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EL-17-2034 Permit NO. EL-8-17-2034 t iz'-LMiami Shores Village t Permit type:Electrical -Residential' 10050 N.E.2nd Avenue NE ' Work Classification. Low Voltage Miami Shores,FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 F�ORLDA issue Date:8/14/2017 Expiration: 02110/2018 Project Address Parcel Number Applicant 1420 NE 103 Street 1132050310030 Miami Shores, FL Block: Lot: MARC AND ANNE LITZENBERG Owner Information Address Phone Cell MARC AND ANNE LITZENBERG 1420 NE 103 Street MIAMI SHORES FL 33138- 1420 NE 103 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 8,000.00 INTERSECKT CORPORATION (305)448-7899 �. _. ............... ._. Total Sq Feet: 0 Type of Work: INSTALLATION OF LOW VOLTAGE WIRING Available Inspections: Additional Info:INSTALLATION OF LOW VOLTAGE WIRING Inspection Type: Classification:Residential Review Electrical Scanning: 1 _j Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $4.80 DBPR Fee Invoice# EL-8-17-64842 $4.20 08/14/2017 Credit Card $254.20 $50.00 DCA Fee $4.20 Education Surcharge $1.60 08/10/2017 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $280.00 Scanning Fee $3.00 Technology Fee $6.40 Total: $304.20 _.l 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 AFFIDAVI : 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 o g. Futhermore,I authorize the above-named contractor to do the work stated. August 14, 2017 uth ri d Signature:Owner / Applicant / Contractor / Agent Date �l h Building Department Copy August 14,2017 1 EVge_ tt,)c( jrai-011a- 116 - 3L4 --goal Miami Shores Village ED Building Department AUG 1017 'L 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 _ 1- „ Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 � s�� BUILDING Master Permit No.RC-3-15-562 PERMIT APPLICATION Sub Permit No. ❑BUILDING ® ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF [:] CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1420 NE 103 Street City: Miami Shores County: Miami Dade Zip:33138 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: i OWNER: Name(Fee Simple Titleholder):Marc Litzenber g Phone#:305-753-6511 {Address: 1420 NE 103 Street City: Miami Shores State: FI Zip: 33138 Tenant/Lessee Name: Phone#: Email: marc@thelitzenbergs.com CONTRACTOR:Company Name: lnterseckt Corporation Phone#:305-448-7899 Address: 2307 S Douglas Rd Suite 101 City. Miami state: FI Zip: 33145 Javier Lugo 305-448-7899 Qualifier Name:: Phone#: ES12000842 State Certification or Registration#: Certificate of Competency#:' DESIGNER:Arch itect/Engineer: P.hone#: Address: s •City:KK� .. State: Zip. V Value of Work for:thig Perm}t`''$+8'1Q00 Square/Linear Footage of Work: ��Typeof Wo'r'k`:`I,❑,�Additfoii�� © ❑ Re air Re lace _ � �Sf a ��.��rrZ;r.3:>,.:-.,Y•» ••r;;,;r• I Alteration ;� New p / p ❑ De1m�lition �Description of_Work:�I]stallatian}of low voltage wiring HQ U�h.�� (�/ Specify color of color thru tile: - - --�-- Submittal Fee$ c.50 Dn 1^A Permit Fee$ CCF$ L� • $� CO/CC$ Scanning Fee$ ,� Radon Fee$ 6I • ZO DBPR$ (4• 2© Notary$ r '^ r U ' _r Technology Fee$ (O - O Training/Education Fee$�Q �Double Fee$ Structural Reviews$ Bond$ ' I TOTAL FEE NOW DUE$ .17 k(Revised02/24/2014) Bonding Company's Name(if applicable) x, Bonding Company's Address rr 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: YOURFAILURE 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 in h occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspe n will not be approved an a tion fee will be charged. F Signatur Signature or AGEN V CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowle ged before me this �- day of 20 by 2 day of U 20 by Z— ??�f4 ho is personally known to �iV L who is personally known to me or who has prQdurpd L "C '510 me or who has produced as identification and who did take an oath. identification and who did tr---• IE •� EVOENNANtYA GRADOVA NOTARY PUBLI NOTARY PUBLIC• ''' ''e IMY COMIAISSION#GG019768 EXPIRES August 09,2020 Sign: Sign: EVOENIYA GRADOVA, Print: = Print: 019768. Seal: I EXPIRES August 09,2020 Seal: *********r**•t+e**+e*r**s***t****t***V*********ts****t****s***s*****+e**+e*****st+e*sss*****t�****'*�**********t`*+es f k APPROVED BY , �b�11-�I!r [2' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) AC�a DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 7/24/2017 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 , NAME: CPC FINANCIAL SERVICES INC PHONE (305) 774-9618 305)774-9620 3835 SW 8 St A/C II Ext: A/C,No: Coral Gables, FL 33134 ADDRESS:]modia@ cpc—insurance.com INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Lloyds Of London INSURED Interseckt Corporation INSURER B: Technology Insurance co 2307 S Douglas Rd Ste 101 INSURER C: Coral Gables, FL 33145 INSURER D 305.448.7899 x201 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. INSR TYPE OF ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S$1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ $300,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ $10,000 A x Y ESCO6182688 4/16/17 4/16/18 PERSONAL&ADV INJURY $$1,000,000 GENERAL AGGREGATE s$2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $$1,000,000 POLICY X PRO- POLICY T LOC $ AUTOMOBILE LIABILITY Ea accident $ t ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED 1_1 $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC TATU- I OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OF , EXCLUDED? ❑ NIA Y (Mandatory in NH) TWC3606384 2/5/17 2/5/18 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 =Professional ESC06182688 4/16/174/16/18 $1,000,000 occurrence lit .$1,000,000 aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) License #:ES12000842 / Type of contractor: Specialty Electrical Contractors CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2nd Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4t2 T I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD i RICK SCOTT_GOVERNOR _...,.JONATHAN ZACHEM,SECRE'T'ARY w " ,STATE-0 F F�.{:7'R DAA�11-\ �, , �.u, �,�_ .. DEPARTMENTCIS-BUSJNESS AND i ROOES510NAL"REGU A�� ...✓"'�� ELECTRtGAL,CCN'fRACTCiRS,LiCENStNGBOAR©,°`,�.°�,# The.SPEcIALTY ELECTRICAL,'CONTRACTOR ?_ Named ;.Under thewprovisionslof.Chapterr4�i89-Fs- m .E« pifati6nn,�date AUQ631 ;2018 -� -"; SAS A LIMITED�.ENERDY S� MS"'SPECML1ST. :. ., II O"JAVIER.A � INTERSICKT CORA *' 230 'S'DOUGt_AS-RQA caRAL-�GABcEs Wit: 314� ~-*--- issuEa. asiasr2o�7 D!$PLAYAS REQUIRED 8Y LAW s�o� �.��asasaaaosaa � '�'�� I 1 005351 f Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY LBT `"5153093 BUSINESSNAME/LOCATION RECEIPT NO. EXPIRES ' INTERSECKT CORP RENEWAL SEPTEMBER 30, 2018 r 2307-SW 37 AVE 101 5385117 Must be displayed at place of business I MIAMI FL 33145 Pursuant to County Code Chapter SA-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED INTERSECKT CORP x.213 SERVICE BUSINESS BY TAX COLLECTOR _.._.. Employee(s) ;... 3... r:,; _... ;.... x,.. 845.00 07/03/2017 CREDITCARD-17-041786`W 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 ornongovernmental regulatory laws end requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Cade Code Sec 8&-M. For more information,visit iyMnmiiomidade.00VRaxcollel;I Y A d I 4