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EL-17-2686 Permit NO. EL-11-17-2686'i �sKO Sy,� Miami Shores Village Permit Type:Electrical-Residential 10050 N.E.2nd Avenue NE .Warn Classification:Alteration Miami Shores, FL 33138-0000 ' Permit Status:APPROVED 'tires,N• Phone: (305)795-2204 FCORiDA ,. - issue Date: 11/20/2017 Expiration: 05/19/2018 Project Address Parcel Number Applicant 186 NE 107 Street 1121360070170 186 NE 107 ST. LLC Miami Shores, FL 33161- Block: Lot: Owner Information Address Phone Cell 1 186 NE 107 ST. LLC 501 GRAND Concourse MIAMI SHORES FL 33138- 501 GRAND Concourse MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 R&A ELECTRIC (305)331-3710 Total Sq Feet: Type of Work:REMODELING OF KITCHEN&BATH Available Inspections: Additional Info:REMODELING OF KITCHEN&BATH Inspection Type: Classification:Residential Review Electrical Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee InVOICe# EL-11-17-65628 $2.25 DCA Fee $2.00 11/20/2017 Check#:2058 $ 110.45 $50.00 Education Surcharge $0.40 11/13/2017 Check#:2733 $50.00 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.45 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'l 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 t at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construct'on and zoning. Futherm e, I authorize the above-named contractor to do the work stated. November 20, 2017 uthorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy November 20,2017 1 Miami Shores Village Nps 13 zoW 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 FBC 201 BUILDING Master Permit No. RC l-�-2q I PERMIT APPLICATION Sub Permit No. L I`1 ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION. SHOP CONTRACTOR DRAWINGS I JOB ADDRESS: O City: Miami Shores /� County: Miami Dade Zip: 3 Folio/Parcel#: ,/ 7-134- -610 -7-0.1 Z0 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 100 NC Id s� �" Phone#:� Address: 0 � c�C/� /� /�✓S 6 City: �1��'�l�f i SI��S St te• Zip: I Tenant/Lesse ame: ^^ Phone#: Email: �v V CONTRACTOR:Company Name: OW.-G C Phone#: r Address: 7r City: / L State: Zip: >-7 0 Qualifier Name: G 2 /O�.9- Phone#: �O�W State Certification or Registration#: D0lLEVCertificate of Competency#: 00 00 T tp DESIGNER:Architect/Engineer: --2/14 Phone#: Address: City: State: Zip: Value of Work for this Permit:$ / 0©' Square/linear Footage of Work: Type of Work: ❑ Addition [Alteration ❑ New ❑ Repair/Replace ❑ Demoli ion Description of Work: � r�':n,A�Ss'w�1MN�Rt9FrI�.�s^Kb Specify color of color thru rutile: iz�,�,_.P; �, ;j ,,tt t [ !7 Heil G PIa�J vl+a ... 4 Y ! I• P y '1 dd' '"ie y. Li'i� t "^' t� tC qw": a� r._.1. •, '2P 9 9r)+: I.t iXS1Q-5I Q4!' ,1fxEc s `'`' ^'•#� Submittal Fe l$ I tPermit Fee$ ` � imG CCF$ n c t �: C0/CC$ " +:., I Scanning Fee erRS 3,rig«^satax3-tlillk�adon Fee$�•aa $ (� a rsrlt;Ya No o rY$ .P'YJiY�.�71ia.�.'631i►.('"i'13:4T1'-ti'aitiP;}A�!' -rs�tt. 1, t�.air'y�".�'°'',�r°ry{�%'urv`yew-b'°�,'c's�n7'"x's�F'�:S;,e�:+'T;:+�e�q Technology Fee$r'" "�r"" ^�� "=Yigining/Education Fee$ Double Fee$ Structural Reviews$ 'Bond$ - TOTAL FEE NOW DUE$ (Revised02/24/2014) t 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 ' Signature OWNE r AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this I- L`day of Nv 1, --�,4--=-ti— 20 �1 by . day of 20 by who is personally known to ✓�c- is personally known to me or who has produced as me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign:�l� Sign: F.. Print: L 1 5 sL C.,i�'.s�l"l e► ��o,^c Print: lam"S``� Gtr—1-1-6 Vn o._._ F1 o,i l Seal: Seal: LISA CHRISTINA FIBRES f� LISA CHRISTINA FLORES iP Notary Public-State of Florida ;PF`""e.'•. ' �•. Notary Public-State of Florida ******** ## Ir"PPf9NMM/** ********** My Contin.Expires Jan 28,2019 - •''a°,w� ��•r ,os + My Comm.,Expires Jan 28,2019 8ondedgrouatNaMoralNotaryAran. on didtbrougtNiftiaiWary.Assn. APP,R Plans Examiner "" Zoning &��1�lY G Structural Review Clerk (Revised02/24/2014) t a - � u°'rfyin9 BO ETENCY x � `.r_ a ruction ResCOMP •� _, °`.;, Const cERTIFICA r` Bus'NEss DO46 97 RIC SNC 3County LUIS chap10 of Miami-Dade RGE ter 1 J� rovns of 0 �fied under the p . is cert i t i a ' QUALIFYING-TRADE(S) 0001 ELECTRICAL 0002 BURGLAR A LAP' 0004 FIRE ALARM tLgMVDADE H,.NW.miamidade.9ovleconomY Jaime D.Gascon,P E. �.•..... ........ Secretary of the Board ro ertY�9hts herein. Miami-Dade County retains all p P f i .-•_-...._.:_.....-......_....._._.-................................... _. .-__-._........................._....------------._._._.............._. Muni ci pal Contractor's Tax Fbcei pt Miami-Dade County, State of FloridaM C -THIS IS NOT A BILL-DO NOT PAY CC NO: 97®00046 BUSINESS NAMElLOCATION RECEIPT NO. EXPIRES R&A ELECTRIC INC 1211 NE82ST 7517842 SEPTEMBER 30, 2018 MIAMI,FL 33138 Pursuant to County Code Sec 10-24 OWNER TYPE OF BUSINESS__ - -=R&AEECTRC INC flFCTRCALCONTR4CTOR PAYM ENT RECEIVED CIO ARROLADIXGELUISQUAURER BY TAX COLLECTOR 200.00 09/28/2017 0202-17-005402 Thi s receipt is riot valid in the fol lowing Munici pal ities:Aventura,Doral,4 aleah,keyBiscayne, I Miami Gardens,Miami Lakes,Palmetto Bay,P'inecrest,Sunny Isles Beach,Town of Outler Bay. MI I For more information,visit www.mianridade.govltaxcdlector Local Business Tax Fbcei pt M iami-Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY 3701613 Etat RV&A ELECTRIC INC RENEWAL EXPIRES 1211 NE 82 ST 3866465 SEPTEMBER 30, 2018 MIAMI, FL 33138 - Must be displayed at place of business Pursuant to County Code Chapter 8A Art 5& to R 8 A ELECTRIC INC 196 - ELECTRICAL `' a<``IV :` CONTRACTOR 45.00 09/27/2017 Worker(s) 3 97E000046 0208-17-005032 This Local Business Tax Receipt only ccn•'rms payment of the Local Business Tax.The Receipt is not a license, permit,or a certi^cation of the holder's quali cations,to do business:Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business The RB'.HPTNQabove nxmtbedisplayed onall commercial vehicles-Miami__adeCode Sec 8a_276. ,n -,�:• MIAMI DADE�v .,r. For more information.visit ww}v rriAMdada gov/taxcdt actor R&AELEC-01 DDEPAZ ACD� �� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/rYYY) 1110112617 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 CONTACT NCF Insurance Associates A"CNN Ext):(305)446-5474 FAX No):(305)444-8796 8700 W Flagler Street Suite 320 E-MAIL D RE Miami,FL 33174 INSURERS AFFORDING COVERAGE NAIC# INSURERA:Wesco Insurance Company INSURED INSURER 8:Inte on Preferred Insurance Company 31488 R 8r A Electric,Inc. INSURER C:Technology Insurance Company Roberto Rivero P.O.Box 611835 INSURER D: Miami,FL 33261 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. IL SN TYPE OF INSURANCE AINDDDL SUBR POLICY NUMBER MPOLICY EFF IDDIYYYYl POLICY LI pY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1'000,000 CLAIMS-MADE � PREME E occurrence $OCCUR PP1196364-03 09/05/2017 09/05/2018 DAMAGES( RENTED 100,000 MED EXP(Any one n 1,000 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000'000 POLICY jECOT- F-]LOC PRODUCTS-COMP/OP AGG 2,000,000 OTHER: B COMBINED SINGLE LIMIT 10Q000 AUTOMOBILE LIABILITY accident) $ ANY AUTO 2003353127 09/30/2017 09/30/2018 BODILY INJURY Per rson OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ F DED I I RETENTION$ $ C WORKERS COMPENSATION PER OTH- I AND EMPLOYERS'LIABILI Y Y/N ANY PROPRIEfOR/PARTNER/EXECUTIVE ❑ 03654746 09/09/2017 09/09/2018 ,A UTE FR E.L.EACH ACCIDENT 100'000 OFFICERIMEMBER EXCLUDED? N/A - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 it yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Electrician Electrician fax:305-756-8972 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVENUE MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE q f5g.., ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD