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EL-17-542 hermit No EL-3-17442 • `'°RAS�,� Miami Shores Village ~ Pf/Irflf Type:Electrical _Residential 10050 N.E.2nd Avenue NW r M W otk Classifcation:.Addition/Alteration " Miami Shores,FL 33138-0000 Perrnit Status:APPROVED Phone: (305)795-2204 <.OR1DP Issuer oate:311712017 FExpiration: 09/13/2017 Project Address Parcel Number Applicant 45 NW 93 Street 1131010340270 Miami Shores, FL 33150- Block: Lot: JOHN CURRY caner Information Address Phone Cell JOHN CURRY 45 NW 93 Street (954)770-4549 MIAMI SHORES FL 33150- 45 NW 93 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 ALL PHASE ELECTRIC CORP 305-345-6480 Total Sq Feet: 0 Type of Work:INSTALL NEW OUTLETS AT KITCHEN COLIN Available Inspections: Additional Info:INSTALL NEW OUTLETS AT KITCHEN COUN Inspection Type: Classification:Residential Scanning: 1 Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W.W. Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $t.20 DBPR Fee Invoice# EL-3-17-63126 $3.38 03/02/2017 Check#:604 $50.00 $ 192.96 DCA Fee $3.38 Education Surcharge $0.40 03/17/2017 Credit Card $ 192.96 $0.00 Notary Fee $5.00 Permit Fee-Additions/Alterations $225.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $242.96 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. March 17, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy March 17, 2017 1 FMAR IVED Miami Shores Village 2 2017 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 s L f FBC 20 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. — 5 4 z ❑BUILDING X ELECTRIC F-1-ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP r rCONTRACTOR DRAWINGS JOB ADDRESS: `y w 9"Yo( City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name ,(Fee Simple Tittlleholder) �Okw W�� Phone#: Address: `�� lc� ,5T �J City: �`iLt( c State: Zip: -L i Tenant/Lessee Name: Phone#: a Email: CC) _2 V/ r.oy� CONTRACTOR:Company Name: Phone#, �' �^��j. zdo/� 10 Address: y�— ® City: State: Zip ✓✓ Qualifier Name: Phone#: ��, State Certification or Registration#: d'—Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration =❑ New Repair/Replace ❑ Demolition Description of Work: ?PjTG/7 l!'» Specify color of color thru tile: 1;!,;.,to Yr c Submittal Fee$C/V 1 Permit Fee'$ ��z �o CCF$ Scanning Fee$ Radon Fee$ DBPR$ ' '` ''' `:-t-Notary$ I Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ _ ..�— (Revised02/24/2014) s , W 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 aipplicant 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 ,. . _ . �,�.....s - inspection will nbi be approved and a.<reinspection,..:., ,_..�—fee_. ...�will 6e charged. -- i , t V Signature t y ' Signature OWN or AGENT CONTRACTOR The foregoing instru cknowledged before me this The foregoing instrument was acknowledged before me this a day of U 20 1 -- by 2 day of .►"V�J��' M* ,20l. by �-Wh w o is personally known to " �Ctt O •. L,f�p'C,2 who is personally known to me or who has produced as me or who has produced V'e Y as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTAR 'r Sign: Sign. Print: �_►CJ'�!� 1 .L� w� Print: t, Seal: Seal: YANADYP ETO Alba L Lemus ` '= ;.; MY COMMISSION#FF 214031 NOTARY PUBLIC a EXPIRES:March 25,2019 �.►c `J-'--TEFLOl�1� RFd` Bonded Thru Notary Public Underwriters • ` � �,� ,[r::p,scs�i;.?3/'2017 ; APPROVED BY Plans Examiner ' Zoning a Structural Review Clerk (Revised02/24/2014) ACQR0, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/02/2017 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 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 BAEATRIZ RODRIGUEZ NAME: Southwestern Insurance PHA NNo Ext): (305)556-7399 FAAXC No): (305)556-5469 4375 Palm Ave. E-MAIL ADDRESS: ronin826@gmail.com Hialeah, FL 33012 INSURERS AFFORDING COVERAGE NAIC# Phone (305)556-7399 Fax (305)556-5469 INSURER A: ASCENDANT INSURANCE CO INSURED INSURER B: PROGRESSIVE INS CO I All Phase Electric Corp INSURER C: NORMANDY HARVOR INS COMP 7351 NW 7TH ST# BAY K INSURER D: INSURER E: MIAMI FL 33126 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. INSR TYPE OF INSURANCE ADD SUBR I POLICY EFF POLICY EXP LIMITS LTR IN R WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE- $ 1,000,000.00 F-1CLAIMS-MADEa OCCUR DAMAGE ( RENTED 100,000.00 PREMISESSEa occurrence $ ❑ MED EXP(Any one person) $ 5,000.00 A ❑ GL-41401-4 01/23/2017 01/23/2018 PERSONAL&ADV INJURY $ 1,000,000.00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000.00 ❑ JRO- POLICY ❑ PRO 1:1LOC PRODUCTS-COMP/OPAGG $ 1,000,000.00 ❑ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 50,000.00 Ea accident $ ❑ ANY AUTO BODILY INJURY(Per person) $ AOAUTOS BODILY INJURY(Per accident $ B ❑ AUTOS 08314488-4 11/09/2016 11/09/2017 ❑ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ ❑ AUTOS Per accident ❑�/ PIP$10,000 ❑ $ ❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ C ❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION ❑ PTAT TE ❑ EOR H AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE-7 N/A NHFL0034242016 03/03/2017 03/03/2018 E.L.EACH ACCIDENT $ 500,000.00 OFFICER/MEMBER EXCLUDED? i (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) i Electrical Work CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE miami shores village building THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES FL 33138 AUTHORIZED REPRESENTATIVE t 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01)QF The ACORD name and logo are registered marks of ACORD