EL-17-2609Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
ti
P
Parcel Number
Permit NO. EL -11-17.2609'
Permit Type: Electrical -Residential
Work Classification: Service Change
PermitStatus: APPROVED
issue Date:11l912017
Expiration: 05/08/2018
Applicant
1055 NE 105 Street
Miami Shores, FL
1122320280810
Block: Lot:
NAKULJATHAR
Owner Information
Address
Phone
Cell
NAKUL JATHAR
1055 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone
KEBOS ELECTRICAL UNLIMITED INC (786)280-0358
Cell Phone
Valuation:
Total Sq Feet:
$ 3,000.00
0
Type of Work: NEW SERVICE REPLACE PANEL
Additional Info:
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations .
Scanning Fee
Technology Fee
Amount
$1.80
$2.25
$2.00
$0.60
$5.00
$150.00
$9.00
$2.40
Total: $173.05
Pay Date Pay Type
Invoice # EL -11-17-65531
11/09/2017 Credit Card
7
Amt Paid Amt Due
$ 173.05 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
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 zonings Futhermore, I authorize the above-named contractor to do the work stated.
November 09, 2017
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
November 09, 2017 1
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
BUILDING
PERMIT APPLICATION
BUILDING 0 ELECTRIC ❑ ROOFING
0PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 1055 NE 105 ST
Master Permit No.
Sub Permit No.
FBC 20 (L(
e.c, -
❑ REVISION ❑ EXTENSION ❑ RENEWAL
0 CHANGE OF Ej CANCELLATION 0 SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
County: Miami Dade
Zip: 33138
OWNER: Name (Fee Simple Titleholder): 1\10-14(... JAT 4 Z, Phone#: 301—'46 H 113'2-3
Address: 10 5 5 N E I Os rH
City: Nt /AM ) Sj-IoRCS
ST
State: FL -
,Tenant/Lessee Name:
Email:
zip: 33 (3 '
Phone#:'L305-321-3'70
�"
CONTRACTOR: Company Name: KEBOS ELECTRICAL UNLIMITED INC
Address: 5629 SW 5 TERR
Phone#: 786-280-0358
City: MIAMIState: FL zip: 33134
Qualifier Name: JORGE CHAVIANO
r State Certification or Registration #: Certificate of Competency #:
EC13007551
Phone#: 786-280-0358
+ DESIGNER: Architect/Engineer:
Address: City:
Value of Work for this Permit: $ 3000.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑� Alteration ❑ New ❑ Repair/Replace
Description of Work: NEW SERVICE, REPLACE PANEL
Phone#:
State: Zip:
❑ Demolition
Specify color of color
thru tile:
Submittal Fee $ Permit Fee $ /✓�/o'U 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)
0-5
A
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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
2' day of ()Qb[ rte— , 20 _ by
\ jt uL_ V nay 3 true_ , who is personally knownto
me or who has produced FL Yom—` i1` Z li�no-"'" as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
S f SID (off
�y O�pRYPUB, Notary PuolioState ofFlorida
`. ? Sindia Alvarez
( My Commission FF 156750
4.0, 0.01' Expires 09/0312018
Signature
The foregoing instrument was acknowledged before me this
23 day of OCTOBER 20 17 by
JORGE CHAVIANO ,(W'(io is personally known tom
ne r who has produced ' as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
############################################################################################################
APPROVED BY
(Revised02/24/2014)
Plans Examiner
Structural Review
Zoning
Clerk
007250
Local Business Tax Receipt
Miami -Dade. County, State of Florida
-THIS IS NOTA BILL - DONOT PAY
J 6574819
._
BUSINESS NAME/LOCATION
KEBOS ELECTRICAL UNLIMITED INC
5629 SW 5 TERR
MIAMI EL33134
OWNER
KEB05 ELECTRICAL UNLIMITED INC
Worker(s) 1
RECEIPT NO. -
RENEWAL
6845474
LBT
EXPIRES:2-- -----
SEPTEMBER 30, 2018
Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
SEC. TYPE OF BUSINESS
196 ELECTRICAL CONTRACTOR
EC13007551
PAYMENT RECEIVED
BY TAX COLLECTOR
$45,00 07/18/2017
CHECK21,71767883-
This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license,
permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT N0. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276.
For more information, visit www.miamidade.gov/taxcollectot
RICK SCOTT, GOVERNOR
KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
LICENSE NUMBER
EC13007551:;`
The ELECTRICAL CONTRACTOR
Named below IS CERTIFIED
Under: the provisions of Chapter 489 FS
5 Expiration sdate:AUG 31-, 2018
CHAVIANO, JORGE
KEBOS ELECTRICAL UNLIMITED INC.
5629 SW 5TH TERRACE' ;'"``:;
MIAMI 'FL 33"134
ISSUED: 05/25/2016
DISPLAY AS REQUIRED BY LAW
SEQ # L1605250000580
11/01/2017 10:15AM FAX 3052634856
A
EXCLUSIVE
CERTIFICATE OF LIABILITY INSURANCE
Z0001/0001
I DATE (MM/DDIYYTY)
11/01/2017
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 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 dols not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT
NAME:
PHONE 305.263-4855
EXCLUSIVE INSURANCE AGENCY ILEANA ZUNIGA
7175 SW 8 ST #204
MIAMI
INSURED
Kebos Electrical Unlimited Inc.
5629 SW 5th Terrace
Miami
COVERAGES CERTIFICATE NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOhVE FOR THE POLICY PERIOD
REVISION 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.
INTR TYPE OF INSURANCE SR
ADDL SUER '.
NSD 4WD POUCY NUMBER (M P/DDnEYj yl POLICY LIMITS
X COMMERCUIL GENERAL LIABILnY
7 CLAIMS.MADE n OCCUR S 1,000'000
S 100,000
FL 33144
FL 33134
INC. No FM)
ADDRESS: exClUsiveins@comcast.net
INC.X
No
305-263-4856
INSURERISI AFFORDING CQVERAGE
INsuRER A : GRANADA INSURANCE COMPANY
INSURER e :
INSURER C :
INSURER D :
INSURER E :
INSURER F
NAIL 0
OENI, AGGREGATE LIMIT APPLIES PER: !
POLICY n j2CT I J LCC
OTHER:
AUTOMOBILE &JASIUTY
ANY AUTO
OWNED
AUTOSONLY
HI
AUTOS ONLY
UMBRELLA LAB
EXCESS LIAB II
AUTOS ULED
NON -OWNED
AUTOS ONLY
0185PL00068142 -0
03/09/2017
03/09/2018
EACH OCCURRENCE
PREaeQMISES (eae ri0)
MED EXP Any one person)
PERSONAL & ADV INJURY
s 6,000
GENERAL AGGREGATE
PRODUCTS -COMP/OP400
s 1,000,000
S 1.000,000
$ 1,000,000
OCCUR
CLAIMS.MADE
DED I 1 RETENTION
1 WORKERS COMPENSATION
1 AND EMPLOYERS' LIAaIUTY
yr N
ANY PROPRIETOR/PARTNER/EXECUTIVE ^
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
DEBSCR/PTI N 0� OPERATIONS below
N/A
(tea ec�cIclefe) SINGLE LIMIT
$
BODILY INJURY (Per parson)
S
BODILY INJURY (ParaocIdem)
PROPERTYA6AMAGE
(Peraorlidont1
S
$
EACH OCCURRENCE
AGGREGATE
S
I STATUTE I I ER
E.L EACH ACCIDENT
E_L, DISEASE - EA EMPLOYEE S
E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES
(A�—
EIecUIcal Contractor CORD 107, AQdiUorul Remarks Saha4ulB, may be attached If more apace Is required)
I
CERTIFICATE HOLDER
fi
.
ACORD 25 (2016/03)
Miami Shores Village
10050 NE 2nd Ave.
Miami Shores
FL 33138
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL, BE DELIVERED IN,
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTN RIzeD REPRESENTATIVE
The ACORD name and logo are register@. a . �ACORD
ORM
ttights reserved. •
JIMMY PATRONIS
CHIEF FINANICAL OFFICER
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 6/3/2017 EXPIRATION DATE: 6/3/2019
PERSON: FUENTES EDUARDO
FEIN: 264193359
BUSINESS NAME AND ADDRESS:
KEBOS ELECTRICAL UNLIMITED INC
17891 NW 87 CT
H IA LEAH FL 33018
SCOPE OF BUSINESS OR TRADE:
Licensed Electrical Contractor
IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under
this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.'.. apply
only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be
exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the
person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a
certificate at any time for failure of the person named on the certificate to meet the requirements of this section.
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609
PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
CONSTRUCTION INDUSTRY EXEMPTION
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS COMPENSATION LAW
EFFECTIVE DATE: 1/142016
PERSON: CHAVIANO
FEIN: 264193359
BUSINESS NAME AND ADDRESS:
KEBOS ELECTRICAL UNLIMITED INC
EXPIRATION DATE: 1/13/2018
JORGE
5629 SW 5 TERR
CORAL GABLES FL 33134
SCOPES OF BUSINESS OR TRA
H
E
R
E
IMPORTANT
Pursuant to Chapter 440.05(14), F.S., an officer of a corporation
who elects exemption from this chapter by filing a certificate of
election under this section may not recover benefits or
compensation under this chapter.
Pursuant to Chapter 440.05(12), F.S., Certificates of election to
be exempt... appy only within the scope of the business or trade
listed on the notice of election to be exempt.
Pursuant to Chapter 440.05(13), F.S., Notices of election to be
exempt and certificates of election to be exempt shall be
subject to revocation if, at any time after the filing of the notice
or the issuance of the certificate, the person named on the
notice or certificate no longer meets the requirements of this
section for issuance of a certificate. The department shall revoke
a certificate at any time for failure of the person named on the
certificate to meet the requirements of this section.
(LICENSED ELECTRICAL
CONTRACTOR 1
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609
t'ao
r—
PROPERTY: 1055 NE 105 ST- MIAMI SHORES 33138
OWNER: NAKUL JOTHAR
FOLIO: 11-2232-028-0810
RECEIVED
Nov 01.2017
NEW 2" EMT.
3# 3/0 CU.
1 #6 GROUND
2
NOTES:
1- NEW PANEL 200AMP - M.L 42 SPACES / LOCATED (GARAGE).
2- NEW 2" EMT. / 3# 3/0 CU. / 1 #6 GROUND.
3- NEW METER COMBO 150AMP. / MAIN BREAKER (10,000. K.I.C)
4- NEW PVC SCHED (80) . / NEW PVC SCHED (40). / 3# 3/0 ALUM.(FPL).
(UNDERGROUND 24")
5- 1#4G./%PVC-2RODGR5/88'.
e
.,y,i
+4i� V,,•
l
k
Rt . • i i �l i W •.
NEW PANEL COMBO
200 AMP. MAIN BREAKER
10,000 K.A.I.0
LOCATED (GARAGE)
KEBOS ELECTRICAL UNLIMITED INC
5629 SW 5 TERR • MIAMI, FL 33134
LIC # EC13007551
Jorge Chaviano - Qu E lifier
NEW PANEL COMBO
200 AMP. MAIN BREAKER
10,000 K.A.I.0
• •
• • •
•• •
•
••••
• •
• • J •
• •
•• ••
• • •
• •
• •
• • •
•• •
• •
•
• •
•
•
••••
• •
••••
• •
•
•
• •
•
••• •
• •
• •
••
•
•
•
• •
• •
•
••
•
•
•
•
184 G.
% PVC
2 ROD GR 5/8 8'.
BRIDGE LOW VOLTAGE
NEW 2" PVC - SCHED (80) \
NEW 2" PVC - SCHED (40)
24' DEEP UNDERGROUND
3# 3/0 ALUM (FPL)
PROPERTY: 1055 NE 105 ST
i
MIAMI SHORES 33138
OWNER: NAKUL JOTHAR
FOLIO: 11-2232-028-0810
KEBOS ELECTRICAL UNLIMITED INC
5629 SW 5 TERR • MIAMI, FL 33134
UC # EC13007551
Jorge Chaviano — • ualifier
ELECTRIC LOAD CALCULATION
PANEL200A
ITEM
DEMAND
GRL LIGHTING AT 3 W/SF
7,566 W
SMALL APPLIANCE CIRCUITS
3,000 W
WASHER
1,500 W
DRYER
6,000 W
RANGE
8,500 W
WATE HEATER
7,200 W
MICROWAVE
1,200 W
WINE (NEW)
800 W
DISHWASHER (NEW)
1,200 W
REFRIGERATOR (NEW)
1,000 W
TOTAL OF HOUSE LOAD IN WATTS
37,966 W
FIRST 10 KW AT 100%
10,000 W
REMAINDER AT 40%
11,186 W
A/C # 100%
8,500 W
TOTAL DEMANDED WATTAGE
29,686 W
TOTAL WATTS
DIVIDED BY 240 VOLT. = AMP.
123.7 A
•
••
•
• • •
•
•• ••• •• • • • ••
•. ••• • • • • • ••
• ••• ••• • •Y• •••
• • • • • • .
• • • • • • •
• • • • • • • • •
• •• •• • • •• ••
••• • • • • •
000 • • Y • 000 • •
• • • • • • • •
• • • ••• • • •
• • • • • • • • • •
• •• •• • • • •• ••
••• • • • 000 4 •