRIC TO POOL
Specify color of color thru tile: ) Ufe.,
Submittal Fee $ Permit Fee $ 1162d7i4"lJ CCF $ ' (0 0 CO/CC $
Scanning Fee $ 3 Radon Fee $ q . 5 0 DBPR $^^ q • 50 Notary $
Technology Fee $ ' Q Training/Education Fee $ 1....0 Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 313000*
(Revised02/24/2014)
41/4
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
a
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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of
, 20 1 / , by
who is personally known to
me or who has produce • J,,; (gyp . as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
c A`ccrUY
M' ry3t NANCY CALTABIANO
;.-ri MY COMMISSION # FF 656746
�A. EXPIRES: February 2, 2020
px. Bonded Thru Notary Pubic Underwriters
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
c)`(\ day of
Nur\ (Cib
me or who has produced \ as, -
_20 ---\10 by
.\\
, who ispersonally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
NANCY CALTABIANO
MY COMMISSION # FF 956746
° = EXPIRES: February 2, 2020
,: r Bonded Thru Notary Pubic Underwriters
APPROVED BY -/02-f--✓4 Plans Examiner Zoning
(Revised02/24/2014)
Structural Review
Clerk
09/26/2016 7:30 AM FAX 7543075484 CSI EC
a 0002/0006
, )4, , 77'
oz.vimt
ifri,,(AD.B.A.:
CTQB
Construction Trades Qualifying Board
, BUSINESS CERTIFICATE OF COMPETENCY
16E000018
COGDILL SERVICES INCORPORATED
OGDILL DANNY L
Is certified under the provisions of Chapter 10 of Miami -Dade County
QUALIFYING TRADE(S)
0001 ELECTRICIAN
Juliana H. Sales P.E. ,dhicezoir
Secretary of the Board
Miarni-Dade County retains ali property n hts herein.
MAPCO
MAT,'
vAvw.rniamidade.siovIeoononly
09/26/2016 7:30 AM FAX 7543075484
CSI EC
F ricJa'3 Warmest We:corre
CITY O POMPANO-BEACH-
BUISINESS TAX RECEIPT
FISCAL YEAR: 2016-2017
THIS IS NOTA BILL
Business TaY Receipt Valid from:.Octo:ber I, 20116 through September 30; 2017
S/2641016
[3j 0003/0006
44551416
COGDILL SERVICES INCORPORATED
COGDJLL DANNY L • WO
21.0 NB 25 ST
POMPANO BEACH FL 33064
THIS' IS YOUR BUSINESS TAX RECEIPT. PLE,ASE POST IN A CONSPICUOUS PLACE AT THE
BUSINESS LOC4�'FION,
BUSINESS OWNER: . COGDILL SERVICES INCORPORATED
BUSINESS LOCATION: 210 NE 25 ST POMPANO BEACH FL
RECEIPT NO:
17-00081329
CLASSIFICATION
CO.NTRACTOI2..ELE,CTRICAL (CME)
NQTICC,: A NEW A.PPI.LCATON'MUs 1 BE, FILLD 11- 1,1E BUSINESS N.1MI:;, OwNE,.RSHIP OR ADDRESS tS CHANCiEI) TU1 TSSUANCE.OF A
BUSINESS TAX RECEIPT SHALL NOT BE DEEMED A WAIVER O[ NY' PROVIS!ON OF THE CITY CODE NOR SHALL THE:JSsuANCE OF A 1
BUSINESS TAX RECEIPT BE CONSTRUED TO BE A JUDGEMENT OF THE CITY AS TO THE COMPLTL'-NCE: OF THE APPLICANT TO TRANSACT
SI;SINF,SS, THIS,DOCt;MENT CANNOT BB ALTERED. • •
.
BUSINESS TAX RECEIPTS EXPIRE SEPTEMBER 30 OF EACH YEAR
RICK SCOTT, GOVERNOR
KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
ER13014968
The ELECTRICAL CONTRACTOR
Named below HAS REGISTERED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2018
(INDIVIDUAL MUST MEETALL LOCAL LICENSING
REQUIREMENTS PRIOR TO CO oWTING IN ANY AREA)
• -
COGDILL, DANNY LEE
• COGDILL SERVICES !NCO TED
• 210 NE 25TH STREET
POMPANO BEi)Cht..1,---:-
• •
t" • ;.--`.-...1:F'"1".•
_ -
2 3
DISPLAY AS REQUIRED BY LAW
SEQ # L1608250002808
TCL 9TOZ/9/60
f9V2LOCT7CL
9000/S000
10
010
a
A��GOU�iTY
V 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: COGDILL SERVICRS INCORPORATED
Owner Name: DANNY L COGDILL
Business Location: 210 NE 25 ST
POMPANO BEACH
Business Phone:
Tax Amount
R@CBIpt*:ELECTRICAL%ALARMS/CONTRA R —
Business Type: {MASTER ELECTRICIAN CONTCI(
Business Opened:04/07/2014
StatelCountylCert/Reg:14-CMR-18303 -x
Exemption Code:
Rooms Seats Employees Machines Professionals
1
For Vending Business only
Number of Machines: Vending Type:
27.00
Transfer Fee NSF Fee
0.00 0.00
Penalty
Prior Years
Collection Cost
Total Paid
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:
DANNY L COGDILL
210 NE 25 ST
POMPANO BEACH, FL 33064
2016 - 2017
Receipt #05C-15-00005845
Paid 08/26/2016 27.00
686SLOCISL
9000/6000
09/26/2016 7:31 AM FAX 7543075484 CSI EC
II 0006/0006
a.
DATE
CERTIFICATE OF LIABILITY INSURANCE 9/23/2016
THIS CERTIFICATE 18 ISSUED AS A NATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLGER. 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 1NSURER(3), AUTMOR1ZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: K the centrism holder Is an ADDIT]ONAI. INBUsteu, ens Polley(es) must be endorsed. It SUBROGATION IS WAIVED..ubJ.et to
the tenor and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not center rights to the
certificate bolder In Ileo of such endors.ment(a).
PRODUCER
Pettineo Insurance Agency, Inc.
2430 E Commercial Boulevard
Fort Lauderdale, FL 33308
INSURED
c6I4
c954-4939424
.WDRESSL_
*,$.01954-493-8968
immuAsk ARORmRO OOVCIIAO!
INSURER A. Federated National—Cosanercial
PACs
Cogdill, Services, Inc.
Cogdill, Danny
210 NE 25th Street
Pompano Beach, FL 33064
954-042-1316
naso im B ; Progressive
INa3uRlagc:RetailFirat Insurance Compaay
INsu tD;
INSURER P •
IN.^,URLM I
COVERAGES
CERTIFICATE NUMBER; REVISION NUMBER:
THIS IS TO CERTFY TWIT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITH8TANOINQ 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 AFFORDE=D 6Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS.
TYPE OF INsuRANCE At1DL MatN W MD POLICY NUMBER
X
OOYMbecLN. Ofa1NA. LOGUT'
I cL IUMS.AtADE ❑X occuR
00.tt AGGREGATE LIMIT APPLIES PER
XPOLICY n JPFCaT n LOC
OTHER.
AuTOAAOEM1E UABRIIY
ANYAUTO
ALL B _ Aunt
NIA
HIRED AUTOS
UMBRELLA LIAR
IDCCcSS LIAR
GL -0000026876-01
03/04/16
03/04/17
UMITS
walomuimeAck s 1,000,000
DAMA70 Rkffrig,
sea $ 100,000
4t6�6»AN� o,I.a•no.) : 5; 000_
PERSONAL 6ADV INJURY s 1, 000, 000
GENERAL AGGREGATE s 2,000,000
PRODUCTS. COMP/OP AGO $ 2,000,000
TIC ti-Masp"423
1 NON -OWNED
03216410-1
$
,1!` 9 Lod<r $ 300,000
BODLY INJURY (Per person) s
7/17/167/17/1 !OOILYINwm(Potecdowlt) $
/Par.�xinen0 s
DSO I `AfrrEAMCN2
$
CLNA4SAVOE
WORKERS bONPensATION
AND EMPt.Q j. 3 LtAanJTY
C+ o/NCMNnANMe
AWY seesRur v+ cr Axnevaxacurrvr
DINNidery la len
4' gD1
DESdeoeffb• untidy
CRIPTION OP OPsRATIONS D.lew
EACH ocUNMCNC6
AGGREGATE
VIM
NIA
0520-47843-0
7.r 1 1 CR
5/20/165/20/1
EL. EACH ACCI0 ND
$
1,000,000
LL. DISEASE • EA EMPLOYEES 1, 0 0 0, 0 0 0
t J_ D13TA$e • POLICY UMrT ; 1, 0 0 0 , 000
DESCRIPTION OF OPERATIONS / 1.0 -CA BONS / VEHICLES (ACORD 101, MOWN Reale. Sdwdul., may be iNaobod 1 m n vacate meshed)
electrical Contractor
�ERTIFIOATE HOLDER
Miami Shores Village Bldg Dept
10050 NE 2nd Ave
lji,wmi Shores FL 33138
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POI ICIES BE CANCELED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELrVERED IN
ACCORDANCE WITH THE POLICY PRQ ,1$ QfaS.
AUTHORIi:ED REPRESENTATIVE
4COR025(2013/04)
• m 1985-2013 ACORD CORPORATION. All rights reserved.
The ACORD name acrd logo ere registered marks of ACORD